"PRE-HAB": AN OUNCE OF PREVENTION FOR SHOULDERS AND LOW BACK

By Dr. Michael Camp, DPT, CSCS, PES

Dr. Michael Camp, DPT, CSCS, PES, specializes in manual manipulative medicine. He has been involved with rehabilitating and improving the performance of athletes from the PGA, MLB, NFL, NHL, NCAA, minor league baseball, tennis, and Olympic hopefuls. Dr. Camp currently treats numerous IFBB bodybuilders, figure competitors, mixed martial art fighters, and various high school and college athletes.

One of the goals of Alpha Male Challenge is to get guys off the couch and back on their feet.  Many of you may have already had shoulder or low back pain or injuries – two very common problem areas. Most of you will have developed these problems due to bad posture habits over many years. 

As a physical therapist, a very large piece of my practice is dedicated toward treating the “weekend warrior” types of injuries.  If you are suffering from a shoulder or low back injury, it is absolutely essential that you first seek medical advice before beginning any physical protocol within the Challenge.  Remember, even what you may now consider to be a small problem, in time, will often become a bigger one.  

Before you start “pre-habbing,” I recommend that you consider purchasing a foam roller.  This device has become quite popular over the past few years, and for good reasons.  The foam roll is about 6” around and can be one foot to 3 feet in length and can cost as little as eight dollars.  It provides what I like to call, “The poor man’s massage.”

It’s an amazing tool for helping to effectively loosen up tight and restricted muscles (the technical term is self-myofascial release). 

Self-myofascial release can improve muscles’ pliability before a workout, and can help decrease soft tissue adhesions and scar formation allowing muscles to contract and perform at their optimal function.  This remarkable self-administered procedure can be performed on the pecs, lats, triceps, shoulders, and back muscles. 

Let’s Begin – We’ll start off by desribing how to position each “pre-habbed” body part on top of the foam roller. Using the hamstring muscles as an example, sit up and place the foam roller underneath your legs, bringing it close to your buttocks, the origin of the hamstring muscles.

Begin the “pre-hab” action by moving your body along the foam roller, in short strides, down towards your knee, the insertion point for the hamstrings.  Roll from buttocks to knee for ten repetitions. 

The next muscle we can work is the iliotibial band and this muscle originates from your hip, down over your knee and attaches to your shin bone.  Lie on your side over the foam roll and move your body in short motions freeing up those restrictions. 

Foam rolling for your back: setup is lie onto the foam roll, with it being positioned acorss your back at the shoulder blade level.  Next perform a bridge lifting your buttocks off the floor and increasing the pressure onto the roll and begin the rolling motion towards your low back.  Make sure to keep your abdominals tight and again use short controlled motions.

Last muscle we will discuss foam rolling is the latissimus muscle.  Lie on your side over the foam roll placed at your waist level. Your arm that is along the floor will be outstretched with your palm turn towards the ceiling.  This will be one of the most uncomfortable positions, but the benefits are great.  Now begin by rolling your bodyweight over the foam roll, causing it to move towards your arm pit.  Again perform 10 repetitions moving up and down each side of your lats.

SHOULDERS

The shoulder is a very unstable joint, and its function is crucial in every aspect of our daily activities.  Shoulder pain usually starts out minor, but if ignored can progress to painful rotator cuff tearing, bone spurs, and labrum tears.  In addition, a shoulder injury leads to compensation from other muscles to perform the job, eventually disturbing the body’s true performing mobility and stability factors.

Let’s begin by strengthening the rotator cuff muscles.  Their primary function is to assist in upper arm movement.  You’ll begin with the “theraband” external and internal rotation movements.  I refer to this as “Band-Camp”J

While standing, position your arms at your side and bend them to form the letter “L.”  Place a rolled up towel between your side and just above your elbow on both arms.  Standing up straight with slightly bent knees, tight abs and good posture, rotate both shoulder joints and arms externally or outward from your body while making sure to keep the inside forearms pinched tightly to the rolled-up towels. You might at first question how such an insignificant exercise movement could produce results, but rest assured this little movement will make a world of positive difference. 

I ask my clients to perform sets of 50 repetitions.  These muscles are small and contain more of the type I muscle fibers, which are more fatigue resistant. 

