Strength is Never a Weakness: September 2014

Friday, 5 September 2014

Rotator Cuffs; The Downfall of many lifters

Rotator Cuff Injury: My Rehab Journey and Recommendations.

I sustained a dislocated shoulder last season playing rugby at the Ulster Schools U19 Rugby trial. This is the second time I have dislocated my right shoulder. A dislocated shoulder is when the humerus dislocates or “pops” out of the shoulder joint due to a high impact (such as rugby tackle in my case).

I have made the decision to quit rugby due to this injury as it would probably reoccur in a contact sport, that’s why I have changed sport and taken up Powerlifting. The rehabilitation exercises for a dislocated shoulder are called “Rotator Cuff” exercises. This is because during a shoulder dislocation, the “Rotator Cuff” is normally torn when the humeral head of the humerus dislocates from the shoulder joint. As it dislocates, it tears the Rotator Cuff tendons along the supraspinatus muscle. This is known as a Rotator Cuff tear.

The rotator cuff is made up of four muscles. These four muscles are the supraspinatus, subscapularis, infraspinatus, and teres minor. The muscles form a cuff around the shoulder joint (hence the term “Rotator Cuff”) and attach to the upper portion of the arm called the humerus.

Shown above is the view of the rotator cuff from behind (taken from Strength Training Anatomy 3^rd Edition)

Fortunately my dislocation was anterior (humerus is dislocated forward). This did not create a large tear, but it caused me problems such as a looser shoulder joint, instability and not comfortable in certain planes of motion when moving my arm. To reduce the instability of the joint and reduce pain when moving my arm I have a number of exercises (which I still use) to prevent this. For all rotator cuff exercises it is done with a 2-4kg dumbbell, 2-4kg cables or using light resistance bands with high reps and high sets.

I personally prefer to use cables as they provide a constant resistance and I feel I get a better workout from using them. However some exercises utilising dumbbells are required. The components of fitness that will be worked are Muscular Endurance and Proprioception. I will also be working on reducing shoulder instability.

Muscular Endurance: “is the ability of muscle or group of muscles to sustain repeated contractions against a resistance for an extended period of time”. http://sportsmedicine.about.com/od/glossary/g/MuscleEndur_def.htm

Shoulder Instability: “Shoulder instability means hat the shoulder joint is too loose and is able to slide around too much in the socket”.

http://www.orthogate.org/patient-education/shoulder/shoulder-instability.html

Proprioception: “Proprioception is the sense of the orientation of one's limbs in space. This is distinct from the sense of balance, which derives from the fluids in the inner ear, and is called equilibrioception. Proprioception is what police officers test when they pull someone over and suspect drunkenness. Without proprioception, we'd need to consciously watch our feet to make sure that we stay upright while walking” http://www.wisegeek.com/what-is-proprioception.htm

Stretching the Rotator Cuff Muscle:

Before doing the rotator cuff exercises you need to stretch the muscle/muscles being worked. This is shown below from the picture taken from Strength Training Anatomy 3^rd Edition. On the picture it has a step by step guide to stretch out the Rotator Cuff Muscles.

Rotator Cuff Exercises

1/ Lying Down external rotation:

This is can be done with a 2-4kg dumbbell/ 2-4kg cable/light resistance tubing on both arms. Have a small pillow or cloth between your elbow and your side. This can be done without the pillow or cloth - it is personal preference to make it more comfortable. The purpose of this exercise is to move your arm from across your stomach to as far as your range of motion goes without being sore. The arm moves away from the body (external rotation) or abducts away from the body. This just targets the rotator cuff muscle. During a rep the concentric phase is 1 second and eccentric phase is 3 seconds. This is to develop muscular endurance.

Standing External Rotation

This is the same exercise but standing up and instead of using dumbbells it can be performed with using some tubing or cables. Same weight, reps and sets are still applied. This can be done without the pillow or cloth its personal preference to make it more comfortable. I use this before a lot of my workouts as it really warms up the rotator cuff and shoulder joint.

2/ Standing Internal Rotation

This is can be done with a 2-4kg dumbbell/ 2-4kg cable/light resistance tubing on both arms. It is purely personal choice whatever or not you use a small pillow or cloth between your elbow and your side. The purpose of this exercise is to move your arm from an abducted position to across your stomach (it’s the opposite of the external rotation exercise). The arm moves towards the body (internal rotation) or adducts towards the body. This just targets the rotator cuff muscle. During a rep the concentric phase is 1 second and eccentric phase is 3 seconds. This is to develop muscular endurance. I incorporate this exercise before my main workout as it is to warm up my shoulder joint and rotator cuff.

