Skip to main content

Todays Trending Topic ♛

How To Use Occlusion Training To Enhance Your Workouts

By Kyran Doyle  In Training
Occlusion training or blood flow restriction training has been getting a lot of attention lately.
You might be wondering if it is something that you should implement into your workouts or if it is something to steer clear of.
As with just about every fitness strategy there are two sides to the argument.
Some people say that is brings no benefits and then there are others that claim that it can enhance muscle growth and aid your workouts.
In this article you will learn exactly what blood flow restriction (occlusion) training is, how effective it is, and how you can use it in your workouts. WHAT IS OCCLUSION TRAINING?
Occlusion training involves restricting the flow of blood to a muscle group while training. That is why it is also commonly called “blood flow restriction training.”
Basically you take a wrap or band and apply it to the top of your limb.
The aim of this isn’t to completely cut off circulation to the area as that is dangerous and painful.
This means that y…

The Subscapularis: Shrug Off Shoulder Pain


Chiropractor Alexander Jimenez investigates the relevant anatomical and biomechanical considerations related to the subscapularis, plus injury within the subscapularis, how to assess subscapularis function & finally rehabilitation ideas for injured as well as dysfunctional subscapularis muscles.

Introduction

Injuries to the muscle are infrequent causes of shoulder pain in the athlete. Immediate injuries to the muscle- tendon unit can affect the athlete like swimmers and tennis players. Malfunction in the subscapularis in the kind of fatigue and inhibition can lead to biomechanical abnormalities in the glenohumeral joint such as poor lateral stabilization of the shoulder joint in the shoulder that is athletic.

Anatomy


The subscapularis originates the anterior scapular (subscapular fossa) and inserts onto the lesser tuberosity of the humerus. It’s the largest of the rotator cuff muscles and its cross-sectional area is larger than the other three rotator cuff joint (infraspinatus, teres minor, surpraspinatus). Its main roles on the glenohumeral joint are:

1. Depressor of the humeral head;

2. Anterior stabilizer of the humeral head (glides the humeral head posteriorly relative to the glenoid fossa);

3. Internal rotator of the shoulder (together with the highly effective pectoralis major and latissimus dorsi).

The tendon fibres mix with the anterior capsule of the shoulder and therefore fortify the posterior shoulder capsule. The muscle is regarded as less significant as a shoulder internal rotator (as the pectoralis major and latissimus dorsi are powerful internal rotators) also is significantly more important as a dynamic anterior stabilizer of the glenohumeral joint through its activity in preventing anterior shear/glide of the humeral head.

The subscapularis has an intimate relationship with the long head of the biceps via the shoulder “Twist”. This is a complex that functions to stabilize the long head of the biceps tendon in the bicipital groove. The pulley complex consists of the superior glenohumeral ligament, the coracohumeral ligament, along with the ventral attachment of the subscapularis

Tendon, and is located inside the rotator Interval between the anterior edge of the subscapularis tendon of the superior edge and the tendon. Injuries to the subscapularis tendon may compromise the integrity of their bicep’s ‘sling’ (Nakata et al 2011). To keep the knee tendon in place and stabilized, tension from the superior glenohumeral ligament and the help of the very superior insertion stage of the subscapularis from supporting the fascia is demanded (Aria et al 2010). Disruption of this ‘biceps sling’ is a frequent pathology in athletes that require forceful and frequent shoulder rotation such as the position in baseball pitching.

Injuries To Subscapularis

Like all of the rotator cuff muscles subscapularis is susceptible to pressure forces which may damage the muscle-tendon and also muscle unit’s integrity. Although tears to the subscapularis are not as prevalent as tears from the other rotator cuff (particularly supraspinatus), injuries to the subscapularis might prove to be problematic due to its anatomical proximity to the long head of the biceps tendon.

Ruptures of the subscapularis have been reported in the literature (Gerber and Krushell 1991). The mechanism is a pressured hyper-extension rotation force such as falling onto an outstretched arm, on the shoulder or infrequently it might be a result of a shoulder dislocation. These kinds of injuries will lead to severe shoulder pain using a painful weakness in internal rotation, greater range of motion into external rotation (which is then constrained by pain at end of range) along with also a weak/pathological ‘lift-off’ test (see below).




Injuries to the subscapularis tendon can also occur in athletes or occupations that take a great deal of forceful shoulder internal rotation (baseball pitching, tennis, swimming). Overuse of those complicated can create a strain response and fibrosis tissue deposition in the gut, may lead to. Trigger points in the muscle can create that weaken and tighten the muscle.

In these instances, pain is felt as a deep anterior shoulder pain, exacerbated by overhead inner spinning movements (swimming and serving), weakness in the ‘lift-off’ evaluation (see above) and also reduced array of passive external rotation whilst the arm is placed by the side is noted (Thurner et al 2013).

Finally, a neighborhood muscle imbalance shoulder between the subscapularis and the infraspinatus can cause positional faults from the mind of the humerus, whereas the humeral head is not centralized in the glenoid fossa and excessive anterior shear of the humeral head happens that leads to impingement and uncertainty sensations in the shoulder.

Role Of Subscap In Shoulder Stability

Hess et al (2005) found that in a simulated throwing action using shoulder rotation, participants with shoulder pathology had a delayed onset on recruiting of subscapularis compared infraspinatus and supraspinatus. Nevertheless, in regular pain free shoulders that the subscapularis was activated earlier and until the shoulder began to externally rotate, evidence that the subscapularis functions in a mechanism to ‘pre-empt’ movement and also to contract to provide anterior shoulder stability.

