Sharon Johnston, LAT, ATC, NSCA-CPT

Head Athletic TrainerSTARS SPORTS MEDICINE

Head Athletic Trainer- STARS SPORTS MEDICINE

What is an athletic trainer?Education: Biomechanics, Nutrition,

Exercise Physiology, Therapeutic Exercise, Injury Evaluation, Emergency Care, Taping and Wrapping, Modalities

My ExperienceSports: children, adolescents, high school,

college, professional; hockey, rugby, gymnastics, rodeo

Occupational Medicine: CAST (Conditioning and Strength Training)

Physical Therapy Clinic

DiscussFitnessWellnessHealthy Living

TeachStretchingExercisesRelaxation

PerformStretchesExercises

How the body ages Body areas injured Aches and Pains How to manage symptoms Body Mechanics/Biomechanics Prevention and Safety Wellness

As we age several things happen:Normal wear and tear on our joints

decrease the cushions between our bones (i.e. meniscus in knee and discs in spine)

Changes to our spineThe discs can degenerate, creating a bone

on bone surface or it may alter the shape of the spine

Osteoarthritis can wear down the cartilage in your joints decreasing the joint space, compressing the disc *3

The normally smooth bone surfaces become rough and left untreated can lead to bone on bone *3

*1

Notice the normal disc and the abnormal discs that are below

*2

Spine Knees Shoulders These are just a few orthopedic (muscle

and bone) injuries. Other injuries are possible.We will just stick with these.

We may not be able to avoid the age factor and wear and tear, but we can change biomechanics and how we treat our bodies.

Cervical Spine (neck)7 Vertebrae

Thoracic Spine12 Vertebrae

Lumbar Spine5 Vertebrae

Sacrum/CoccyxOne large bone

*4

Remember Normal Disc Degenerated Disc Herniated Disc Thinning Disc

Bone Changes Varying mechanical loads can cause fractures Improper posture or poor flexibility can increase

the risk for injury Osteoporotic Changes

Mosby’s Medical Dictionary defines osteoporosis as- A DISORDER CHARACTERISZED BY ABNORMAL RAREFACTION OF BONE, OCCURING MOST FREQUENTLY IN POSTMENOPAUSAL WOMEN, IN SEDENTARY OR IMMOBILIZED INDIVIDUALS, AND IN PATIENTS ON LONG-TERM STEROID THERAPY.

May cause pain, fractures, loss of stature, or deformities.

Shoulder Anatomy:HumerusClavicleAcromionScapula

Shoulder MusclesRotator Cuff: Supraspinatus, Infraspinatus,

Subscapularis, Teres MinorDeltoidBicepsPectoralis (major and minor)LatsTrapsRhomboids

ShoulderTendonitis (overuse, inflammed tendon)

Biceps tendon Elbow complex Rotator Cuff Muscles

Clavicle (fractures from falling)

KneesBones

Femur Tibia Fibula Patella

Muscles Quads Hamstrings Adductors Hip Muscles

*5

LigamentsACLPCLMCLLCL

*5

CartilageMedial MeniscusLateral MeniscusPatellar tendonQuadriceps tendonArticular cartilage

*5

Knee on the right is that from a healthy 32 year old female

Knee on the left is from an 85 year old man.

*6

After a taxing work day it is expected that one might be sore or “achey”

Difference between the aches and the painsAches: a dull persistent pain *7

Sore: causing pain or distress *8

Pain: localized physical suffering associated with bodily disorder (as a disease or an injury) *9

Fluids Nutrition Ice or heat

Ice: first 24-72 hours, decreases inflammation and swelling

Heat: after 72 hours, increase blood supply to help promote healing

Stay moving!Take a walkStretch!

Stretch!

The following stretches will be interactive.

Strengthening: Resisted ExtensionHold tubing in right

hand, arm forward. Pull arm back, elbow straight. Repeat with left arm, too.

Repeat 15 times per set. Do 3 sets per session. Do 1-2 sessions per day.

Elbow Flexion: Resisted With tubing wrapped

around left fist and other end secured under foot, curl arm up as far as possible. Repeat with right arm, too.