3/ Standing Shoulder Raises:

This is done with a 2-4kg dumbbell on both arms. The purpose of this exercise is to move your arms from your waist to shoulder height somewhere between arms straight and horizontal level. The arm moves away from the body (external rotation) or abducts away from the body. This just targets the rotator cuff muscle. During a rep the concentric phase is 1 second and eccentric phase is 3 seconds. This is to develop muscular endurance. I change my grip as it works the muscles in a different way one rotator cuff session using a overhand grip, another using a side grip.

Overhand and side grips

Side Grip

Overhand Grip

Dumbbell moves through a curved plane as shown from the pictures above.

4/ Standing External Lateral Movement

This is done with a 2-4kg cable on both arms. The purpose of this exercise is to move your arms from in front of you to parallel with your shoulder (horizontal level). The arm moves away from the body (external rotation) or abducts away from the body. This just targets the rotator cuff muscle. During a rep the concentric phase is 1 second and eccentric phase is 3 seconds. This is to develop muscular endurance.

5/ Standing Internal Lateral Movement

This is done with a 2-4kg cable on both arms. This is the opposite of the exercise above (Standing External Lateral Movement). The purpose of this exercise is to move your arm from a parallel position with your shoulder (horizontal level) to your arm being directly in front of you. The arm moves towards the body (internal rotation) or adduction towards the body. This just targets the rotator cuff muscle. During a rep the concentric phase is 1 second and eccentric phase is 3 seconds. Again this exercise is to develop muscular endurance.

6/ Standing Rotator Cuff Stability Ball Exercise

This exercise is used to increase stability of the shoulder joint and develop muscular endurance of the Rotator Cuff. Whilst standing have your arm stretched out full straight in front at shoulder height. The ball is level with you touching the wall. Your hand is on the ball and has control of the ball. Some of the movements performed are going up, down, left, right and diagonally from both sides. This is done by moving your arm into these positions but your body remains static and upright. Your arm which is touching the ball is the only moving part. This increases stability of the shoulder joint. Another form of this exercise is spelling out the alphabet then spelling it backwards.

7/ Standing Rotator Cuff Stability Ball Bounce Exercise

This exercise is used to increase stability of the shoulder joint and develop muscular endurance of the Rotator Cuff. Whilst standing have your arm stretched out full straight in front at shoulder height. The ball is level with you touching the wall. Your hand is on the ball and has control of the ball. This exercise is very similar to the last one the only difference is the amount of movement is reduced. Instead of moving your arm to move the ball across the wall, the only part that moves is the hand on the ball. The hand will lightly bounce the ball into the wall and repeat this until fatigue. The ball is touching the wall at all times and should be at shoulder height. This is done for 3 sets until fatigue is felt on both arms.

8/ Lying Down Side Raises

This exercise is on a bench or on table with your stomach on the table. You can have a small pillow or cloth for your head or not, whichever you find more comfortable. This can be done without the pillow or cloth its personal preference to make it more comfortable. The purpose of this exercise is to move your arms away from the bench to shoulder height to the side. The arm moves away from the body (abducts away from the body). This just targets the rotator cuff muscle. During a rep the concentric phase is 1 second and eccentric phase is 3 seconds. This is to develop muscular endurance. I change my grip as it works the muscles in a different way so one rotator cuff session using an overhand grip then using a side grip.

9/ Lying Down Front Raise

This exercise is very much like the Lying Down Side Raise except you are moving your arm forward instead of sideways.

Again, this exercise is on a bench or on table with your stomach on the table. A pillow or cloth for your head is optional. Have a small pillow or cloth for your head. The purpose of this exercise is to move your arms away from the bench to shoulder height straight in front of you. The arm moves away from the body (abducts away from the body). This just targets the rotator cuff muscle. During a rep the concentric phase is 1 second and eccentric phase is 3 seconds. This is to develop muscular endurance. I change my grip as it works the muscles in a different way so in one rotator cuff session, I use an overhand grip, then change to using a side grip.

10/ Standing External Rotation (Elbow Out)

This can be done with a resistance band, dumbbell or a cable. With a resistance band or a cable you can move the anchor up and down to challenge the rotator cuff to work at different angles. I personally use a cable as I feel I can get a better workout. To start the exercise your elbow is bent over using an overhand grip at shoulder height. You then pull your elbow up but keeping your arm at shoulder height as shown in the pictures. This just targets the rotator cuff muscle. During a rep the concentric phase is 1 second and eccentric phase is 3 seconds. This is to develop muscular endurance.

