Shoulder Injuries Attributed to Resistance Training: A Brief Review

Kolber, MJ, Beekhuizen, KS, Cheng, M-SS, and Hellman, MA. Shoulder injuries attributed to resistance training: a brief review. J Strength Cond Res 24(6): 1696-1704, 2010-The popularity of resistance training (RT) is evident by the more than 45 million Americans who engage in strength training regularly. Although the health and fitness benefits ascribed to RT are generally agreed upon, participation is not without risk. Acute and chronic injuries attributed to RT have been cited in the epidemiological literature among both competitive and recreational participants. The shoulder complex in particular has been alluded to as one of the most prevalent regions of injury. The purpose of this manuscript is to present an overview of documented shoulder injuries among the RT population and where possible discern mechanisms of injury and risk factors. A literature search was conducted in the PUBMED, CINAHL, SPORTDiscus, and OVID databases to identify relevant articles for inclusion using combinations of key words: resistance training, shoulder, bodybuilding, weightlifting, shoulder injury, and shoulder disorder. The results of the review indicated that up to 36% of documented RT-related injuries and disorders occur at the shoulder complex. Trends that increased the likelihood of injury were identified and inclusive of intrinsic risk factors such as joint and muscle imbalances and extrinsic risk factors, namely, that of improper attention to exercise technique. A majority of the available research was retrospective in nature, consisting of surveys and descriptive epidemiological reports. A paucity of research was available to identify predictive variables leading to injury, suggesting the need for future prospective-based investigations. (C) 2010 National Strength and Conditioning Association

Dr. Rick Rosa

Alexandria Chiropractor

Exercise at work to prevent low back pain

Exercise at work to prevent low back pain

More jobs now require prolonged sitting which has been associated with loss of the lumbar lordosis, intervertebral disc (IVD) compression, and height loss, possibly increasing the risk of lower back pain. There are numerous studies suggest that exercise can play an important role in preventing occupational and non-occupational low back pain. An innovative approach was published in the April issue of The Spine Journal that used an office chair exercise that is performed while seated. The exercise provides a brief decompression of the lumbar spine by moving forward on the chair seat, placing the hands on the seat of the chair, pressing downward with the arms to take pressure off the lumbar spine, and arching the back and shoulders backward at the same time. This decompression maneuver held for 5 seconds followed by 3 seconds of reloading (sitting normally) and was repeated 4 times. Sequential MRI demonstrated a marked increase in vertical height of the lumbar spine using this decompression strategy. The authors concluded that “Seated upright MRI and stadiometry, as performed in this study, appear to be feasible methods for detecting compressive and decompressive spinal changes associated with normal sitting and, alternately, seated unloading exercises. Larger studies are encouraged to determine normative values of our study measurements and to determine if morphological changes induced by seated unloading predict treatment response and/or reductions in the incidence of sitting-related LBP.”

There are numerous quality evidence that post-treatment exercise programs can prevent recurrences of back pain. There have been many studies published this past decade that support the value of exercise in primary, secondary as well as tertiary prevention of low back pain. These studies have been conducted with multiple age groups and multiple settings including sports venues and the workplace.

Source:
http://www.chiroaccess.com/Articles/Exercise-and-the-Prevention-of-Low-Back-Pain.aspx?id=0000162

Dr. Rosa

Changes in Head and Neck Posture Using an Office Chair With and Without Lumbar Roll Support

Changes in Head and Neck Posture Using an Office Chair With and Without Lumbar Roll Support

-This is a nice study that illustrates once again how interconnected different areas of the spine are. Following a whiplash injury, many patients must return to their offices and immediately begin a full schedule. The authors' conclusions support the notion that by supporting the lumbar spine, favorable changes can be made in the cervical spine. In my chiropractic clinic in Greenbelt, MD we stress the spine, and ultimately the body as a whole.
-LC


Spine: 20 May 2010 - Volume 35 - Issue 12 - pp E542-E548

Horton, Stuart J. MPhty, DipMDT; Johnson, Gillian M. PhD; Skinner, Margot A. PhD

Objective. To investigate change in sagittal alignment of head and neck posture in response to adjustments of an office chair with and without a lumbar roll in situ.

Summary of Background Data. Forward head posture has been identified as a risk factor for neck pain, and there is evidence to show that ergonomic correction in sitting may reduce the incidence of pain. The effect placement of a lumbar roll has on cervical spine posture has not been previously investigated experimentally but rather, is assumed to have a positive influence on head and neck posture.

Methods. Thirty healthy male participants (18-30 years) were photographed while registered in the natural head resting position in each of 4 sitting positions with and without a lumbar roll in situ. Two positions incorporated adjustments to the back rest and 1 to the seat pan of the office chair. The craniovertebral (CV) angle, as a determinant of head and neck posture was measured from the set of digitized photographs obtained for each participant. Comparisons between the CV angle in all postural registrations were made using a mixed model analysis adjusted for multiple comparisons.

Results. Of the positions examined, significant differences in the mean CV angles were found with the backrest of the chair at 100° and at 110° (P < id="SPELLING_ERROR_6" class="blsp-spelling-error">situ and the backrest position at 110°, there was a significant increase in the mean CV compared with the angle without the lumbar roll in situ (2.32°, 95% confidence interval:
1.31-3.33; P < 0.001).

Conclusion. The degree of angulation of the backrest support of an office chair plus the addition of lumbar roll support are the 2 most important factors to be taken into account when considering seating factors likely to favorably change head and neck postural alignment, at least in asymptomatic subjects.

Dr. Rosa

Bike Fit using Video Motion Analysis Dartfish

Many injuries that occur as a result of ridding a bike can be traced back to poor bike positioning.
The first step to correcting a problem or gaining some watts on the bike is with a proper bike fit. There are many schools of thought and methods but I feel that SICI ( Serotta International Cycling Institute) has the best methods, training staff and the ability to know its reproducible. Using Video to analyze motion has been around for years the first exposure I had was working with Dr. Robert Roe a chiropractor that had worked at the Olympic training center in Colorado in the early 90 using a much more cumbersome and primitive form of analysis. At that time we were using it to evaluate work loads on patients. Now I have been using Dart fish to analyze bio-mechanics of all types of athletes. At SICI we trained using there fitting principles and High Def cameras to evaluate motion down to the smallest detail. It is a more dynamic fitting process that can breakdown movement to a much higher degree. When you add power and HR data things get even more interesting. The amount of information and precision is really remarkable. I have added a video of a fit I did in Northern Virginia of a Pro cyclist that is having a few problems even after several Bike fits by other professionals.




This is an example of a marker that was placed on his right leg that is short when compared to the left and is not tracking properly. The patient feels like his right leg is wobbly and dives in medialy on the power stoke. He notes hitting the top tube. I will also let you know that after the exam I also found very specific weak core strength that needed to be address. Using this software and combining that my physical exam finding I am able to find a new starting point to make small adjustments until the correct fit is obtained.