Repeat 15 times per set.

Do 3 sets per session. Do 1-2 sessions per

day.

Press: Thumb In (Single Arm)

Face away from anchor in stride stance, leg forward opposite exercising arm. Press arm forward with thumb in. Repeat with other arm, too.

Repeat 15 times per set. Repeat with other arm. Do 3 sets per session. Do 1-2 sessions per

week. Anchor Height: Chest

Low Row: Thumbs Up

Face anchor, medium to wide stance. Thumbs up, pull arms back, squeezing shoulder blades together.

Repeat 15 times per set.

Do 3 sets per session. Do 1-2 sessions per

week.

Anchor Height: Waist

Shrug

Anchor tubing under feet in parallel stance. Thumbs forward, shrug shoulders up.

Repeat 15 times per set.

Do 3 sets per session. Do 1-2 sessions per

week.

Lat Pull Down

Face anchor with knees slightly flexed. Palms down, pull arms down to sides.

Repeat 15 times per set.

Do 3 sets per session. Do 1-2 sessions per

week.

Anchor Height: Over Head

Hip Abduction: Side-Lying (Single Leg)

Lie on side with knees bent, tubing around thighs just above knees. Raise top leg, keeping knee bent.

Repeat 15 times per set. & Repeat on other side.

Do 3 sets per session. Do 1-2 sessions per week.

Hip Flexion – Resisted

With tubing around left ankle, anchor behind, bring leg forward, keeping knee straight. Repeat with right leg, too.

Repeat 15 times per set.

Do 3 sets per session. Do 1-2 sessions per

day.

Hip Extension – Resisted

With tubing around right ankle, face anchor and pull leg straight back. Repeat with left leg, too.

Repeat 15 times per set.

Do 3 sets per session. Do 1-2 sessions per

day.

Hip Adduction – Resisted

With tubing around left leg, bring leg across body. Repeat with right leg, too. Make sure you have something close by to help with balance.

Repeat 15 times per set.

Do 3 sets per session. Do 1-2 sessions per

day.

Hip Abduction – Resisted

With tubing around right leg, other side toward anchor, extend leg out from side. repeat with left leg too.

Repeat 15 times per set.

Do 3 sets per session. Do 1-2 sessions per

day.

Theraband Exercises REMINDERS

Keep non-exercising hand on hip for stability.Do not lock elbows for upper extremity press

exercises.Keep abdominals tight to help stabilize trunk.Keep knees slightly bent for stability.Always stay in pain free range of motion.Always anchor your band! Attach it to door

jam or to a heavy piece of furniture that wont move.

Cat/CamelFrom starting position, tuck chin and

tighten stomach while arching back. Hold 2 seconds. Repeat 15 times. Can perform 2-3 times per day.

Lower Trunk RotationKeeping back flat and feet together, rotate

knees to one side. Hold 5-10 seconds. Repeat to other side. Do this 3 times each side. Can be done 2-3 times per day.

Single Knee to ChestGently pull knee to chest until stretch is felt.

Hold 15-30 seconds. Repeat with other knee. Repeat 3 times each side. Can be done 2-3 times per day.

Double Knee to ChestWith hands behind knees, pull both knees in

to chest until a comfortable stretch is felt in lower back and buttocks. Keep back relaxed. Hold 15-30 seconds. Do 3 times, can be done 2-3 times per day.

Single Sided Lower Trunk RotationKeeping shoulders flat on floor, pull leg

toward floor until stretch is felt. Hold 10 seconds. Repeat with other leg. Do 3 times, can be done 2-3 times per day.

Calf Stretch- GastrocKeeping back leg straight, with

heel on floor and turned slightly outward, lean into wall until a stretch is felt in calf. Hold 15-30 seconds. Repeat with other leg. Do 3 times, can be done 2-3 times per day.

Calf Stretch- SoleusKeep back leg slightly bent, with

heel on floor. Lean into wall until a stretch is felt in calf. Hold 15-30 seconds. Repeat with other leg. Do 3 times, can be done 2-3 times per day.

