Shouldering Up

This week, my husband and I attended a fabulous presentation by Dr. Eric Oestmann on Rotator Cuff Disorders. While designed as continued education for physical therapist, it had plenty of information for our use as personal trainers.  We see shoulder problems more often than we like, and I myself am intimately acquainted with impingement syndrome, shoulder surgeries and a frozen shoulder.

Most interesting for me were the assessment modalities to determine range of motion of the two shoulder joints. Yes, indeed, two! Not just right and left but two per side. The one we always think of is the one of the arm called glenohumeral joint. The other one is a little more obscure, and we may not even think of it as a joint: it is called scapula-thoracic joint and is the movement of the shoulder blade against the rib cage. The movement of those joints can be assessed individually, and the result can give valuable information as to what needs to be stretched or strengthened.

What struck me during the presentation is how much overlap there is between physical therapy and personal training. For me, manual manipulation is off limits; won’t do it, it’s not in my scope of practice. At the same time, I can instruct people in the use of the foam roller with MELT thus empowering people to mobilize their connective tissue. And while I must not and cannot diagnose and treat a problem, it is within my scope of practice to identify muscular imbalances and address those.

As I listened to Dr. Oestmann who approached from the field of physical therapy, I realized how lucky I am to be a personal trainer. I only see people who actually WANT to exercise and don’t have to give a second thought to those who don’t. Physical therapists are also limited in time and often must be done after a given number of visits whether their patient is sufficiently better or not.

One take home assessment immediately became a challenge to the students in my MELT class the following day. It is called clock exercise and goes as follows: lie on your right side, right leg almost straight, left leg bent and left knee touching the floor. Put your left hand on a straight arm on the floor near the left knee.  Keep your left arm straight and your knee on the floor as you circle your arm around your head and to the backside of your body. The goal is to keep the hand in touch with the floor at all times. Repeat on the other side. This should indeed be possible, and it would be an indication of ideal shoulder range of motion.  We did this at the beginning of the class as an adjunct to the MELT assessment. After some serious MELTing, we checked the same assessment again and – voilà – it was improved for many participants.