Whether you have experienced chronic pain over a long period, sustained an injury, or suffered through an acute pain episode, prevention and recovery from pain and dysfunction require different exercises and protocols for each individual.
The Performance Pyramid was developed initially as a model that we applied to our high-performance athletes, both as a return to sport protocol and for enhancing their athletic performance. After working successfully with thousands of athletes, we quickly realised that the strategic sequence we were applying to athletes would also significantly enhance our outcomes with the ‘general’ population and recreational athletes as well.
“There’s an athlete in every body!”
And now, the Performance Pyramid provides a working framework for every client that comes to the Effortless Superhuman and facilitated the creation of the ‘Effortless Superhuman (ES) Method.’
Helping clients step up the rungs of the ladder carefully during a treatment plan or return to activity protocol has been essential to our success. Whether you’re an elite athlete, weekend warrior or simply enjoy physical activity, satisfying each level of the Performance Pyramid is an essential component of feeling your best, preventing injury, and achieving optimal performance.
“It’s essential to focus on the Foundation Principles of Health!”
Overcoming pain and injury may mean rehabilitating the entire body by focusing on the ‘foundation principles of health‘, clearing ‘pain and dysfunction’ and then specific corrective exercises to progress upwards through the performance pyramid and return to sport or activity.
Shoulder Injury Rehabilitation
Shoulder injuries are very common, and they can sideline an elite athlete’s career as much as they can make activities of daily living difficult and painful for anyone.
The shoulder is a vulnerable part of the body that requires preventive care and proactive treatment to recover from injury. The risk of shoulder pain and injury increases significantly depending on a range of factors and choices made by the individual including the sports or activity they participate in, their job, lifestyle choices, and overall health, chores at home, force trauma, and many other contributing factors.
The main Glenohumeral (shoulder) Joint is a shallow ball and socket joint that allows almost 360 degrees of movement. However, with this ‘freedom’ of movement comes an inherent risk of injury. The glenohumeral joint (GHJ) requires help from surrounding ligaments, the joint capsule, and muscles to create stability and protect it from injury. If you present with pain or dysfunction in the region of the shoulder, your Effortless Superhuman ‘pain and dysfunction’ practitioner will follow the ‘Effortless Superhuman (ES) Method’ to help determine the contributing factors and outline the best treatment strategies.
Common Shoulder Challenges
- Rotator Cuff Strain – Common in athletes who do a lot of over-head shoulder movements.
- Shoulder Instability – When the shoulder joint is dislocated, or ligaments are stretched causing instability.
- AC joint – AC joint injuries are widespread in AFL football and tend to occur from impact, such as a fall onto the shoulder.
- Referred Pain – Pain or tightness from the jaw, neck, middle back, lower back, hips.
- Shoulder Stiffness
Finding the source of your shoulder complaint requires a detailed ‘whole-body’ assessment that considers the health of your nervous system, the range of movement at every joint in your body – from the tip of your toes right up to your jaw, and the length of all your muscles. Your shoulder is a part of the integrated movement system and relies on the complete health of all structures and systems of the body.
Dem Bones:
- Toe bone connected to the foot bone
- Foot bone connected to the heel bone
- Heel bone connected to the ankle bone
- Ankle bone connected to the shin bone
- Shin bone connected to the knee bone
- Knee bone connected to the thigh bone
- Thigh bone connected to the hip bone
- Hip bone connected to the back bone
- Back bone connected to the shoulder bone
- Shoulder bone connected to the neck bone
- Neck bone connected to the head bone
The vast majority of shoulder complaints respond super well to conservative treatments such as postural changes, improved breathing patterns, mobilisation of the spinal column, sports massage, acupuncture, and corrective exercises. Although a small percentage may require surgical intervention or other more invasive treatments.
Once the ‘Health’ and ‘Pain and Dysfunction’ levels of the pyramid are satisfied, the next step is to take a solid look at mobility and flexibility as well as stability. As we stated earlier, the shoulder is a highly mobile joint and while this is a great thing, it also causes problems when movement takes place at the expense of stability.
There are countless exercises available that can help improve and maintain shoulder health and can be used in a shoulder injury recovery program. When you experience shoulder pain or dysfunction, the muscles around the shoulder can change, which can affect your strength, flexibility, and internal control.
“If you’re not assessing, you’re guessing!”
Which corrective exercises you want to use will depend on the results of a comprehensive, functional movement screen. Effortless Superhuman offers a world-class ‘Athletic Screen’ that provides our practitioners with an individualised risk profile report for each client. From here, the practitioners can provide precise corrective exercises to enhance the functional movement patterns of each client, leading to strong, stable joints and reduced injury risk. How fantastic is that!
The sport(s) or activities you participate in, along with the physical demands of your job will all have an impact on the type of rehabilitation program that is created for you. Our world-class athletic screen is powered by the Move2Perform software which allows for individualised assessments and reporting. This software is so powerful that it allows us to compare your results to other participants based on age, gender, activity, sport, level or intensity of participation, and even specific occupations such as firefighter, policeman, or military.
This only makes sense since the physical demands of a 56-year-old female recreational tennis player will be different from those of a 27-year-old male rock climber or a 42-year-old female firefighter.
It only makes sense to test appropriately, gain measurable outcomes (objective measures), design an individualised shoulder recovery program, and then retest to ensure the program is achieving the desired outcomes – that is, a body that can meet the physical demands of its sport or activity level.