Quad StretchPull heel toward buttocks until

stretch is felt in front of thigh. Hold 15-30 seconds. Repeat with other heel. Do 3 times, Can be done 2-3 times per day.

Rhomboids StretchPull arm across chest until

stretch is felt. Turn head away from pull. Hold 10 seconds. Repeat with other arm. Do 3 times, can be done 2-3 times per day.

Chest StretchWith arms forming a

T, lean forward until stretch is felt. Hold 15 seconds. Slide arms up to form a V and repeat the stretch. Do 3 times, can be done 2-3 times per day.

LevatorHold edge of chair

firmly with right hand. Lean trunk away from stabilized arm. Hold 15 seconds. Do 3 times in each direction. Can be done 2-3 times per day.

Posterior ShoulderGently pull on left forward

elbow with other hand until stretch is felt in shoulder. Hold 15 seconds. Do 3 times each arm, can be done 2-3 times per day.

TricepsGently pull on left raised

elbow with other hand until stretch is felt in shoulder. Hold 15 seconds. Do 3 times per arm, can be done 2-3 times per day.

Studies conducted show that changing of body positions change the amount of intradiscal pressure in a 70kg individual

*11

Squat Stoop Bring items close to your body Ask for help! Push rather than pull Distribute workloads Make more trips

Bend at hips and knees, not back. Keep feet shoulder-width apart.

Squat to reach or rearrange your work area, and avoid twisting and bending

Avoid twisting or bending back. Pivot around using foot movements, and bend at knees if needed when reaching for articles.

Pushing is preferable to pulling. Keep back in proper alignment, and use leg muscles to do the work.

Move heavy items one at a time, or move portions of the contents.

Ask for help and delegate to others when possible. Coordinate your movements when lifting together, and maintain the low back curve.

Squat down, and bring item close to lift.

Distribute weight evenly on both sides. Use a cart whenever possible. Do not twist trunk. Move body as a unit.

Slide object up one thigh, and hold close at waist level with both hands before standing up.

Think firstDo you need help?Try to move the box with your foot. If it

can’t be moved with your foot- GET HELP! Use good body awareness and

mechanics Have your work area inspected for

proper ergonomics (WORKSTAR- program)

Take a break to walk and stretch Change positions

Proper Hydration- consuming foods and beverages that contain waterPhysicians recommend 8 or 9 glasses *12

Institute of Medicine: women 9 glasses, men 13 glasses *12

A glass is 8 fl. Oz *12

Proper Diet- well balancedConsult with your physician if you need

special nutritional considerations (e.g. diabetes and gout)

Yearly physicals Vitamins

Multi-vitaminsVitamin B ComplexVitamin CVitamin D

Herbal Supplements

No one can MAKE you be well. Do it for yourself! Perks:

Energy and StaminaFeel great!Weight changesChange in body shape

Long healthy life

ROM Numbness and Tingling Decrease in strength Changes to sleep cycles Increase in “pain” medication (i.e. anti-

inflammatory) Ultimately- you know your own body.

You know how you respond to injury.

1.http://www.mayoclinic.com/health/osteoarthritis/DS00019

2.http://www.mayoclinic.com/health/medical/IM01682 3.http://www.spineuniverse.com/conditions/degenerative-

disc/what-degenerative-disc-disease 4.

http://www.cedars-sinai.edu/Patients/Programs-and-Services/Spine-Center/Anatomy-of-the-Spine/Curves-of-the-Spine.aspx

5. http://www.breg.com/patient_education/knee.html 6. . http://www.sciencephoto.com/media/138824/enlarge 7. http://www.merriam-webster.com/dictionary/ache 8. http://www.merriam-webster.com/dictionary/sore 9. http://www.merriam-webster.com/dictionary/pain?

show=0&t=1317151391 10.

http://www.cooley-dickinson.org/sites/default/files/images/pain-scale.gif

11. http://www.leechiro.ca/2011/02/lumbar-disc-herniations/ 12. http://www.mayoclinic.com/health/water/NU00283

Questions?? Comments… Feel free to email or call me:

johnsshm@sarmc.org367-6858