The shoulder complex is just that… complex! It is a series of incredibly mobile regions stacked on top of each other in such a way that if there is a significant issue in any one of these regions, the whole thing doesn’t work well. What I want to do with this blog post is give you QUICK and EASY assessments you can do on your shoulder to discover what it can do and what it should be able to do!
This quick and easy assessment gives us an idea of how well your shoulder can go overhead (flexion) and how well it can go behind you (extension). If you’re having difficulty with either of these movements, make note of which is the most challenging and let's move on to the next test.
Lying down with a towel under your elbow, see how much range you have going backward and forward with your wrist. In total, you should have about 160 to 170 degrees of total motion with the shoulder staying pinned on the table (see how the second image has the patient pinning their shoulder to the table so it doesn’t come up). Typically we see the back of the wrist touching the table when going back and the front side of the wrist nearly getting to the table, for a normal range of motion. If you’re having difficulty with either of these, take note and let's move on to the last assessment.
Being able to use your shoulder overhead is challenging without the correct musculature in place and ready for action. The “Reach, Roll, Lift” assessment really tests your shoulder’s ability to have good range of motion, as well as good muscle activation to pull your hand off the ground. First, crouch down, then slide your palm across the ground overhead; roll your thumb upward to the sky while keeping your outside of the hand on the ground; finally, pull your thumb and arm to the sky, keeping your arm straight. If this is not possible, make note, and let's move on.
After you’ve done these three assessments, you may have found you are lacking certain fundamental movements of your shoulder that are required for healthy functioning of your upper body. At Athletes’ Potential, we specialize in working with correcting these issues regularly and getting our patients back to the activities they love, fast, and without the need for injections or surgery.
If you discovered that you are unable to perform any of these three assessments, feel free to reach out to us and schedule a treatment today!
Thanks for reading,
Dr. Marcus Rein, PT, DPT, CF-L2
A hot pan - don’t touch it! A wet slippery slope - probably should avoid it. A cactus - definitely avoid it. The experience of pain has taught us these simple rules, and we should be thankful! Burning our hand, slipping on rocks, and getting poked by a cactus’ spines are all three damaging things that we do our best to avoid to ensure our own health. These examples are the easiest way to understand pain, in that it is an alarm system that is designed to protect us from damage by giving us a quick response from which we can learn.
Let’s go one level deeper. What happens if you go on a big hike and wake up the next day with your legs in pain? It’s a deep soreness that you haven’t felt before and it’s really bothering your hips and knees. Is this cause for concern? Is this damage? What kind of pain is this?
What if you are simply sitting down in the gym after a workout and turn to pick up your water bottle and your back spasms, causing intense discomfort? Is this cause for concern? Is this damage? What kind of pain is this?
How about just waking up with shoulder pain for no reason, but it lasts for 10 years? It won’t respond to medication or injections, and resting it just makes it worse. Is this cause for concern? Is this damage? Why the heck is this pain still around?
As you can see, the alarm system pain provides is activated in all of these scenarios. This alarm system provides a symphony of sensation that plays its tune and it's up to you (and maybe the assistance of a professional) to decode the symphony. Let me share with you the things I look for in a patient’s presentation to help decode their sensations:
1. Numbness, tingling, or burning?
If you are having numbness, tingling, or burning that does not resolve quickly or returns regularly, you likely need an assessment from a professional to determine its root cause. PTs are very skilled in caring for this type of pain! However, if this sensation is with progressive weakness or progressive loss of sensation, you should contact your primary care provider for assessment quickly. If it is rapidly progressive, you should go to the hospital.
2. Pain that's slowly getting better but still around?
As long as the pain is getting better overall, healing is occurring. If it's slow, it's still progress, so don’t discount it! If you are frustrated in the pain’s slow speed of improvement, it might be time to come in to see us as we are also very skilled at finding ways to more rapidly accelerate your healing.
3. Pain that is not getting better for over a month?
If you’ve been having pain that has not been improving for over a month, it is definitely time to see a professional. PTs are fantastic at diving into the mechanical issues that are causing your pain and improving the painful region’s overall capacity to provide you a higher healing potential.
As a final note… there are SO many factors that can affect pain! Here’s a short list of proven secondary factors that have a direct effect on the subjective interpretation of the pain alarm system:
Modifiable Factors Proven to Affect Pain*:
Non-modifiable Factors Proven to Affect Pain
As you can see, this complex experience doesn’t just include the local injury but so many other factors! If you would like to read more about the pain experience and its study, I highly recommend "Explain Pain." It is a short read that is well researched and provides a great contextualization of the entirety of the pain experience.
