This is the Hawkin&;s kennedy test – it&;s an orthopaedic test designed to be coupled with a few other tests in order to test for subacromial impingement – often coupled with the painful arc and an infraspinatus test.To try this – keep the upper arm parallel to the floor, and rotate the forearm inwards towards the ground, you can do this at various angles as you move the arm across the body.Either try this yourself or have someone try this on you. If it hurts you may have some sub-acromial impingement! Ask yourself: Do I do a lot of repetitive overhead movements?Does it hurt when I throw right in the front point of the shoulder?Do I avoid certain movements because it hurts or feels awkward?Do I favor one side over the other because of this?Book an assessment with a professional as there are plenty of factors that can contribute to this. To name a few: Weak rotator cuff musclesTight rotator cuff musclesImproper glenohumeral rhythmPoor movement patternsThoracic spine limitationsSICK scapula

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@dr_nhan (@get_repost)・・・Shoulder Impingement Syndrome (aka Subacromial Impingment): one of the most common conditions I see that result in shoulder pain. Most patients will complain of pain near the front or side of the shoulder with very particular arm movements, usually involving flexion and/or abduction of the glenohumeral joint along with certain degrees of internal and external rotation. Some may experience referral pain on the side of the arm or even down near the elbow, thinking it&;s elbow pain.Anatomically, when the arm is lifted into these painful ranges, the structures between the humerus and acromion (what we call the subacromial space) have the potential to get pinched. These structures may include the supraspinatus tendon, biceps tendon, subacromial bursa, and subscapularis tendon. The reason this pinch occurs is most commonly due to less than optimal biomechanical movement – the most common being scapular instability, scapular dyskinesis, and poor rotator cuff engagement or sequencing. Hence, if you attempt to move the shoulder without proper shoulder stability or muscle firing patterns, the humerus can ride up too close to the acromion which causes the structures in the subacromial space to pinch underneath the acromion. Thus, to mend these issues one must train the muscles that stabilize the scapula and the rotator cuffs muscles to function appropriately. My shoulder protocol of choice for these cases involve training the serratus anterior with high plank protractions, rhomboids with rows, subscapularis with internal rotations, infraspinatus and teres minor with external rotations, and posterior deltoid with horizontal abductions. You can refer to the last four exercise videos on this page for demos on variations of these exercises. This protocol is also a great prehab warm up routine that I personally use before my upper body days in the gym, which can help PREVENT shoulder impingement from even occurring. Feel the gains to prevent the pain

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[Finger anatomy series 3/3] 3.The Proximal Interphalangeal joint or PIPNow that you know about the flexor tendons, the function of the pulleys and where they tend to pull, you should be able to guess why the PIP joint is so important!The PIP is the main joint that dictates the forces along the pulleys due to the position and angle of pull from the forces of the tendons.Demonstrated here is more of a hanging grip or an open handed grip. The angle of the PIP in this image is quite large and thus the resultant forces on the pulleys is minimal !! The SMALLER angle in the PIP = GREATER forces on the pulleys! Take this into consideration when thinking about how you grip your holds! I&;ll demonstrate with some more pictures in the following posts!

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[Finger anatomy series 2/3] 2. Annular Pulleys These puppies prevent your finger from doing something known as bowstringing. These pulleys are fibrous bands that are used to maintain the contact of the finger tendon along the bone. What they do is transmit the force of the tendon into different angles of pull. Without them our hands wouldn&;t function very well and would look very weird. Bowstringing occurs when there has been a COMPLETE pulley rupture. With climbing the A2, A4 and A3 are most commonly injured!A2 is the largest of them all and attaches directly to bone. This one takes the brunt of the work when we go to climb or crimp!A3 attaches to whats known as the volar plate – it doesn&;t really attach directly to the bone! This is super super important when ADOLESCENTS or younger adults are climbing as an injury here can PERMANENTLY affect a GROWTH PLATE! It can potentially cause dramatic issues for their future. A rule of is if an adolescent complains of finger injury – SEEK PROFESSIONAL HELP. A4 attaches to the bone directly as well closer to the finger tip and is much smaller than the A2. How can you use this to help? Put less strain on your pulleys! Warm up with progressive bodyweight when crimping. Slow and steady wins the race. Feel free and content with any questions or concerns but up next is the PIP and how to crimp safer and stronger!

