1. train right: shoulders terry kane, physiotherapist

2. you are an exercise scientist

3. train right = results & referrals. Appropriate Exercise for client “X” Inappropriate Exercise for client “X” Appropriate Dose for client “X” Results & Referrals Injury Inappropriate Dose for client “X” (too much) Injury Inappropriate Dose for client “X” (too little) No changeNo change / Injury What’s appropriate for one client may not be appropriate for another

4. train right Hippocratic Oath  If in doubt, first do no harm. Personal Training Oath  If in doubt, first do no harm. Clients expect you share the same oath as healthcare professionals. They expect that every exercise that you give them is safe for them... that’s why they pay you.

5. What we know  Mechanisms of Injury Mechanisms of Injury 1.Acute 2.Overuse 3.Acute on Vulnerable  Genetics  Age  Fatigued tissue  Old injury  Recent injury 5

6. there is no such thing as a ‘bad’ exercise…. But there are exercises that are; 1.Inappropriate for the client 2.Inappropriately executed 3.Inappropriate dose a.Past medical history b.Current medical conditions c.Neuromotor Skills d.Experience e.Flexibility f.Strength g.Endurance 6

7. there is no such thing as a ‘bad’ exercise…. But there are exercises that are: 1.Inappropriate for the client 2.Inappropriately executed 3.Inappropriate dose a.Poor technique b.Inexperience c.Inadequate instruction d.Incorrect instruction 7

8. there is no such thing as a ‘bad’ exercise…. But there are exercises that are; 1.Inappropriate for the client 2.Inappropriately executed 3.Inappropriate dose a.Too much too soon b.Sudden increase in frequency c.Sudden increase in intensity d.Sudden increase in volume of exercise. 8

9. review Anatomy Scapula  Coracoid process  Acromion  Glenoid fossa  Glenoid labrum  Subacromial space Clavicle Humerus  Bicipital groove  Greater tuberosity  Lesser tuberosity

10. review Muscles Rotator Cuff  Subscapularis  Supraspinatus  Infraspinatus  Teres minor Biceps  Long head  Short head Scapular stabilizers  Serratus Anterior  Trapezius  Rhomboids  Levator scapulae  Latissimus Dorsi

11. review Biomechanics  Scapular plane  Scapulohumeral rhythm  Subacromial impingement  Painful arc  Winging scapula  Apprehension sign  Stress-Strain Curve

12. review Biomechanics  Scapular plane  Scapulohumeral rhythm  Subacromial impingement  Painful arc  Winging scapula  Apprehension sign  Stress-Strain Curve

13. review Biomechanics  Scapular plane  Scapulohumeral rhythm  Subacromial impingement  Painful arc  Winging scapula  Apprehension sign  Stress-Strain Curve

14. review Biomechanics  Scapular plane  Scapulohumeral rhythm  Subacromial impingement  Painful arc  Winging scapula  Apprehension sign  Stress-Strain Curve

15. review Biomechanics  Scapular plane  Scapulohumeral rhythm  Subacromial impingement  Painful arc  Winging scapula  Apprehension sign  Stress-Strain Curve

16. review Biomechanics  Scapular plane  Scapulohumeral rhythm  Subacromial impingement  Painful arc  Winging scapula  Apprehension sign  Stress-Strain Curve

17. review Biomechanics  Scapular plane  Scapulohumeral rhythm  Subacromial impingement  Painful arc  Winging scapula  Apprehension sign  Stress-Strain Curve

18. review Biomechanics  Scapular plane  Scapulohumeral rhythm  Subacromial impingement  Painful arc  Winging scapula  Apprehension sign  Stress-Strain Curve

19. Quick Scan Exam

20. If in doubt, first do no harm. Jury of Your Peers  Would another personal trainer agree that a given shoulder exercise you prescribed is safe and appropriate for the same client?  Medical / Health profile  Technique  Dose If in Doubt 1.Elbows below 60 d of abduction (impingement) 2.Hands and elbows visible throughout entire motion (scapular plane) 3.Slow and controlled (stress- strain curve) 4.Appropriate load (stress- strain curve)