Tricep Dip - concentric portion

Diagonal Cable Lat Pull-Down

- eccentric portion

Pectoral Strain

From the Athlete:

“My name is Miranda and I’m currently in prep for my first NPC Bikini show,

so you can only imagine how much frustration can happen when you hurt

yourself 5 weeks out from your very first competition. I had heard of cold laser

therapy before, but was never really sure how it would work OR the outcome I

would get from it. After a day of lifting and using excessive back and shoulder

muscles, I started having really bad pain in my right shoulder up toward my pec

area. I was instantly frightened knowing I couldn’t afford to take any weeks off

from the gym and “recover”... I woke up the next two mornings with severe,

sharp pain even taking my jacket off or raising my arm about horizontal…

Luckily, it wasn’t anything too serious. Michaela recommended that I do at least

2 sessions of cold laser. The session took maybe about 2 minutes and BAM, one

treatment was over! She advised that I will notice a difference by that evening

and she was 100% correct. I even woke up the next morning with zero to little

pain! Who would have thought such a treatment could heal so fast. I then did a

second treatment the following day, and noticed even greater improvements upon movements rotating my shoulder! As an athlete I am already back to lifting heavy and on the path to bettering myself with no pain or anything in my way!”

The Shoulder Joint
The shoulder is without a doubt the most vulnerable joint in the human body. With the ability to move in six different directions, it allows us to do everything from put on and take off clothing, to lift and pull weights in every direction including above the head, to throw a jab versus and upper cut. It goes without saying that the shoulder is also one of the most frequently injured joints in the body. Between the muscles of the rotator cuff (sometimes called the “rotator cup” or “rotary cup”) which help stabilize the shoulder when you lift your arm up to the front (flexion) or the side (abduction), the muscles that connect your shoulder blade to your spine (the scapulothoracic muscles), and the pectoral muscles, at least 12 muscles in addition to their associated tendons and ligaments are at risk for overuse and traumatic injuries.

We recently had the opportunity to work with Rock Solid Athlete Manager and Social Empire assistant, Miranda Geist, who is nearing the end of her prep for the Omaha Pro NPC Duel of Champions on June 10, 2017. Miranda came to us stating she woke up with pain along the front of her shoulder around the pectoralis major insertion following a chest and back workout. She had no previous injury to the area and didn’t feel a pop or anything traumatic happen at the time during the workout. We were able to narrow the possible causes down to four options: tricep dips, bench press, chest flyes, and diagonal cable lat pull downs.

Causes for Muscle Strains and Tears
Muscle tears and strains can happen one of two ways: traumatically or over a duration of time. It’s important to understand the three ways muscles contract in order to see how a muscle can be torn. Check out another articlewe’ve written for our website that discusses the three ways our muscles contract: 1) concentrically, 2) eccentrically, and 3) isometrically and how these can contribute to both muscle injury and rehabilitation. A traumatic tear can be caused by trying to work with too heavy a load during a concentric contraction like a bench, decline, or incline chest press, chest flyes, and push-ups, or when it’s fibers are quickly stretched beyond their limit during an eccentric contraction like returning to neutral during a lat pull-down or during the descent of a tricep dip. A gradual strain can begin to occur over time if a sufficient warm-up and active recovery techniques like a cool-down and adequate stretching aren’t included in a workout regime.

Let’s get into a bit of anatomy, then talk about when the strain could have

occurred. The pectoralis major, the large, flat muscle that makes

up the visible portion of the chest, attaches to the collarbone (clavicle), the

sternum (the bone that connects our rib cage in the front), and the top of the

abdominal wall. It’s responsible for lifting the arm in front of the body (flexion)

and across the front of the body (horizontal adduction) to 90 degrees in addition

to helping with rotating the arm internally (making the thumb point inward

with the arm next to the body and downward when the arm is raised to the side).

Take a look at the pictures below. During a tricep dip, the anterior deltoid and pectoralis major work together to help push the body up from the dip. The lower an athlete dips during the
eccentric portion of the lift (the actual dip), the more stress she’ll place on the shoulder joint. Miranda typically uses one or two 45lb plates on her lap during this exercise. In her particular case, if she was fatigued, this load could put more load on the muscles than they can handle at that particular time causing them to stretch even though they’re activated and in the middle of doing a shortening contraction. The result is a strain or tear.

