incline dumbbell press

flat bench press

Take Care of Yourself on Chest Day

Our first article discusses the importance of posture and the chronic injuries that result from spending large amounts of time in the same positions. Our daily patterns, everything from how much time we spend sitting, to what positions we sit in at a desk and while driving, to the routine movements required by our hobbies, occupations, and athletic activities play a part in our posture because we end up using some muscle groups more frequently than others. Without proper active recovery techniques, this can lead to strength and flexibility imbalances and cause somewhat predictable injuries. Athletes are prone to these and they can cause everything from shoulder impingements and rotator cuff tears, to mid and lower back pain, to hip and knee issues because the sport-specific movements they do on a regular basis use the same muscle groups consistently. An adequate warm-up and cool down in addition to stretching and active recovery techniques are crucial to keeping an athlete healthy, however they seem to be the most frequently overlooked.

In our first article, I discuss how the muscles we use most frequently due to the positions we spend the most time in can become tight if there's not an adequate active recovery plan including a cool-down and stretching each day. Tight (short) muscles have long (weak) partners on the opposite side of the body. A classic example is tight (short)

pectoralis muscles in the chest and upper trapezius in the back causing stretched-out,

lengthened (weak) middle and lower trapezius, rhomboids, and serratus anterior in the back.

The pectoral muscles help pull the shoulder blade forward into a hunched position which

keeps the middle and lower trapezius and rhomboids, muscles that pull the scapula

backwards, constantly stretched out. In this case, without stretching the pectorals, the traps

and rhomboids can't ever get back to neutral. Our bodies always find the path of  least

resistance and adapt to the stresses we place on them, so this posture becomes the most natural

feeling position for the back to be in, and an athlete's biomechanics can be significantly altered in a negative way.


Warm-Up and Stretching

Let's start at the beginning. What can an athlete do as part of a warm-up to ensure his body is ready for activity and help prevent injury? A teacher of mine in physical therapy school related tendons and muscles to a stick of gum. The warmer the gum is, the less likely it is to snap in half. The same goes for our muscles; they can endure a lot more stress, they can lift heavier weights, they can generate more power, they can move faster when they're warm. An adequate warm-up typically consists of at least 5-10 minutes of cardiovascular activity (anything from running on a treadmill to using an elliptical to doing jumping jacks) to warm up muscles and tendons getting them ready to accept the stress of whatever activity is about to be done. It's also critical for an athlete to stretch the muscles he's about to use. There are three basic types of stretching: static, dynamic, and pre-contraction. I will expand more on this in future articles, however the two most common types of stretching seen in general exercise and fitness tend to be static and dynamic stretching. Static stretching involves holding a muscle at the point in its range of motion where a stretching, but not painful, sensation is felt 2-4 times in a row for 15-60 seconds each depending upon the athlete's age, sport, and intention(1). Dynamic stretching includes active stretching where the limb is continually moved through its entire range of motion (think arm circles and windmills), and ballistic stretching where some type of bouncing or quick, alternating movements are used to warm-up the tissue and prepare a muscle for activity (think quick heel raises to warm-up the calves)(1). The literature goes back and forth, and there's still more research to be done in order to find the perfect warm-up and stretching combination for each type of sport and athletic activity, however the most up-to-date guidelines regarding stretching as part of a warm-up for athletes state that static stretching is most beneficial for sports that require a certain degree of flexibility (gymnastics, dance, jiu jitsu, rock climbing, wrestling, etc), and dynamic stretching is most beneficial for sports requiring power and agility through thing like running and jumping (soccer, basketball, etc).


Chest Day Workout

Let's take a look at a chest workout put together by professional bodybuilder and IFBB

Pro, Sean Harley, owner of RockSolidTraining.com, RockSolidNutrition.com, and

iThinkFit Gym here in Omaha, NE. In this video, he and his partner and co-owner of

RockSolidTraining.com, RockSolidNutrition.com, and iThinkFit Gym, Heath Murray,

demonstrate aflat bench press, an incline dumbbell press, and incline, flat, and decline

flyes. During these exercises, the anterior deltoid helps the pectoralis major and minor,

frequently called the lower chest and upper chest muscles respectively, to bring the arm

toward the midline of the body in a motion called "horizontal adduction" (b,c).







































The middle and lower trapezius in addition to the rhomboids work together

to stabilize and hold the shoulder blade back toward middle of the spine. In

the video, both Sean and Heath make several points to discuss the

importance of the ability to maintain this position, called

"scapular retraction"(d), during the exercises as it ensures the intended

muscles are being activated and worked without any sort of compensation

from assisting muscles. There are, of course, variations to each of these

lifts, which they discuss as well. For instance, the pectoralis minor and

anterior deltoid are stressed more during an incline dumbbell press, and the

sternal head of your pectoralis major (the portion attached to the sternum, the bone that connects the rib cage) is stressed more during a flat dumbbell press because of the different gravitational vectors caused by each position. The same principle applies to incline vs. flat vs. decline flye exercises.


