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Frozen shoulder is a common shoulder pathology that can cause pain, decreased range of motion, disrupted sleep, and a decreased ability to perform basic daily activities. It is a frustrating complaint that has few treatment options from the standard care approach. As an acupuncturist focusing on shoulder pain, I have heard everything from “wait two years, it will just go away” to aggressive procedures that include anesthesia and manual manipulation of the shoulder to quickly reintroduce full range of motion. From my experience, people generally don’t like being told to sit around and do nothing and aren’t fans of unreliable aggressive and painful procedures. So, what can be done to help?

Unfortunately, there is no one shot cure all approach. There are however, options to try that may be very beneficial both at home, or with a professional. It is the health care professional’s duty to meet every patient where they are at when they walk through the door. Recognizing what works for one patient may worsen symptoms of another in regards to movement, is pivotal. That being said, we want to talk about home care options here and only briefly offer options for health care providers.

Frozen shoulder occurs in three stages: freezing, frozen, and thawing. Each of these stages comes with a separate focus. Generally speaking, the freezing stage is painful, the frozen stage is when the least mobility is available, and the thawing stage is the recovery period. Throughout each stage, tolerable movement is key. It is commonly thought that the frequency of tolerable range of motion is useful at increasing speed of healing. So, what are methods of tolerable range of motion?

Initially speaking, exercises to work on include both a wall walk and a pendulum exercise. These exercises don not require any special equipment and can be performed in a pain free manner by most people. The wall walk exercise can be performed in two separate directions, which makes it useful for range of motion. The video below discusses and demonstrates both of these exercises and how you can make them most effective.

 

If the above exercises worked well or are to easy, then it is time to test out the movements in the video below! You can use a dowel, broom stick, or perhaps a friend to try out these movements. In practice, these are often referred to as proprioceptive neuromuscular facilitation (PNF for short). If these can be performed correctly and pain free, you will note marked improvement in range of motion immediately. It is important to be consistent with the exercises to try and keep progressing. The video below demonstrates how to use this style of stretching with a stick. It is possible to use a home pulley system in a similar fashion as well.

Outside of these exercises, there are other methods of homecare that can be used. Self massage can be very helpful at decreasing pain and increasing range of motion temporarily. Good target muscles to “roll out” include the pectoral muscles and infraspinatus. The videos break down the details on how to perform these easy homecare options, but it is important to note that this should be done in a tolerable manner in regards to pain. These techniques can be performed before and after exercises, but do not go overboard on it beforehand. Utilize quick and light massage techniques to loosen the fascia up versus really working deep into those trigger points when doing before an exercise. Stronger and longer compressions can be used at the end of homecare exercises. If you find self massage to be really helpful, you can consider investing in a ‘Theragun’ or similar machine. They are not an inexpensive investment, but for the patient that really values trigger point work, ‘Theraguns’ provide easy homecare relief. Many local running stores have the option to test them out if your health care practitioner doesn’t have one.

Another excellent homecare option is taping. Taping takes a willing partner, but can be useful at mitigating related pain, aiding in muscle firing during exercise, and temporarily increasing range of motion. There are many different options when it comes to purchasing tapem, but my personal preference is Rock Tape. In the video below, I demonstrate a great approach to taping the shoulder that can be followed along at home!

If you decided to try any of these methods above,  let me know how they go by dropping a comment below. If you are inclined to try alternative treatments for your care, Trigger Point Acupuncture can be a very effective method of providing relief and increasing range of motion when combined with the other treatment options discussed above. Obviously, a blog post is not made to be a replacement for seeing professional that can identify your personal needs. Please discuss these options with a licensed health care professional before trying them on your own. Happy healing!

 

 

False Grip Gymnastics Rings

I work with CrossFit enthusiasts regularly to help them improve specific gymnastic skills

 

As a hand balancing instructor, I work with CrossFit enthusiasts regularly to help them improve specific gymnastic skills. As a Bellevue acupuncturist, I see CrossFit enthusiasts with injuries some avoidable, some not.   Regardless of my relationship with the athlete, I’ve learned they enjoy taking their health and fitness seriously and want to reach their full potential. To help do that, I have compiled my top 3 tips for the Crossfit athlete.

