what team open baseball the first 60 years?. how many president threw out the first pitch? who was...
TRANSCRIPT
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What team open baseball the first 60 years?
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How many president threw out the first pitch? Who was the first?
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Eleven - Taft
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What did Truman do differently?
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First Southpaw
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Opening day Snow Fight• Unfortunately, Opening Day has also been marred by riots and civil disobedience.
• At the start of the 1907 season, the New York Giants opened against the Phillies following a heavy snowstorm.
• In preparation for the game, groundskeepers were forced to shovel large drifts of snow onto the outer edges of the field in foul territory.
• • After falling behind 3-0, the disappointed fans at the Polo Grounds began hurling
snowballs onto the playing field, disrupting play.
• As the melee progressed, chaos ensued and fans began rushing onto the field to continue the snowball fight.
• After being pelted, Home plate umpire Bill Klem had enough and called a forfeit in favor of the Phillies.
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Rehabilitation of Shoulder Instability
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• Ligamentous/capsular laxity (non-contractile)
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Treatment strategies
• Bracing• Taping• Muscle strengthening• Proprioceptive/kinesthetic training• Neuromuscular dynamic stability
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• Posterior instability response better than anterior instability
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Scapulothoracic Exercises4 Core Exercises (Mosley)
• 1. Scaption with the thumb up for the upper trapezius
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Scaption
• (abduction in the scapular plane of 30-45 degrees forward in the horizontal plane) or flexion;
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2. Press up for the lower trapes, latissimus doris and teres minor
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3. Push up with a plus for the serratus anterior
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4. Scapular Retraction for the Middle Trapezius and Rhomboids
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Glenohumeral ExercisesTownsend 4 Core Exercises
• 1. Scaption with the thumb down (up) empty can or full can for the supraspinatus
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2. Press ups for the lower trapezius, latissimus dorsi and teres major
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3. GH flexion for the anterior deltoid and the coracobrachialis
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4. External Rotation with horizontal extension for the infraspinatus, teres minor, and posterior
deltoid
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Rotator Cuff Exercises (30/30/30 Position)
• 30 degrees of abduction• 30 degrees of scaption• 30 degrees of diagonal tilt
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30 degrees of abduction
• Used to protect the rotator cuff and prevent wringing out effect on the supraspinatus tendon
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Second 30 degree position places the arm into scaption
• Protects the anterior inferior capsule• Prestretches the posterior rotatator cuff
muscles• External rotation muscles are the weakest of
the 6 directions of the GH joint
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30 degree diagonal tilt
• Prevents a posterior internal impingement and is more comfortable than the transverse plane position when performing GH rotation exercises
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• Studies show that adducting muscle activity will increase the space of the subacromial space
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Summary reason to use the 30/30/30
• Prevents the wringing out effect• Scaption position protects the anterior
inferior capsule• The scaption position is a functional arc of
motion for the shoulder• Comfortable positions to do ER/IR exercises• GH adduction increases the width of the
subacromium space
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• Advance the patient to the 90/90 position to advance the rotator cuff strengthening program if the patient need to use the arm in overhead activities
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Total Arm Strengthening Exercises (TAS)
• Biceps and triceps cross the GH joint can contribute to dynamic stability of the GH joint
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Exercise Progression Continuum
• Multiple-angle isometrics submaximal effort• Multiple-angle isometrics maximal effort• Short arc exercises submaximum effort• Short arc exercises maximum effort• Full ROM exercises submaximum effort• Full ROM exercises maximum effort
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Cross Education Training?
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10-15% increase in strength on the contralateral side
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Bilateral deficits?
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Total strength is less than sum of each individually
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Systematic Variable Range Repetition
E2C
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E2C
Eccentric to concentric
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Deceleration and acceleration impulses create more muscle tension
Increasing progressive ranging exercises the intensity of exercises is
increased at the additional angle
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Progressive Range of Motion
Protects the soft tissue healing structures
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As heal add more ROM
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Time rate of force development
Ability to develop force rapidly (FT fibers)
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Contra-Coup Concept of shoulder stability
(C3-S2)
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Common Thought
• ER most important and the subscapularis for anterior instability
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Contra-Coup Concept
• Subscapularis contraction cause anterior translocation of the humeral head
• Infraspinatus contracture causes posterior translation of the humeral head
• Use GH: IR:ER is 3:2 or ratio 100%:66%
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Neuromuscular Proprioceptive/Kinesthetic Deficits (Functional Neuromuscular Dynamic
Stability
Functional Stability is dependent on neuromuscular dynamic control
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Stage 1: Proprioception and Kinesthetic Exercises (baseline for Dynamic stability)
• Diminish Pain and Inflammation• Normalize motion• Restore proprioception and kinesthesia• Establish muscular balance
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Stage 2: Dynamic (Proactive) Stabilization Exercises
• Restore muscular balance• Enhance dynamic functional stability• Rhythmic stabilization
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Stage 3: Reactive Neuromuscular Control
• Improve muscular power and endurance• Enhance dynamic stability thru
proprioceptive and kinesthesia• Improve reactive NM abilities• Rhythmic stabilizations
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Stage 4: Functional Skill Movements and Activities
• Maintain shoulder joint complex muscular balance
• Maintain reactive NM dynamic stability• Gradual return back to activities
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Summary
• Heavy Focus on dynamic stabilizers and neuro muscular control