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Shoulder Pain?

September 9, 2011

At some point in your life, you will likely will run into some type of shoulder pain.  The most common diagnoses of shoulder pain in the general population are tendonitis, bursitis, and impingement as a result of overuse.  Physical therapists are trained to assess the patient’s condition and treat the cause of the dysfunction, not just the symptoms.  Shoulder pain can be caused by muscle imbalance, abnormal movement of the scapula (shoulder blade) and shoulder joint, hypermobility of the shoulder joint, hypomobility of part of the shoulder joint, to name just a few.

You might be wondering, what does shoulder pain have to do with core exercises?  Quick anatomy review:  your shoulder blade is connected to your spine and your arm by several muscles.  In order for your arm to move freely and not rub against the undersurface of the acromion (part of your shoulder blade), those muscles need to operate in a specific rhythm.  If the group of muscles that connect the shoulder blade to the spine are weak and stretched out, this can result in a forward shoulder posture which can adversely affect the rhythm and movement of the entire shoulder complex.

I’ve mentioned before, you must have Stability before you have Mobility.  The stability in the shoulder comes from the scapula and all the muscles that attach to it.  There are numerous core exercises that require adequate scapular stability in order to perform correctly.  Some of them would be inappropriate for people with current shoulder pain.  The old adage, “no pain, no gain”, does not apply to shoulder injuries (90% of the time).  If it hurts every time you reach up, or throw, or swing at a ball, I would recommend taking a break, and scheduling an appointment with a physical therapist right away.  There are specific “rehab” exercises that you need to do.

For those of us who are looking to prevent shoulder pain, here are a few core exercises that require scapular stabilization and strength from the rotator cuff.


Plank on SB with Movement I, p. 36

Plank on SB with Marching II, p. 56

Prone Walkout with Pike, p.60

Plank with 1-arm DB Row, p.69


Longevity and Strength

August 16, 2011

Prevention. A nearly impossible sell to insurance companies, a hard sell to the general public… so how about athletes? In college we lifted weights and did plyometrics to jump higher, move faster, and hit harder. I never once heard, “We’re doing this exercise to limit your risk of a knee injury.” Hopefully, college teams today are acknowledging what research has shown us, and are working with their athletes to prevent injuries that can change their athletic careers forever. And for the rest of us, times a tickin’, time to get your butt in gear- literally!

I am referencing research which demonstrated that weakness in specific core muscles are risk factors for lower extremity injuries including traumatic ACL tears, knee pain, ITBand friction syndrome, and stress fractures. It just so happens that several of those muscles are located in your butt. Specifically, hip abduction (lifting your leg to the side), hip external rotation (rotating your knee away from your body), hip and trunk extension (lifting leg behind, and backward bending), and abdominal strength.

The workout for this issue will consist of exercises that will mirror the same strength tests that were used in this research. Everyone knows you can play beach volleyball into your 40’s (or is that something I like to tell myself?!). Knee injuries happen at any age, so I would suggest starting these exercises today!

Good luck and Be Well!

Ball Combo #1, p. 69
Side plank with leg lift, p. 63
Knee to Chest Crunches, p. 74
Side step with RB or Sumo Squat with Leg Lift, p. 83

Who is Your Physical Therapist?

June 1, 2011

Most of us have a doctor, we have a dentist, we likely have a hairstylist- the people in our lives who take care of us.   So, who is your Physical Therapist?

Did you know, more than 1 in 4 Americans has a musculoskeletal condition requiring medical attention.  “Musculoskeletal conditions are the most common cause of long-term pain and physical disability” (Akesson, K.,K.E. Dreinhofer, et al. (2003) “Improved education in musculoskeletal conditions is necessary for all doctors.” Bull World Health Organ 81 (9): 677-83.)

So, who should be the first provider for evaluation of these musculoskeletal conditions?  Let’s consider a few more statistics before we answer that.

In 1998, Freedman and Bernstein found that 82% of medical school graduates FAILED a 25 question competency examination in musculoskeletal medicine. Among the 85 graduates tested, the average time spent in rotations or courses devoted to orthopedics in medical school was 2.1 weeks! One third of these examinees graduates WITHOUT ANY formal training in orthopedics.

Physical therapists evaluate, diagnose, and treat the musculoskeletal system.  Therapists who graduate from an accredited physical therapy program today receive a Doctorate of Physical Therapy.  Each state has a  licensing board who upholds strict standards of practice for all PTs.

We are movement specialists.  Rehabilitation and Wellness.

So, Who is YOUR Physical Therapist?


Swen-Marie Germann, MPT

Phenomenal Rehabilitation, Wayzata; 952-476-0224

Humbled by Yoga… again.

April 21, 2011

If ever I need a reminder that the physique I see in the mirror isn’t as strong as it looks, I go to Yoga.  That’s what I did today, and it didn’t let me down.

I am by no means, a yogi.  To which I realize that if I attended more classes, I may actually get better at this!  However, I seem to think that I’m just strong enough to get through an hour of sun salutations, downward dogs, planks, twists, etc. etc.  Today, I’m pretty sure I collapsed out of poses or made modifications faster than most others in attendance.  I’ll give myself a little credit for sticking it out for the entire hour (as there were a few who quietly exited before our final “ooooommmmm…”).