So, if you are having pain and want to better understand it, start with contextualizing it as an alarm system that you must learn to interpret. If you’d like to understand your pain further, “Explain Pain” is a great option.
And, finally, when you’re ready to have your pain improve, come see us at Athletes’ Potential!
Thanks for reading,
Dr. Marcus Rein, PT, DPT, CF-L2
* van Hecke O, Torrance N, Smith BH. Chronic pain epidemiology - where do lifestyle factors fit in?. Br J Pain. 2013;7(4):209-217. doi:10.1177/2049463713493264
During the month of September we focused our efforts on helping YOU combat nagging knee. It's super helpful to take the time to watch the first video before moving on to the rest. You need to understand the types of knee pain and where yours might be coming from before you can start to solve a problem. As always, reach out to us if you're not getting better, you have questions or you're ready to get out of pain and start living your life.
Knee Pain can be frustrating. However, in order to improve it, you need to know what you're dealing with. Are you having more mobility related issues or stability and control issues? Confused? Watch Dr. Danny walk you through 2 simple tests to see which category you fall into.
What if you don't have enough mobility and you have knee pain? These exercises will give you hope! Walk through these exercises with Dr. Jacob and see if you can improve your mobility and decrease your knee pain.
1. Couch Stretch- one of our all time favorite drills- but focus on the cues.
2. Knee gapping- if your pain is coming from your joints, this is the exercise for you.
3. Hamstring mobility- grab a band and work on your hamstring mobility to help improve your knee pain.
Are you having knee pain? Dr. Marcus is going to walk you through 3 exercises to strengthen your leg to decrease knee pain and get stronger.
1. The first one is a classic- wall sits. He throws in some twists for those of you that think you're too strong.
2. One way to get strong legs is to target your hamstrings with hamstring roll outs. Move out as far as you are comfortable while maintaining form.
3. Last we want you to target your glutes.
Go through these and see if you can help decrease your knee pain. If not, or these are too painful, you need an expert to help you
If you're having knee pain, here are 3 cues to help alleviate some pain.
1.The first one, is the simplest, SIT DOWN! Compare this to your squat and see how much further back your hips AND knees are.
2. Practice squatting without sitting and focus on keeping your knees back. Do not let your knee come over your toes.
3. Focus on pointing your knees out towards your pinky toes. Do not let your knees come into your big toe. Knees out!
Give these a shot and see how you can improve any lingering knee pain. Questions? Give us a call at 470-355-2106.
In our Bulletproof Your Back Series (follow along on our Instagram page!), we're bringing our clients 4 videos to help them improve back pain. We go through
If you are suffering from a form of low back pain, work your way through these videos and see how you can improve your back pain.
Our July Series on Instagram brought you these 4 videos to help runners improve 4 key areas:
Good luck hitting the road (or Beltline or treadmill!)
As you wander through your bedroom in the early morning, reaching for shelves that seem to shift as you approach, you realize how helpless you are without your eyesight. Instead of walking, you carefully scootch your feet step by step, hands forward like a zombie, into the inky outline of a bathroom door.
Now it may come as a ‘duh’ kind of question, but why would we do this? Why would we modify our behavior to accomplish a goal that could easily have been accomplished much faster and efficiently if we just marched right through the dark towards what we thought was the bathroom?
I’ll allow these gifs to speak for me:
We modified our behavior based on those memories of SLAMMING our toe into that damn table one too many times, just as we modify our behavior when anything incredibly painful happens to us. Remember that time you sprained your ankle when trail running? I’m sure you learned to be more careful with your steps! Remember that time you played volleyball for four hours and woke up like a train rolled over you, backed up, then body slammed you? Sure you do.
You remember. Your body remembers. And, due to these memories, we do our best to make good decisions to avoid these painful problems in the future.
The reason I’m telling you these stories is to paint a picture that our body and mind remember injuries, and that these injuries that may have occurred decades ago are still affecting our bodies today. Don’t believe me about your body remembering injuries? Research shows a good ability to predict osteoarthritis in patients decades before it occurs… the main predictor is if they’ve had a knee surgery or injury.1,2 That osteoarthritis is your body’s ‘bad memory’ of your bad night you messed up that knee. And your mind remembers injuries just fine as well… just think of one of your many injuries and I’m sure it’s as vivid as a firework on the 4th.
Growing from these painful metaphorical and literal memories is a major challenge, and that challenge is met daily with the help of proper physical therapy treatment; to reset your body’s movement and your mind’s pathologically-based control of your body in order to imprint a new patterning system that accommodates your injury. In short: Unlearn old patterns. Build new ones. Grow.
