Dynamic Movement Strategies for the Shoulders, Arms & Hands

Dynamic Movement Strategies for the
Shoulders, Arms & Hands

Understanding Relationships & Functionalizing Exercise

Course Description

In this fun and interactive movement course, we will observe, analyze and participate in movement based exercises while learning new treatment strategies designed for immediate clinical application. This course will focus primarily on scapulo-thoracic coordination with, and influences upon, the arm and hand. The hands are at the end of a long line of support systems that we can liken to a crane—a strong but moveable base, various vulnerable pivot points/levers and a point of interaction with the environment. We will explore both experientially and intellectually how the slinky-like rib cage and thoracic spine constitute a mobile and flexible base from which the arms can move. Thoracic integration, scapular control and muscle coordination will feature prominently—rib cage mobility, dynamic scapular stability, synergistic muscle regulation and antagonist balance are emphasized over static scapular stabilization or individual muscle strengthening. Informational movement sequences are built around functional contexts of reaching, grasping, manipulating, pushing, pulling and holding—connecting the dots between exercise and ADLs is imperative for long lasting results. Come and experience this fresh approach to optimizing movement that introduces ways of making the exercises we prescribe more informative, more functional and much more effective.

Course Objectives

By the completion of this course, the participant will be able to:

• Define Regional Interdependence & Specificity Principle
• Identify long-term habitual movement and postural mistakes and correlate to GH bursitis, tendinosis, impingements/instabilities, frozen shoulder, tennis/golfer’s elbow, forearm myofascial syndromes, carpal tunnel, various UE fractures, DeQ and more
• List three primary differences between Static Integration & Dynamic Integration exercise
• Define the difference between Global & Differentiated movement or postural patterns—list two examples of each in the arm and shoulder girdles
• List three principles of Optimal Movement and give examples of common shoulder and upper extremity clinical presentations resulting from sub-optimal movement
• Explain the benefits of informational exercise strategies—use of constraints, change of venue, reciprocating movements, goldilocks principle and link to functional context

Course Outline

Lab sessions include experiential movement, partner observations, facilitation techniques, modifications & discussion of clinical relevance.

Day 1

7:45-8:00—Registration and Snacks

8:00-9:45—Introduction to Integrated Movement

• Comparing Dynamic & Static Integration Movement Principles
• Language of Integrated Movement: Global & Differentiated Relationships
• Course Overview/Themes: Common UE Traumatic & Repetitive Stress Injuries

10:00-12:00—Lab I: Effort Minimization, Hand Differentiations & Diagonals

• Floppy Hands & Ladies’ Hands: Recognition & Control of Unnecessary Effort
• Wrist/Finger Differentiations & Encouraging Tenodesis
• Forearm, Elbow & Wrist Issues: Balancing Antagonists & Minimizing Co-Contractions

1:00-3:05—Lab II: Scapulo-Thoracic Relationships I—Anchoring the Arm in Abduction

• Thoracic Diagonals: Extension with Posterior Tilt & Flexion with Anterior Tilt
• Shoulder Girdle Diagonals & Force Couples: Balancing & Mobilizing UE Support
• Reciprocating Differentiated Movements: Balancing & Re-Calibrating Antagonists

3:20-5:30—Lab III: Scapulo-Thoracic Relationships II—Anchoring the Arm in Flexion

• Orienting the Glenoid: Scapular Integration vs Scapular Stabilization
• The Grand Coalition of the Arm: Thoraco-Scapular-GH Relationships
• Controlling Impingements & Training the Rotator Cuff: Coordinating Synergists

Day 2

8:00-9:45—Lab IV: Upper Extremity Differentiations—SG/GH & GH/Forearm

• Differentiating Humeral & Forearm Rotation: Functional Relevance & Pattern Specificity
• Linking Exercise to Functional Context: Use of Object Facilitators
• Maintaining SG Posterior Tilt/Depression with GH Internal Rotation

10:00-12:00—Lab V: Other Directions—Reaching Behind Back, Overhead & Across

• Exercise Progressions: Building On Previous Learning & Extrapolation to ADL’s
• Limbs Moving as Extension of Dynamic Torso: Appropriate Distribution of Movement
• Change of Venue Variations: Facilitating Patient Pattern Recognition & Problem-Solving

1:00-3:05—Lab VI: Closed Kinetic Chain Variations

• Reversing Origin & Insertion: Bypassing Habitual Muscle Activation Patterns
• Mobilization or Stabilization: Taking a Patient-Centered & Individualized Approach
• De-Coupling Serratus Anterior from Abdominals & Anterior Intercostals

3:20-5:30—Lab VII: Resistance & Endurance

• Putting it All Together: Integrative Drills, Toys & Yoga Derivatives
• Review Objectives, Questions & Wrap Up