Treat Your Body Right: Injury Prevention

Injury can be caused by many factors. Remember above we discussed that strength and flexibility imbalances can lead to somewhat predictable injuries. These imbalances pull the body into a poor starting position which effects the quality of movement throughout the exercise and cause the body to move in a harmful direction or use smaller, alternate stabilizing muscles to complete the motion -- poor movement patterns. Fatigue or using too much weight both contribute to poor movement patters as well which will lead to injury. By any method, acute trauma or chronic poor movement patterns, injury occurs when the body has forcefully moved in a manner and/or direction other than the way it was intended. For the intents and purposes of this article, we will discuss how injury occurs through poor movement patterns because of fatigue during the exercise or poor posture causing an improper starting position.

Shoulder impingements are common for rock climbers, mixed martial artists, wrestlers and other sports that focus heavily on developing the chest and shoulder musculature while the back muscles aren’t utilized

quite as much. The shoulder joint is more susceptible to injury because it can move in

eight different directions (flexion, extension, abduction, adduction, horizontal

abduction, horizontal adduction, internal rotation, external rotation) compared to the

knee that can move in two (flexion and extension). It’s also vulnerable to injury

because it’s attached to the thorax by nothing more than the muscles that surround it

as opposed to a joint like the knee that has bone-on-bone attachments. That being said,

it’s much easier to understand why strength and flexibility imbalances would cause

such a mess.


Shoulder impingements are caused by a combination of strength imbalances between

the middle and lower trapezius which pull the shoulder blades (scapulae) back into

retraction, tightness in the upper trapezius and levator scapulae which work together

to elevate the shoulder blade or “shrug the shoulders,” the pectoral muscles which

cause the shoulder blades to tilt forward slightly, and the serratus anterior which pulls

the shoulder blades forward into protraction (see illustration d). A common

compensation seen when an athlete begins to fatigue or is using too much weight

during a chest or shoulder workout is for the middle and lower trapezius to become

tired and the upper trapezius to take over responsibility for completing the movement.

It sits in a constant contraction and shortened position and will ultimately become

over-activated if this pattern is repeated (2).


Any decent chest workout stressing the pectoral muscles and anterior deltoid will be complimented by a back workout that stresses the complementing muscles of the back including middle and lower trapezius, rhomboids, and latissimus dorsi (other muscle groups should be included in a back workout, however these particular muscles pertain to the shoulder joint). Including a program for these muscles, in addition to the muscles of the rotator cuff (supraspinatus, infraspinatus, teres minor, and subscapularis) during a shoulder workout will help ensure global strengthening of the forces surrounding the shoulder and help maintain appropriate alignment for proper movement patterns during exercise training and competition.

Cold Laser Therapy

Cold laser therapy is a non-invasive, natural healing modality utilized in veterinary, chiropractic, and physical therapy clinics to help injuries actually heal as opposed to masking the pain like ice or anti-inflammatory medications (NSAIDs). Its natural light energy is absorbed by the body and used to jump-start the natural inflammation process, which allows some sports injuries to heal up to 50% faster than rest and ice alone. There's no tingling sensation like one might experience with an electrical stimulation (e-stim) or TENS unit, and treatments can be completed in a fraction of the time. Overuse injuries such as bursitis, which is inflammation of the fluid-filled sac that protects the supraspinatus tendon in the rotator cuff from becoming frayed and degenerated, and tendonitis, which is inflammation of the tendons in the shoulder are two more common types of injury that can be seen in the shoulder if proper active recovery techniques and stretching are not incorporated into our daily exercise. An adequate cool-down (10 minutes spent doing body-weight or very light-weight sets of the exercises just performed) causes the body to continue to pump blood to the muscles that were just used which helps remove lactic acid and bring in the proteins and molecules necessary to rebuild muscle and heal any injuries that might have been sustained. Cold laser therapy works the same way; it brings blood flow to specific areas which allows allows the proper proteins and molecules to rush to the area and heal the injury. We have used cold laser therapy to help treat athletes with tendinitis, bursitis, and shoulder impingements at iThinkFit Gym, Skywalker 101 Boxing Academy, Midwest Wrestling Academy, and the Victory Fighting Championship.