During pressing exercises and flyes in general, the anterior deltoid and pectoralis major work together to lift the load off the body and bring the upper arm (humerus) from a 90* angle out to the side to the vertical position while the triceps extend the elbows. The amount of work the anterior deltoid does increases as the amount of incline increases. Said another way, the

more upright an athlete is during a lifting exercise, the more work the anterior deltoid does and the more flat (“supine”) an athlete is the more work the pectoral muscles do.

Finally, even though a diagonal cable lat pull-down is more more the latissimus dorsi and teres major muscles, it can bring on problems with the pectoralis major because it helps complete the motion (it acts as a synergist). Although it’s difficult to see this motion during the movement, remember that the pectoralis major helps the arm rotate inward. This is necessary to complete the pull-down. Again, in Miranda’s case, if she was fatigued, the load she was working with could be more than what the pectoralis major and lat could handle.Since the pectoralis major is helping with the motion it would be more vulnerable to injury and sustain a strain or tear. Another thing Miranda had mentioned as her recovery continued was that it continued to be aggravated by the hack squat machine. The position she needs to stand in puts the bars on her shoulders in a way that forces her shoulder blades (scapulae) down placing a lot of downward force on the top attachment (sternal head) of her pectoralis major causing the injury to stay aggravated.


Cold Laser Therapy, Microtears, and Muscle Tears
Muscle injuries are a huge problem for athletes. Even though muscles naturally repair themselves through the inflammation process, it's a slow process, and a lot of times athletes continue to deal with weakness and risk of re-injury. “The exhausting physical exercises, drills, and games associated with insufficient recovery interval may

cause athletes to enter a process called overtraining making them more

susceptible to muscle and ligament injuries." The ability of cold laser therapy

to heal all types of muscle, tendon, and bone injuries has been gaining a lot of

attention because of it’s non-invasive, low-cost, quick and easy treatments.

The best part is that unlike corticosteroid injections and over-the-counter,

non-steroidal anti-inflammatories (NSAIDs) like ibuprofen, Advil, and

naproxen sodium, there have been NO NEGATIVE SIDE EFFECTS found

when using cold laser therapy.

A study in Lasers in Medical Science found that cold laser therapy reduced the

inflammation process, initiated and sped up the rebuilding phase, and created

new blood vessels around the injury. When a muscle tears, the blood vessels tear

along with it, typically causing bruising and swelling. This pooled blood can’t be used to heal the injury because it doesn’t have the oxygen, white blood cells, new collagen cells, and nutrients needed to rebuild tissue. Those are brought to the injury via the inflammation process. This old, pooled blood needs to be moved out of the area so new blood vessels created can everything into the area and the tear can be repaired. Cold laser therapy works with the energy house of the cell to make this process happen faster.
Think You Might Have Torn a Muscle?

M&B Wellness Solutions offers multiple services to help relieve the deep ache from DOMS, and heal partial muscle tears. Whether it’s cold laser therapy, traditional, insurance-based physical therapy, or our PT Squared Program where our physical therapist works together with the highly experienced trainers at iThinkFit to design the perfect plan that will help athletes train through the recovery process, we have what it takes to help athletes recovery quickly and stay at the top of their game.

The best way to start your road to recovery is to see a healthcare professional specializing in movement and rehabilitation who can assess your range of motion, strength, and quality of movement to determine if your pain is due to chronic overuse, from strength and flexibility imbalances, or poor biomechanics. Stop by M&B Wellness Solutions located inside iThinkFit Gym for an evaluation with a licensed physical therapist so we can get you on your way to moving the best you possibly can.

Michaela Cantral, PT, DPT

                                                                                                                                                                                              June 6, 2017

Tricep Dip - eccentric portion

Diagonal Cable Lat Pull-Down

- concentric portion

-- Miranda Geist

Omaha Pro NPC Dual

of Champions Competitor

Rock Solid Athlete Manager

Chest Flye - eccentric portion

Chest Flye - concentric portion

M&B Wellness Solutions

Your Complete Rehabilitation and Wellness Specialists