I’ve decided that the combination of holding a pose in a stretched position, a general lack of flexibility, and my minimal to moderate muscular endurance are the main reasons for my difficulty with Yoga.  Or maybe its because I’m not breathing as loudly as the woman next to me.   Actually I’d say there was more moaning in this class than breathing, but either way.

So how do I feel now?  Glad I did it, but would like to go back to the gym for some 10 rep lifts 😉

Skinny Fat

April 18, 2011

Have you heard the term before?

I hadn’t either until I ran across a blog where a woman was using that term to describe herself and a resounding “ding” went off in my head prompting me to the awareness of my own “skinny fat”. No lie. I have it. So does my dog!  No one around me really noticed. It’s been easy to hide in baggier tops to lessen the look of shelf forming on my butt. Most don’t notice, which in and of itself lends damage to the skinny fat phenomona. No one knows. No one cares. Except, I NOTICE and I CARE! This is not my body and not my size. Does that make sense?

Skinny Fat is a term used for someone who is lean in stature & build but as slipped off the wagon a time or two or seventy seven hundred times.. It’s having a good metabolism, which used to be great and not knowing that the same entertaining food can no longer be consumed at the rate it was before. It’s realizing that exercise is a must. It’s something no one wants to talk about because people who don’t suffer from it and have their own weight issues kind of hate you for even caring about the extra pounds… but it all starts somewhere and I need to be open about it.

My moment of truth (AGAIN) was twofold. A) Skinny Fat blog article  B) Getting on the scale

I really tried to make a go of getting healthy last year around this time, but I failed and let intoxicating ways just take the reigns of control. It wasn’t doing any harm to anyone else and the skinny fat was creeping on so slowly that I barely noticed it was there until my jeans were failing to fit me the way they used to. Conversations in my head of “did I just wash these” to “aren’t these supposed to be my ‘fat’ pants” were becoming all too common. I had to get on the scale and I had to see myself in the mirror truthfully again. This required the ‘turnaround’. You know the one…. turn around and look at your butt in the mirror. See, because I don’t really gain weight anywhere EXCEPT my badonkadonk and my thunderous thighs. Seriously could hear the rumble when in close proximity to me.

This was 2 weeks ago. The knowledge. The need to change. Again.

Since then, I’ve managed to lose several of the pounds gathered (a whopping 10 pounds total needed to lose) by taking back my food to healthy human proportions. Like, a turkey carving tray is not a proper dinner plate, or an amount that could fit on it. Just sayin.. Working into a workout routine, which thank GOD ABSolution is easy to use and shows quick results. Like I feel it. Now.

Do you have skinny fat? Can all the skinny girls who have lost their 6 packs into 4 packs of fat please stand up and wave your arms? Um, thanks! I don’t feel alone anymore.

Top 10: Do This, Not That.

February 18, 2011

Time is money.  Or time is of the essence.  Or time keeps on ticking, ticking, ticking…  Whatever your interpretation of time, time at the gym should be well Spent.  I’m all about making the most of every minute I have at the gym, and you should be too.  So, without wasting anymore of your time, here is my top 10 Do This, Not That list for the gym.

10.  Ask a personal trainer/physical therapist for a consultation DON’T go it alone and see what happens.

9.  Planks Not Sit-ups.

8.  Functional, multi-joint/muscle exercises (ie. Reverse lunge with medicine ball lift and reach) NOT single joint/muscle exercises (ie. machine preacher curls).

7.  Oblique crunches NOT  Spine Twists, seated or otherwise- your back will thank me.

6.  Squats or lunges NOT leg extension machine- my knees hurt just thinking about it- ouch!@#$

5.  Circuit training NOT Multiple sets (with extended rest breaks) training.

4.  Full-body strength training NOT body-part training (unless you plan to be the next Mr./Ms. Olympia)

3.  Exercises that are appropriate for Your ability level NOT exercises that will prevent you from walking up stairs tomorrow or lifting your arms overhead.

2.  Free weights NOT machines-unless you are injured, then we can talk 😉

1.  Something you Enjoy NOT something you Hate.

Be Well!!


Fit Resolve?

January 3, 2011

Huge numbers of well-intentioned people are flocking to gyms across the country right now.   Parking lots will be jammed, equipment in-use, classes full, and lockers in short supply.  Resolutions have a powerful impact, at least for the next 3 months.

My challenge for you in 2011, map out your fitness plan for the entire year.  This doesn’t mean that you need to write down every day that you plan on going to the gym.  Take a look at each month- what will your general fitness plan look like?  For example: January- Gym (3 days/week): build baseline cardio, core strength.

February- Gym (3-4 days/week): continue cardio, try a fitness class.

March- Gym (3-4 days/week): Cardio, Try Bootcamp class

April- Start running outside, first 5K on 4/26/11.

May- Run outside 2x/week, Play tennis 2x/week.

June- Run first 1/2 marathon on 6/5/11.

You get the idea?  Make it a General Fitness Map of 2011.  Keep it in a place that you won’t forget and check it each month.  Make revisions as needed.  Best practice would also be to include a “goal” for each month.  However, if that is too overwhelming, just try to stick to your plan.

As everyone knows, optimum health and wellness is not achieved in 3 months.  Fitness is a lifestyle.  Plan activities that you enjoy throughout the year, and you will achieve real fitness results.

To Your Health!!


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