Static Stretching
Static stretching has been shown to increase muscle length, and is most recommended for restoration and rehabilitative purposes (versus dynamic stretching) (1).  As always, including static stretches for each muscle group at the end of a workout will help prevent things like trigger points in the muscles and overuse injuries like bursitis and tendinitis in the tendons of the rotator cuff. Try these stretches after your next heavy chest day.


          Upper Trapezius Stretch

     Tilt head to one side aiming to touch the ear to the shoulder. LIGHTLY rest hand

     on head while reaching opposite arm behind back. You will feel a strong, but not

     painful, stretching sensation in the side of your neck. For a more aggressive stretch,

     DO NOT pull down on neck. Instead, hold light weightHold for 5 - 15 seconds and

     return to neutral. Repeat to opposite side. Do each side up to three times in a row,

     and up to three times a day.




          Levator Scapulae Stretch

     Turn head 45deg and look down toward front pocket. LIGHTLY rest hand on head

     while reaching opposite arm behind back. You will feel a strong, but not painful,

     stretching sensation in the side of your neck. For a more aggressive stretch, DO NOT

     pull down on neck. Instead, hold light weight in opposite hand rather than reaching

     behind back. Hold for 5 - 15 seconds and return to neutral. Repeat on opposite side.

     Do each side up to three times in a row, and up to three times a day.




          Doorway Pectoral Stretch

     This stretch can be done with arms in three (3) different positions to stretch different

     parts of the pectorals. Stand approximately 2 feet away from wall (give yourself

     enough space to be able to lunge into the corner) and have elbows either 45deg, 90deg,

     or 135deg away from body to stretch the upper, middle, and lower portions of the

     pectorals. Hold 15 - 30 seconds and return to stand upright. Do up to three times in a

     row, and up to three times a day.




          Foam Roll Pectoral Stretch

     This stretch can also be done with arms in three (3) different positions to stretch

     different parts of the pectorals. Begin by SLOWLY sitting back onto foam roller, letting

     one vertebra hit the foam at a time until your neck and the back of your head touch the

     foam. Bring your arms together in front of your face and SLOWLY let them fall to the

     sides ultimately allowing them to relax and their stretching point. Begin by holding this

     stretch for approximately 60 seconds working up to holding it from 3 - 5 minutes.

     *IMPORTANT: when finished with this stretch, instead of sitting back up, roll off the side onto one shoulder and push yourself up from there.

     Performing a sit-up to get out of this stretch will cause tension across the chest and ultimately negate doing the stretch in the first place.




          Stability Ball Roll and Reach (3)

     I found this stretch on breakingmuscle.com and

     think it's a great stretch for the lats, rhomboids,

     and middle and lower traps.


1. Start kneeling with your pinky fingers gently on the

front of the stability ball

2. Roll the ball forward so your arms go up by your ears,

turning your palms up toward the ceiling as you roll.

3. Your head should be relaxed and flat

4. At this point, your arms should be all the way up by your ears and your palms facing the ceiling. You should feel a solid stretch in your upper back and shoulders



What to do if you suspect an injury:

There are numerous ways to begin correcting these strength an flexibility imbalances. The best place to start 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 restrictions are due to weakness or flexibility issues. 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

                                                                                                                                                                  Wednesday, December 7, 2016

    




References:

(1)  https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3273886/pdf/ijspt-07-109.pdf

(2)  https://breakingmuscle.com/learn/the-dynamic-duo-of-shoulder-impingement

(3)  https://breakingmuscle.com/learn/youre-not-actually-strong-enough-to-bench


Photo Credit:

(a)  http://www.daltonbodyworktraining.com/daltonmyoskeletal/addressing-forward-head-posture/

(b)  http://www.all-bodybuilding.com/2016/05/chest-building-routines-and-best-chest.html

(c)  https://www.drivelinebaseball.com/elbow-injuries-and-what-causes-tommy-john-surgery/

(d)  http://www.quailridgestudios.com/med3.html

(e)  https://design.tutsplus.com/articles/human-anatomy-fundamentals-flexibility-and-joint-limitations--vector-25401


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incline dumbbell flyes