Each year in primary care in the UK, about 1% of adults aged over 45 years present with a new episode of shoulder pain.Shoulder pain is therefore a common complaint but it varies greatly in severity and etiology.
The majority of cases are due to rotator cuff disorders such as rotator cuff tear, non-calcific tendinosis, calcific tendinitis. Other causes are adhesive capsulitis (frozen shoulder), subacromial/subdeltoid bursitis, post-stroke shoulder pain and pain referred from the cervical spine.
In any case a doctor will evaluate the problem taking a detailed anamnesis and physical examination (range of motion evaluation), eventualy prescribing imaging tests. It is important to recall any history of trauma and underlying diseases (eg. diabetes, neck problems).
Athletes, especially those who swim, lift weights, toss or play tennis can be affected in particular by rotator cuff disorders.
Rotator cuff disorders are associated with excessive overloading, instability of the glenohumeral and acromioclavicular joints, muscle imbalance, adverse anatomical features (narrow coracoacromial arch and a hooked acromion), cuff degeneration with ageing, ischaemia, and musculoskeletal diseases that result in wasting of the cuff muscles.
Treatment varies, depending on the underlying cause, from drug treatment to extracorporeal shock wave therapy (in people with calcific tendinitis), laser treatment, physiotherapy (manual treatment, exercises), electrical stimulation, ice and ultrasound, to surgical treatment.
I was searching for evidence based scientific papers on the prevention & rehab of shoulder pain, when I found Jamil Natour's work on progressive resistance training in patients with shoulder impingement syndrome. His research studied a group of 60 patients, randomly assigning half to a workout group, half to a control group and then assessed the pain at rest, the pain at movemente, the disabilities, quality of life, etc.
I found te following result very promising!
The control group took an average of 17.4 NSAIDs and 14.4 analgesics, whereas the experimental group took an average of 1.9 NSAIDs and 2.0 analgesics. This difference was statistically significant.
The exercises were flexion, extension, medial rotation, and lateral rotation of the shoulder. Training was carried out twice a week for a period of 8 weeks. Without getting too much into details, which can be found in the original papar, the method used was: 2 series of 8 repetitions, the first series with 50% of the 6 repetition maximum and the second series with 70% of the 6 RM, 2 min rest between. This is what is called the DeLorme method (or progressive resistance training) which is an "ascending pyramid" method of weight training.
Sources:
- http://clinicalevidence.bmj.com
- J.C. Tauro, Shoulder Stiffness, Arthroscopy: The Journal of Arthroscopic & Related Surgery
Volume 24, Issue 8, August 2008, Pages 949-955
- J. Natour, Progressive resistance training in patients with shoulder impingement syndrome: A randomized controlled trial, Arthritis Care & Research, 2008 Volume 59 Issue 5, Pages 615 - 622
- Image: http://www.hss.edu/longisland/
2 comments:
Hi Alberto, I really like your training mix. I too try to combine weight training and aerobic - but usually on alternate days. I have read that if doing aerobic and weights on the same day one should do the weights first, which produces more growth hormone, rather than aerobic first, which inhibits the muscle growth that should have resulted from the weight training. Comments?
I was amused by your account of walking many kilometres to get to your chosen exercise. This happens to me every year when I go walking in the french mountains without a car. I often have to walk for 1.5 hours just to get to the car park where others start their walks (and the same back in the evening, unless I can cadge a lift). I think this is a great recipe for super-fitness! Good luck, Alexandra.
Yes, when I was in Messina I had to walk all the time due to a lack of public transportation. Luckely I'm back home now!
Answering to your question. You made a very interesting point. I've listened to this discussion lots of times. I don't know what truly scientific there is behind the "hormone" hypothesis. I should really look more deeply into this. Usualy this theory is claimed by the "gym guys" that are obsessed by gaining muscle and have sometimes difficulties with the running, the cardio, which they do only to lose some extra fat, with no chrono or endurance goals. Personaly if I want to weight lift AND run consecutively I do the weights first. By run I mean at least a 30 min run, not the 5-10 mins warmup I always do before. This is because I am looking for endurance. After 1 h weight lifting I am indeed tired and with the run I try to give all what I have left. For example, also triathletes tend to leave the running for the second part of the day. Swimming in the morning, running in the evening, using all the energies they have left. This is what works for me. I wouldn't have the energies, physical and mental, to do a quality weight training after a run! Thanks for passing by! Do you have a blog or are in one of the social networks I am in?
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