Let’s go through a typical case of how I teach my patients to build these new patterns:
Bob Smithy Jones Fake Name Jr III comes into the clinic with back pain due to paratrooping since he was 5. He’s now 31 and his lumbar spine is comprised mostly of Legos and popcorn. He likes to deadlift small horses and fight yoga instructors to pass the time, but his lower back isn’t letting him do the things he loves. Bob is desperate. He knows he has to live with this spine for the rest of his life and is concerned with what the future holds. After going through a thorough physical movement and manual assessment, I see half a dozen regions that are contributing to Bob’s pain and dysfunction.
His mechanical memories are leaping out at me from each of my assessments, and his compensations are showing me exactly how he has been subconsciously “avoiding stubbing his toe” for decades. His mental memories are evident every time he guards, takes a sharp breath, or shows hesitation when trying a new exercise. The good news is, the more time I spend with him, the more I can help him!
Breaking these movement dysfunctions down, one by one, session by session, into compartmentalized pearls of digestible information for him to relearn movement is the treatment program. Some of these memories need to be processed with manual therapy, stretching, and motor control training. Some of these memories need to be processed with a good dose of strength training. Through time, grit, and trust, these memories no longer have their teeth around the throat of Bob’s aspirations. The “memories” such as osteoarthritis will always be there, but with the dozens and dozens of pearls in his toolbox, he is able to manage and grow into a new version of his old self. He is also better able to step back and contextualize the different types of pain he feels and is less fearful of his future. This is growth.
Our mind is a powerful thing. Our bodies are equally powerful. Each of them twist together into a complex story that many times involves loss, pain, fear, and sadness. As a working clinician, I see this day in and day out, which is why I am so motivated to help my patients’ minds and bodies learn new movement memories they need to better live the lives they deserve. With work, these old movement memories are reprogrammed into a new movement system that can give a fresh capacity to the function of the previously painful and weak movement patterns.
Thanks for reading,
Marcus Rein, PT, DPT, CF-L1
What's up, everyone? Welcome back to another episode of the Active Atlanta Podcast! Today, we are joined by Abby Keenan, co-founder of Intrepid Performance Consulting.
Abby is a mental performance consultant, has a Master's degree in sports psychology from Florida State, and she has worked with some bad-ass people including Special Operations at Fort Bragg, and people who are trying to get better at performance overall. Abby is an amazing person, and I think you will hear it after listening to our conversation today!
Reach out to Abby:
Via website: https://www.intrepidperformance.com/
Via Instagram: @abbyrkeenan & @intrepidperf
What's going on, guys. Doc Danny here with the Active Atlanta Podcast, and I've got Dr. Jake Swart on with me today, who is one of our providers here at Athletes' Potential. Jake's background is in strength & conditioning, PT, overall movement, and, in general, we want to talk about ways that you can help improve how you're moving, how you feel by adding in strength to your training routine, which many people avoid in particular. I see a lot of older people that avoid it, as well as women. I think they're scared to add that into their routines. We dive into Jake's background, taking patients through movement screening, and much more! We appreciate you listening!
Not familiar with Athletes' Potential? Check us out below!
Hey, what's going on? Doc Danny here with the Active Atlanta Podcast and today we I get to introduce you to one of our team members, Claire Fetter. Claire is our office manager/blood flow restriction Ninja, who's been with us for about five years now and what I want to do is be able to highlight just how extensive the backgrounds of people that we work with actually are. Claire is someone that, when we first met, she was actually at a CrossFit gym and she continues to coach at Crossfit 11:24 in Marietta. She has an extensive strength and conditioning background, as well. We wanted to be able to give her a chance to introduce herself so that when you guys come in, if that happens, that you know who you're talking to and you give her the respect she deserves.
What's up, Atlanta? Today's episode features Lily Collins of The Daily Pilates. In 2015, The Daily was created by Lily Collins, a Pilates enthusiast. With a Kinesiology/Exercise Science degree and extensive background in physical therapy and chiropractic care, she has cultivated a more balanced approach to exercise. Her signature workouts are a result of this and years of experience in athletics, dance and fitness, uniquely fusing traditional Pilates with dynamic strength training.
The Daily is a boutique Pilates and High Intensity Interval Training fitness studio located in West Midtown and Inman Park. With a modern, balanced approach to exercise, we offer a variety of science based classes to customize your unique fitness plan. The secret of success is found in our daily routine and we make it our mission to inspire and motivate our clients to practice wellness each day, inside and outside the studio for maximum results.
Reach out to Lily:
Via website: http://www.doitonthedaily.com/
Via Instagram: @thedailypilates & @lilydawson
Dr. Danny and staff's views on performance improvement, injury prevention and sometimes other random thoughts.