The shoulder joint has a cuff of cartilage called a labrum that forms a cup for the end of the arm bone (humerus) to move within. The labrum circles the shallow shoulder socket (the glenoid) to make the socket deeper.  This next exercise helps build stability to the labrum of the shoulder.  It’s called “alphabets.”

Grab a dumbbell in one hand – Start with a 3 pound weight and eventually progress to 7 pounds.  Lie on your back on a weight bench or floor, extend your arm towards the ceiling, keeping the elbow straight, and write out the alphabet in capital letters, from A-Z.  Capital letters are used to increase your range of movement. The total motion of the letters should be kept in a 10-inch range of motion. 

This powerful exercise causes muscles to perform rhythmic contractions and build endurance, ultimately leading to greater stability.                                              

Perform the alphabet for 3-4 sets and increase the weight every two weeks.

The next exercise sequence is something I call “6-packs.”  It is by far, the toughest and most effective exercise for building strength in your stabilizing and assistive muscles of the scapula and shoulder. 

It is performed by lying on your stomach on a weight bench or on the floor, or even on a physioball (Swiss Ball) if you’re advanced.  It’s a series of six motions, each one held for six seconds and performed for six sets.  Don’t let the triple 6 digits scare you off – everyone of my patient athletes despise “6-packs”, but never forget to include them because they work.  A word of caution: if you perform them on the floor, take a bath towel, roll it up and place your forehead on it so you can breathe.

Your 1st “six-pack” movement is forming the letter “T’ with your arms stretched out and thumbs up. The 2nd movement is also the letter “T” but now with your thumbs turned down.  The 3rd movement is the letter “W”, or as we call it, “goal post.” Bring your bent arms next to your head – Your head is what forms the middle of the “W”.  The Fourth and fifth motions are called “Superman” – The 4th is performed by bringing the arms straight out in front of your head with thumbs up and make sure your elbows remain straight. The 5th is performed by performing the same motion, but with the thumbs turned down.  Your Final 6th movement is performed by brining your arms/hands down by your waist, turn your palms up toward the ceiling and lift your arms up and squeeze your scapula together.

Perform all six motions consecutively, but you must make your best effort at holding each position for an accurate six second count. Six exercises held for six seconds are equal to one set. Complete a total of six shoulder shrieking sets.

Keep your abdominals contracted throughout all of the exercises as it will help to stabilize your spine.

These exercises address areas of weakness from three anatomical planes of motion.  The 1st exercise is the traditional rotator cuff work using a cable or theraband while standing up.  The 2nd exercise targets the labrum of the shoulder and is performed lying face up, taking gravity out of the equation and minimizing stress and pain in the shoulder.  The Final exercise enhances overall strength within the shoulder.

LOW BACK

The “Mac Daddy” of discomfort, pain in the low back, is often attributed to a combination of tight hip flexors and a tight lower back, paired with weak abdominals and weak glutes.

The first thing we need to address is proper stretching of the surrounding areas – your hamstrings, piriformis, and hip flexors.

Straight leg hamstring stretch first-  Set up begins with lying on your back with a rope or strap wrapped around your foot.  As you begin to raise the leg up towards 90 degrees, perform a contraction of your quadricep muscles (thigh) at the point of stretch.  Hold this contraction 2 seconds, then relax and gently pull the leg higher.  Perform this 3 times for each leg, gradually increasing the stretch.

Next muscles to stretch are your quads and hip flexors.  Begin by lying onto your stomach, with the non-strecthing leg straight.  For example lets use the right leg.  Place the strap around your foot, then use your right arm to grab the strap and pull it over your right shoulder, slowly bending your leg.  Contract your hamstring muscle to assist with bending your leg.  You should feel a stretch in the front of your thigh and hip.  At this point, hold the strap tight and try to straighten your leg by firing your quads (thigh Muscles).  Hold for 2-3 seconds and then relax and pull the rope further to increase the stretch.  Again perform 3 times for each leg.

If you want to keep your shoulders and low back strong, healthy and injury free, try this pre-habilitation supplemental training program.  It’ll help you avoid injury while making sure to extraordinarily strengthen these superalative articulations!