How to Heal Shoulder and Lumbar Spine Injuries
My work as a chiropractor consists of treating many different athletes, from track and field amateurs and professionals to competitive tri-athletes to professional baseball, basketball, and soccer players, and of course, CrossFit athletes. In the course of my work I have come across some awesome rare injuries, but the most common things I see are shoulder injuries and lower back issues. Based on my experience, I’m want to offer you a little insight on these latter injuries, as to what helped get some of my patients back on the playing field as quickly, and in the best health, as possible.
Let me start by saying if you have aches and pains that have lasted longer than three days with no improvement with icing, then you need to get to a healthcare practitioner as soon as possible, whether it is a chiropractor, acupuncturist, osteopath, or physical therapist. Find someone who knows the body and that you trust.
Shoulder injuries usually consist of impingement syndrome, bursitis, or tendonitis of a muscle, possibly a rotator cuff muscle or the bicep. I’m sure at one point you have all Googled one or two of the fore mentioned. In general, each of these means the shoulder is not functioning correctly biomechanically, so a different muscle or group of muscles have taken the brunt of the mechanical demand, or there could have been excessive demand placed on the shoulder to cause improper functioning at a stage of fatigue. Whatever happened, you have a hot, inflamed shoulder now.
With the onset of a shoulder injury the first thing to do is to stop inflammation. This means no shoulder-intensive workouts and no lacrosse ball directly on the shoulder. More times than not, people will keep the shoulder inflamed by using a lacrosse ball or tennis ball to mobilize directly on the inflamed areas. Back away from the shoulder and let it be.
The second thing to do is to pay attention to your posture. A lot of shoulder aches and pains can be diminished by proper posture and muscle recruitment patterns. The ideal posture would consist of setting your scapulas in your back pockets (yes, they will never reach but you get the idea) and making a double chin, so your head is directly lined up over your shoulders.
When your healthcare practitioner gives you the green light to go back to your workouts, ease into them and make sure your shoulders are functioning correctly biomechanically. Have someone watch you to make sure you set your scapulas down and back before each lift. If your shoulders are not displaying proper muscle activation patterns, I guarantee you will continue to re-injure yourself.
Here are a few of my shoulder tips:
- Mobilize shoulders and thoracic spine before and after workouts.
- Warm up with scapula pushups and pull-ups.
- Do pushups with your elbows close to your body and elbow pits forward.
- Start with strict pull-ups for three weeks before kipping.
- Remember to set your scapulas (or activate your lats) before anything.
The lumbar spine offers great support as well as distributes weight throughout the pelvis to the lower extremities. If an individual’s joints are not functioning properly, or their deep inner core is not firing, or their gluteus maximus firing pattern is off, then they are definitely at a predisposition for lumbar spine injury. Facet syndrome (also referred to as facet imbrication) or lumbar sprain/strain are the two most common athletic injuries I come across.
Basically, the facet joints are the small pair of joints located on the superior and inferior posterior portion of each vertebral segment. The facet joints orchestrate movement and provide stabilization for the lumbar spine. When these joints are repetitively jammed together, as in deadlifts or a back squat or even handstand pushups, the synovial fluid and articular cartilage can become inflamed and result in pain. With a facet injury, an individual feels pain with excessive extension, stiffness in the morning, and even difficulty rising from the seated position. An individual will feel relief upon forward flexion or in the “roly poly” stretch. A lumbar sprain or strain happens when excessive mechanical demands are placed upon the muscles and/or ligaments. An individual may feel increased discomfort with rotational movements.
When a lumbar spine injury is suspected, as mentioned earlier, get in to see a chiropractor or a healthcare practitioner of your choice. Hold off on load-bearing workouts and excessive “kipping” movements. You may continue to mobilize your TFLs (tensor fasciae latae), gluteus medius, and even quadriceps. Maintain core activation when standing by thinking of the hollow position, or pulling your belt buckle to your rib cage. Take time off, but do not stop moving. Movement brings nutrients to the structures of the spine. Walk thirty minutes a day during the first week. When the second and third weeks come around, try swimming three times a week.
Here are my a few of my lumbar spine tips:
- If you cannot hold the hollow position for sixty seconds, then you should not be putting any weight over your head.
- If you have weight over your head, you had better be “hollowed out.”
- Activate your gluteus maximus before workouts.
- Back squats put the most load on the spine posteriorly.
- Front squats are great for training posture and core.
Again, these are just tips from what have worked for my patients. This article is not designed to be the next WebMD or physical assessment book. Like I said before, if you have pain or discomfort that persists for more than three days, you need to get into see a healthcare practitioner. It is better to get hold of an abnormal situation before things get so bad you cannot even brush your teeth, much less workout.
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