11/ Proprioception Movement Training

This type of training involved me picking a point in a room e.g. the corner. I would then move my arm to that corner (pointing at it) with my eyes open looking at that corner. This would be repeated a few times raising my arm up and down. Then to begin Proprioception training I would close my eyes and try and mimic the previous movement. I would move my arm to the corner (with my eyes closed) and once I thought I was at the corner I would open my eyes to see if I was. This is to develop my sense of the orientation of my arm in space. I would repeat this (with my eyes closed) ten times and repeat it but picking different points in a room.

12/ Lying Down Dumbbell Presses

This exercise has a great training effect on the rotator cuff from a different angle. It allows you to use heavier weights to build up the rotator cuff strength and develop the muscles surrounding it (deltoids and pectorals). The arms are close to the body and move straight up and down from a lying down position. During a rep the concentric phase is 1 second and eccentric phase is 3 seconds. This exercise can be used to develop both muscular strength and muscular endurance and is one of my favourite exercises for the rotator cuff. This picture was taken from Strength Training Anatomy 3^rd Edition and from my own reading in Men’s Health: 101 Best exercises.

Example of My Personal Rotator Cuff Workout

There are 5 exercises in a workout and it changes every week to prevent boredom and to prevent the body from adapting to it. After doing my usual warm up I will proceed to do:

Currently I am not having any shoulder problem due to the sustained amount of shoulder training I have done with these rehab exercises and weight training for developing muscular strength, hypertrophy and power. However to develop muscular strength, I will reduce the reps and increase the weight as shown below.

To improve your bench press in Powerlifting, focusing on rotator cuff exercises can dramatically increase the amount you can bench. All of the exercises I had used for shoulder rehabilitations I will continue to use in my development plan for injury prevention and to achieve a bigger bench press. However I will increase the weight slightly and lower the reps steadily to develop muscular strength for the bench press.

All the above was written back in 2012 for my A-Level PE. and there is only one new exercise that I can add to the above which is using a light resistance band and doing band pull aparts to work on the rear delts. Do 100 reps and your muscles will be screaming out in agony. The rear delts are a neglected muscle but it is very important in the stability of the shoulder joint.

I have been doing the above exercises since 2010 (when I had my first dislocated shoulder) and I haven't had any shoulder issues to this date (touch wood).

I hope you found the information useful in your own training.

Thanks for reading

Andrew Richardson, Founder of Strength is Never a Weakness Blog

I have a BSc (Hons) in Applied Sport Science and a Merit in my MSc in Sport and Exercise Science and I passed my PGCE at Teesside University.

Now I will be commencing my PhD into "Investigating Sedentary Lifestyles of the Tees Valley" this October 2019.

I am employed by Teesside University Sport and WellBeing Department as a PT/Fitness Instructor.

My long term goal is to become a Sport Science and/or Sport and Exercise Lecturer. I am also keen to contribute to academia via continued research in a quest for new knowledge.

My most recent publications:

https://www.sciencedirect.com/science/article/pii/S1752928X19300216

https://www.sciencedirect.com/science/article/abs/pii/S1752928X19301076

My passion is for Sport Science which has led to additional interests incorporating Sports Psychology, Body Dysmorphia, AAS, Doping and Strength and Conditioning.

Within these respective fields, I have a passion for Strength Training, Fitness Testing, Periodisation and Tapering.

I write for numerous websites across the UK and Ireland including my own blog Strength is Never a Weakness.

I had my own business for providing training plans for teams and athletes.

I was one of the Irish National Coaches for Powerlifting, and have attained two 3rd places at the first World University Championships,

in Belarus in July 2016.Feel free to email me or call me as I am always looking for the next challenge.

Contact details below;

Facebook: Andrew Richardson (search for)

Facebook Page: @StrengthisNeveraWeakness

Twitter: @arichie17

Instagram: @arichiepowerlifting

Snapchat: @andypowerlifter

Email: a.s.richardson@tees.ac.uk

Linkedin: https://www.linkedin.com/in/andrew-richardson-b0039278

Research Gate: https://www.researchgate.net/profile/Andrew_Richardson7

Monday, 1 September 2014

Sports Psychology - Group Cohesion for Success

Performers do not exist in isolation; they form groups that have common features. Groups can vary in size, from a few individuals to large teams of players, coaches and a variety of support staff E.G. The British and Irish Lions is a prime example of a large team with a range of individuals with different roles. As Jeremy Guscott (British & Irish Lion) said "Lions tours are about bonding together...Success depends on whether you come together or split into factions...There were times with this Lions squad when we felt invincible - that we could take on the whole world and beat them."