Prehab– CrossFit can be very hard on the shoulders. In order to continue to train injury and pain free, consider a prehab routine. In the case of Crossfit, strengthening the core, rotator cuff and periscapular muscles should be considered.  Check out the video to see some great exercises that can help keep shoulders healthy and prepared for the stress that a good WOD can put on them.

Periodization– Creating a cycle of intensity in your exercise program helps achieve goals and improve the overall quality of said program. This is especially true if you compete in any CrossFit competitions, but works great for every CrossFit enthusiast. If you look at any professional athlete’s training program you will clearly see periodization.  It is an annual plan to layout goals, how to achieve them, and how to do so without getting avoidably injured. It is not written in stone and can be modified to meet an athlete’s individual needs. If you take baseball as an example, these athletes have a clear off season. This does not mean they sit on the couch and eat chips though. The professional athlete will utilize the off season to work on specific skills and to maintain overall health. During spring training season, they take sport specific time to get ready for serious competition. As spring training comes to the end, official season begins. This is when there is constant training and a high level competition occurring. This shows a clear annual training plan for these athletes and it keeps them at their best.  So how would this look for a CrossFit competitor?

If we break down skills of CrossFit into three aspects; gymnastics skills, weight lifting, and high intensity cardio, then periodization will be easier to implement. Most CrossFitters I work with tend to have a preference for a specific area, which from a competitors stand point can come back to bite them. Having a planned approach can all skills will be addressed to be well rounded. A good plan can also prepare the athlete for a competition. For example, take a certain competition, say the CrossFit Open, and make it the main event of the year. Planning that time to be a physical peak would be great to focus on. Divide the rest of the year into cycles where skills are focused on in divided sections. An example is to focus on gymnastic skills such as muscle ups and handstand walks for a few weeks, then switch to a focus on weight lifting for a few weeks followed by cardio skills (i.e. double unders). When working on specific skills, it doesn’t mean that is the only thing you do during this time, just that these skills will be the focus. Continue to rotate these during your off season. Perhaps two months before the Open, enter your own “spring training” where you begin to combine the skills you work on in a way that directly mimics how the Open competition will be. This is a good time to even check out other local competitions or encourage your gym to have an in-house competition. As the Open gets closer (about a week before,) taper the workouts down and take some rest days. The skills have been trained, mimicking of real life challenge has been performed, so taking some time to ease off will be very beneficial. Rest, prevent injuries, and prepare mentally. This will allow you to enter the Open fresh, trained and ready to PR!

Recovery– I could probably write an entire book on recovery, but some important aspects to ensuring an adequate recovery are:

Stretch– All too often people want to get in and get out with a workout. They will slam out a new personal record on the WOD, then get out of the gym to get on with their day. Taking just a few minutes to work on flexibility will not only help with recovery, but improve one’s overall skill level.

Sleep– Something people often neglect is rest. The body needs adequate sleep to work on recovery. When we sleep, we enter a parasympathetic state (rest and digest). The body gets a chance to relax and focus on repairing the day’s work. Personally, before sleeping is when I like to take my herbs and supplements tailored to recovery. I tend to think of sleep as my time to prepare so that tomorrow’s work out can be even better than today’s.

Nutrition– The best way to ensure the body recovers, is to make sure it is adequately nourished. This can be accomplished with a combination of good whole foods and quality supplementation. If you look back at our blog about supplements for athletes, it will give you a small intro into recovery supplementation. As far as diet goes, one simple tip is to be sure to get protein within 30 minutes after a workout. Protein is the building block for muscles. Feed the body protein and it will get to work on healing everything that is torn down during a workout.

Health Team– There is a reason they are called health care professionals. Take the time to have a team that is familiar with your health goals. This can be a Naturopath focusing in the nutritional aspects, an acupuncturist that focuses on sports (like the one’s at Pins and Needles!) helping manage pain and keeping muscles healthy, and a massage therapist to keep the kinks out.

 

Implementing these three tips into your life can really help improve athletic ability within CrossFit. Be sure to take the time to speak with professionals (health care and coaches) to reach your specific goals. If you have specific questions please feel free to leave a comment or contact us! And don’t forget to subscribe to our blog for more great tips!

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