Q&A with a Physical Therapist

Hey Ya’all!  Like I promised, I will begin having a monthly Q&A with professionals who can teach us more about personal training.  Today I interviewed Travis Retzer PT, DPT from Loma Linda university. He is going to teach us about common injuries and how to address them with our clientele.  Listen up!!!

What is a shoulder impingement and are there any contraindications for our clients if they have this condition?
Shoulder impingement is a pinching of the rotator cuff between the greater tuberosity of the humerus and the acromion.  The typical exercises/activities to avoid are overhead movements with the shoulder internally rotated (“lead with the thumb” is what we tell our patients ).  Typically, strengthening programs are geared for rotator cuff isotonic exercises with the elbow at the side.  Scapular depressor strengthening is also important.  The thing we have to teach the most is postural awareness/education (keeping the shoulders back, sitting/standing up tall, etc.)

Are there any general exercises that you recommend having clients avoid because of a higher likelihood of injury, such as a full ROM knee extension, depth squats or shoulder press?
As far as general exercises to avoid… Anyone with a history of knee injury should avoid open chain knee extension due to the force vectors it places on the backside of the patella.  Caution should be taken with squats of any depth (not allowing the knee to extend beyond the toes).   Upper body exercises are tougher to break down… Basically it all comes down to the mechanics being used with an exercise.  We as therapists can be super picky with proper form!  Pull downs behind the head should be avoided, shoulder press behind the head should also be avoided; they put too much stress on the shoulder, especially with heavier weights.

What would be some helpful pointers for a client that has a mild to moderate injury, without over stepping our boundaries as a personal trainer?
As for the question of anyone with a mild to moderate injury… I would recommend having themselves checked out by a physician, either a GP or an orthopedist, to make sure they are a good candidate for a cardio, weights, or combo program.  A lot of people think that the typical aches and pains are a part of life… There may be some truth to it, but it is a good idea to get it looked at by a diagnostician that is trained in making the appropriate referral for them.  Typically, the earlier you address an injury, the quicker the recovery/rehab.  Unfortunately there isn’t enough communication out there, but good advice is: when in doubt, ask!  If you’re unsure of something, hold off on showing a client a new exercise and ask their therapist.

Thanks Travis!  Until next time, keep Showing Up and Shake and Bake!