According to Carron (1980), these groups all exhibit the following characteristics:
- A collective identity
- A sense of shared purposes
- Structured patterns of communication

A racket player can move from singles to doubles and interact with a trainer or coach. Team games are based on units of players combining to function as a whole team (forwards and back in rugby, this can be sub divided into the front row, back row, half backs, back three etc). Players and coaches often attribute a team’s success or failure to how well the personnel of the team worked as a cohesive unit.

Building group identity, providing an environment where performers feel comfortable and willing to work with and for each other, and creating a spirit of unity is all fundamental to sport success. The dynamic of the group, the energy and functioning of the members as one, is a clear aim for a successfully performing group – cohesion acts as glue that binds and bonds individuals to a group identity and cause. Cohesion is defined as “the total field of forces that cause members to remain in a group)

Cohesion comprises both task cohesion and social cohesion:

- Task Cohesion: refers to the degree to which members of a group work together to achieve common goals, for example, to win a specific game.

- Social Cohesion: reflects the degree to which members of a team like each other and interact accordingly.

A school team made up of players who have played rugby since Primary 5 have very strong social bonds than a team of relative strangers. This is what the lions have to overcome and so far they seem to be doing that. Most of these players have played with each other or against for their clubs and country. Some have played with each other from young age and have their coaches on the tour as well. Also it isn’t just the lions that have to worry about group cohesion the Barbarians are another
example.

Building Group Cohesion – A Conceptual Model

There is clear evidence that the more united a group becomes with its cause, and the more interactive group members are socially within the group the greater the probability of success. Leaders in the sports environment should aim to develop cohesiveness within the group. The development of a group normally goes through 4 stages:

- Forming: the group meets or is assembled
- Storming: heightened tension may develop as roles are defined and tasks established
- Norming: rules and standards of behaviour are agreed as cohesion is built
- Performing: the group matures and works together.

Group Dynamics

The dynamic within the group is also an important consideration in building group cohesion. Group cohesion is defined as “a measure of the extent to which a group works together socially or to complete a task”. Group dynamics describes the processes within a group and between the members of the group. This can also be described as the energy the group exhibits. Successful groups with a dynamic have“chemistry”. This is difficult to guarantee – it depends on individual personalities, but can be the product of leadership and cohesion within a group. A clear goal and the nurturing of personalities all contribute to the dynamic within a group. Leaders will seek out individuals to join the group who have similar social and task characteristics and a shared ethos – groups are often fashioned in the image of the leader.

Carron identifies 4 factors that affect the development of cohesion:
- Environmental factors: that binds players together are age, club membership, location etc
- Personal factors: belief in the group, a desire to win, the social relationships within a community etc
- Leadership factors: the influence of the coach or manager in building identity and affiliation through task and social cohesion factors
- Team factors: in relation to the group as a whole, its identity, targets set, the ability and role of each member of the group.

Strategies and Methods for Enhancing Group Cohesion

Building on Carron’s 4D model there are strategies and methods for developing cohesion in a group.

Environmental Factors can be enhanced through:
- Holding training camps to build unity through external changes in social circumstances. The lions held their training camp in Carton House in Dublin this year to start the process of building the team.
- Ensuring all members of the group have equal importance and value by avoiding star billings
- Rewarding all players equally with praise or constructive criticism.

Personal factors can be enhanced through:
- Ensuring all member of the group feel ownership of the group
- Mixing young and old players together in groups, especially when staying away from home
- Developing a shared responsibility for success and a belief that all members are essential to successes of the group
- Creating a belief in the group and its task and social development
- Avoiding the formation of cliques voicing disenchantment with the group task or the social mix
- Identifying the reasons to why members individually want to be part of the group, and building on their motives
- Identifying those members who exhibits social loafing (makes less effort than they would alone), and introducing methods to incorporate them into the group.

Leadership factors can be enhanced through:
- Unite players in their belief in you as a leader through your leadership style and behaviour, mix autocratic and democratic style.
- Treat players as individuals, offer praise and criticism
- Avoid criticising players in front of the group.
- Get to know your members of the team: be aware of each person’s needs and their preferred way of interacting and style of motivation.

Teams can be enhanced through:
- The appropriate use of short, medium and long term goals.
- Clearly identifying member roles within the group as integral to the team ethic: avoid the Ringelmann effect (increased social loafing and loss of coordination as more members are added to the group)
- Devise and identify a clear system of rewards and punishments that the group that the group members have helped devise and have agreed to.
- Encourage social bonding through winter training camps or group social events.