It is suggested therefore that shoulder pain patients lose part of their energetic mechanisms that are stabilizing in the shoulder and as a result the humeral head shear and can glide anteriorly and superiorly from the glenohumeral joint, thus leading to anterior shoulder impingements.

Imbalances in force production involving the subscapularis and the externally infraspinatus could create a local issue from the glenohumeral joint. It’s typical for the athletic shoulder to really have a misaligned and tight infraspinatus in connection to the subscapularis. This neighborhood imbalance sets a mechanical issue in the shoulder the infraspinatus pushes forward the humeral head in relation to the glenoid and the inhibited subscapularis can’t counteract this lateral shear effect. Consequently the head shears and impinges the anterior pain and shoulder structures may result.

Conclusion

Research shows that the muscle has an significant role in supplying anterior glenohumeral joint stability. It centres the humeral head into the movements of this arm/shoulder. Dysfunction in this muscle may lead to of the humeral head which might be a precursor to shoulder instabilities and the more shoulder impingements.

It’s important for the clinician to detect dysfunction inside this muscle through a battery of tests and also direct exercises will be required to rehabilitate function for this muscle.

References

1. Aria et al (2010) Functional anatomy of the superior glenohumeral and coracohumeral ligaments and the subscapularis tendon in view of stabilization of the long head of the biceps tendon. Journal of Shoulder and Elbow Surgery. 19(1):58-64

2. Barth et al (2006) The bear-hug test: a new and sensitive test for diagnosing a subscapularis tear. Arthroscopy. 20(10). 1076 -1084.

3. Burkhart SS, Tehrany AM. (2002) Arthroscopic subscapularis tendon repair: Technique and preliminary results.

Arthroscopy ; 17:454-463

4. Gerber C and Krushell RJ (1991) Isolated rupture of the tendon of the subscapularis muscle. The Journal of Bone and Joint Surgery. 73-B(3); pp 389-394.

5. Hess et al (2005). Timing of Rotator Cuff Activation During Shoulder External Rotation in Throwers With and Without Symptoms of Pain. JOSPT. 35(12); pp 812-820.

6. Nakata et al (2011). Biceps pulley: normal anatomy and associated lesions at MR arthrography. Radiographics. 31(3):791-810

7. Scheibel et al (2005) The Belly-Off Sign: A New Clinical Diagnostic Sign for Subscapularis Lesions. Arthroscopy: The

Journal of Arthroscopic and Related Surgery, 21(10): pp 1229-1235

8. Thurner et al (2013) Subscapularis Syndrome: a case report. International Journal of Sports Physical Therapy. 8(6); pp 871-882.

Popular posts from this blog

Pain in the Quadratus Lumborum Muscle

A majority of the population have at some point experienced low back pain in their lifetimes. Although low back pain is recognized to result from numerous conditions or injuries on the lumbar spine, muscle strains such as a quadratus lumborum muscle strain, are believed to be a leading cause for the recognizable symptoms of pain and discomfort.
The quadratus lumborum muscle is a sizable muscle in the shape of a triangle, located deep on each respective side of the lower back. The role of the wide muscular tissue is to grant mobility to the lumbar spine in sequence for the torso to move laterally from side to side as well as extend and stabilize the lower spine to improve posture. When this muscle is strained or pulled, the symptoms can restrict movement on the lower back and since the muscular tissue is so extensive, recovery from this type of injury usually requires more time and patience to fully heal.


Quadratus Lumborum Syndrome V.S. Facet Joint Syndrome
When symptoms of back pa…

Achilles Tendon Injury

Achilles tendonitis is a medical term used to describe a condition resulting in irritation of the large tendon, the Achilles tendon. Found in the back of the ankle, this condition is recognized as a common cause for injury among athletes. Excessive use of the Achilles tendon results in inflammation together with swelling and pain.
The development of Achilles tendonitis can be associated with two important factors, most frequently among athletes, which are, lack of flexibility and over-pronation. With age, the tendons will begin to lose flexibility, just the same as other tissues in the body. This change causes the tendons to become more rigid and more vulnerable to injury. For some people, the ankle may roll too far downward and inward with each step they take. This is called over-pronation, which places more stress on the tendons and ligaments of the foot, contributing to injury if not corrected.
Achilles tendonitis may also develop from other factors. An increase in an athlete’s …

5 Common Causes for Shoulder Pain

The shoulders are the most mobile joints in the human body. Because the ball of the humerus is designed to be larger than the shoulder socket that holds it, the shoulders need to be supported by muscles, tendons, and ligaments to secure them in a stable or natural position. Since the shoulder can be unstable, it is often a site for many common complications. Below are 5 common causes of shoulder pain and their associated symptoms.
Rotator Cuff Tear
Rotator cuff tears within the shoulder are a very common type of shoulder injury. The rotator cuff consists of a set of four muscles: the supraspinatus, the infraspinatus, the subscapularis, and the teres minor. All of these muscles are attached to the bones of the shoulders by tendons, which purspose is to support, stabilize, and grant the arm movement to move up, down and rotate. The rotator cuff ensures that the arm remains in the shoulder socket. Damage or injury from an accident or gradual wear and tear can result in inflammation to t…

Today's Chiropractic

Location Near You

MEET THE STAFF