A few months ago I had a few weeks when all I seemed to treat was shoulders. On some days, out of about 10 patients I might have seen 7 with shoulder pain! Crazy! And I learned a few things from a couple of them. One patient in particular was memorable as she came up with a strategy of her own, and it was really effective.
If you have read my shoulder masterclass blog posts, you’ll know the types of strategies I use. But recently one of my patients added a very simple but very effective way of improving the proximally driven shoulder abduction exercise.
To quickly recap, I get the patient holding onto a bar at about shoulder height in abduction. Then I get them to drive their pelvis in the frontal plane, driving away from the wall and back repeatedly. While they are doing that, I work on their scapular movements, either speeding up or slowing down the scapular, depending on what the patient requires.
As I have always found this strategy to be effective I had never really looked to change it or improve it. Though having said that, it is hard for some people to get good range because they cannot drive their hips far enough. In this situation I usually let them escape into the transverse plane, which allows them to achieve a greater range in abduction, which is fine. But then recently my first patient of the day, who had been having this problem, said: “If I drive my opposite arm overhead towards the wall I feel I will get much more range”. Why the hell didn’t I think of that? So simple, but awesomely effective! Always happy to learn. 🙂
So I used it with a couple of patients in the afternoon (I had plenty of practice as it turns out) and it was great. If they can do it the old way I leave well alone, but if they struggle we use the overhead driver. It will be interesting to use the next time I have a patient with back pain as well, as often they can’t do this one. Maybe this will make it easier for them?
One of the other shoulder patients had a problem when practising martial arts. As he hit end range he got pain in the posterior shoulder. We reduced it by about 80% with the proximally driven motions (I used flexion and abduction in this case) and then we used IASTM to work around the shoulder while we gradually increase the speed at which he was punching. Once he was punching pain-free we loaded up the shoulder in a press up and by the time he left he had no pain, had full strength/power and should be able to complete his second degree black belt at the end of the month. Lush!