Examples
Imagine a 35-year-old male who plays recreational tennis. His Athletic Screen reveals that he has instability in the core, left hip and through the left leg, which is clear when he performs the lower quarter Y-Balance Test. Relative to the other side, his left leg scores very poorly. As a result of this imbalance, he has a tendency to over-swing the tennis racquet with his right arm leading to shoulder pain. In this instance, treating and rehabilitating the right shoulder is only a small part of the overall solution.
Imagine a 26-year-old female competitive swimmer. She has had repeated left shoulder injuries and required extensive treatment and rehabilitation. During this pain episode, her pain and dysfunction practitioner treats her whole body allowing her to become ‘clinically clear’ (pain-free and dysfunction-free).
Her functional Athletic Screen reveals that she has chronically tight hamstrings, a weak core and that the left shoulder is under-performing in all directions on the upper quarter Y-Balance Test. When her results are compared to other 26-year-old, female swimmers, she scores ‘below’, meaning she is in the bottom 60% and has a ‘substantial’ injury risk (61% chance of re-injury within the next six (6) months of training and competition).
From this example, it’s obvious to see that clinically clear and functionally clear are not the same thing. And that a well-designed rehabilitation program will focus on the key functional weaknesses evident from her Athletic Screen. Retesting these key objective measures will prove that the program is working and highlight when it is safe to return to sport.
Ankle Sprain Rehabilitation
Ankle sprains are common injuries that require a physical rehabilitation exercise program to ensure that the ankle heals completely and reinjury does not occur. Researchers have identified that a history of sprained ankles predisposes subjects to a stiff ankle joint and an array of other related injuries including foot pain, calf and leg injuries, plus back pain.
Most ankle injuries occur during high-speed activities or exercises where enormous forces are placed on the ankle joint and adjacent structures. Your pain and dysfunction practitioner should perform a thorough ‘whole-body’ assessment to determine all of the pain-sensitive structures along with finding any dysfunctions that may be present in your upper or lower body. A detailed examination of your sprained ankle will help to determine the severity of the injury.
| DO’S | DONT’S |
| Follow the Foundation Principles of Health | Do not use NSAIDS |
| Consider natural healing remedies such as curcumin, alpha lipoic acid, resveratrol. | Do not strap the ankle |
| Consider daily use of a contrast bath | Do not limp around on the ball of your foot |
| Seek treatment from a skilled practitioner, even for what may be considered a ‘minor’ ankle sprain. | Do not drink alcohol, coffee or sugary drinks |
| Receive a whole-body scan, including assessment of your nervous system. Focusing on the ankle alone delays healing and increases your risk for future reoccurrences. | Do not try to rehabilitate the ankle yourself, even a minor ankle sprain. Seek guidance from a skilled practitioner. |
| Once your practitioner determines you are ‘clinically clear’, continue through to a functional risk assessment. | Do not think that because you are pain-free and have full movement in the ankle, that you’re ready to return to sport or activity. |
The treatment protocol used at the ‘Pain and Dysfunction’ level of the Performance Pyramid will vary depending on the findings of your whole-body assessment. Certainly alleviating swelling and pain while restoring movement to the ankle joint is an important part of the treatment plan. However, the protocol used to achieve these goals will likely vary from client to client.
- Neuro-dynamic testing is used to assess the health of your nervous system and various treatment techniques can be used to restore balance
- Various mobilisation techniques to the foot, ankle, knee, and hip can be used
- Mobilization and adjustments to the spinal column can be used to restore balance (Cervical spine, thoracic spine, and lumbar spine).
- Soft tissue treatments can be used effectively to local tissues and even tissues located well away from the injured ankle – soft tissues in the foot, lower leg, upper leg, hip region, and all along the spinal column.
Although restoring balance to the ankle joint and promoting healing is an important part of treatment, it’s important to remember that preventing a reoccurrence in the future is also dependent on restoring balance at all the other major joints of the body as well – Neck, shoulders, spinal column, hips, knees, and feet.
Clinically Clear = Pain-free and dysfunction-free.
Once the treating practitioner is confident that they have cleared the ‘pain and dysfunction’ level of the pyramid, the next step in the process is to perform a functional risk assessment. It’s so important to understand that clinically clear and functionally clear are not the same thing.
Clinically Clear ? Functionally Clear
Although you may be pain-free, have full movement back in the ankle joint, restored balance (proprioception) on the affected side, and can hop for 30 seconds on the injured side, it does not mean you’re ready to return to sport or activity. What is required at this stage is a comprehensive, scientifically-proven, functional risk assessment.
The Effortless Superhuman Athletic Screen offers just that!
- Functional Movement Screen®
- Lower Quarter Y-Balance Test (YBT)
- Upper Quarter Y-Balance Test (YBT)
- Ankle Dorsiflexion (Degrees and centimetres)
- 5 x functional hop tests
- Where required, advanced sport-specific field testing
The exercises that your pain and dysfunction practitioner prescribes will be based firmly on the objective measures obtained from this functional risk profile. And of course, repeat testing will prove that the exercise protocol (plan) has been effective in achieving its desired outcomes. In part two we cover the hamstring, hip flexor, and knee joint.
To book an appointment with a Effortless Superhuman ‘Pain and Dysfunction’ practitioner contact us or give us a call on (08) 9388 2768 today.