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1. Flexor tendonsThe flexor tendons in the fingers occur because the muscles of the forearms become tendons as they enter the carpel tunnel into the hand.As you can see from the first image we have a bunch of other muscles of the forearm that affect motion of the hand and wrist. Well ignore those for now! First up is the Flexor digitorum superficialis or FDS. Swipe ️ and see it visualized again with its interaction with its deeper counterpart. The Flexor digitorum profundus or FDP is the deeper muscle that extends to the finger tip and helps us with flexing the entire fingerFDS is a tendon that splits into a V to allow the deeper FDP to run between it right to the tip! It inserts into the middle phalanx and flexes primarily the PIP joint. The design of these two tendons contribute to why we have such fine motor control at our fingers but it&;d be a shame if these tendons didn&;t have anything strong to hold them down! Next up. Pulleys.

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Swipe ️ to see all the climbing grip types. Climbers use their hands in a multitude of ways. This series of will demonstrate the various positions of climbing and grip types.Back to basics. Different hold positions.full crimphalf crimpopen crimppocketnarrow pinchfat pinchopen handPay attention to the positions of each grip and think about the angles between the MIDDLE knuckle in each hold type. This joint is the Proximal Interphalangeal joint or the PIP for short. Notice how the finger position in the pocket is very similar to a half crimp position? Sometimes even the open crimp/open hand position! Only on fewer fingers. The pinch grips are the SAME as the open grip position! Some of you advanced or pro climbers say Dr. Jon! That ain&;t all of them!… Well then here&;s a more exhaustive list but they all use the same concepts as above! What about slopers?Slopers use an open hand grip type to ensure maximum surface area contact for a friction based gripWhat about underclings? a jug hold with open hand/ half crimp grip stylesWhat of a Gaston? This along with the mantle is more of a pushing grip instead of pulling. Gaston is often in a half grip positionMantle is a open hand max surface area friction moveThe absolute best grip in terms of climbing longevity and strain on the fingers hand and pulleys is the OPEN HAND grip type. Remember this. Think about why it may be the case! My next post will showcase some of the anatomy of the finger focusing mainly on the pulleys! Stay tuned.

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A to improving your climbing is to work on your weaknesses. These movements target two of my greatest weaknesses: . thoracic spine extensionshoulder extensionHere are 2 great openers I&;ve been working on:The first one targets more thoracic extension as I limit the motion into my shoulders by bringing them in closer to the wall. Simply stick your butt out further as you sink your body down and take 5 diaphragmatic breaths and bring your chest / face towards the wall. You can target specific vertebra segments depending on how far you stick your butt outSwipe ️ for a modification for targeting more of the shoulders and through the lats. This time try and bring your chest down at a 45 degree angle towards the ground in front of you. . Try these as part of your mobility work before climbing, handstanding or before calisthenics!

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A Winging scapula is a result of weakness of the Serratus Anterior muscle or damage to the long thoracic nerve which supplies this muscle. The result is a protruding shoulder blade into the back.Test yourself – While wearing a tank top:Put yourself in a pushup position against the wallLean forward into your handsAsk somebody to take a picture for you.Do you notice a bump on one side versus the other?If you don&;t have a friend – go into the washroom and take a look at your shoulder heights.Do you notice one shoulder significantly lower than the other?If you do. You have scapular winging. This can affect your ability to lift, pull, or push objects. The reason is because scapular winging is a muscular imbalance which results in malpositioning of the shoulder blade. This disrupts the Scapulohumeral rhythm – which is the optimal ratio of movement when you lift your arm from your side above your head. If this is a result from a long thoracic nn entrapment Active Release Therapy or ART can definitely help with this nervous entrapment. Proper positioning and movement of the scapula is critical for full and normal shoulder range of motion. Without it, your scapular is SICK! (Scapular malposition, Inferior medial border prominence, Coracoid pain and malposition, and dysKinesis of scapular movement) SICK scapula or scapular dyskinesis refers to an injury resulting from overuse and fatigue of the muscles that stabilize and provide motion for the scapula.To counteract it we want to:. Treat the underlying soft tissue adhesionsStrengthen the affected musclesGrease the groove and provide stimuli to maintain the positioning and movement of the scapula

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