Exercises for the Shoulder to Hand - Release Your Kinetic Chain. Dr. Brian James Abelson DC.

kinetic chain relationships, tissue interactions, core imbalances, elastic power, and aerobic training. We strive to give you a balanced means of achieving a good strong body that is injury-free.

       Our exercise routines always take into consideration a key fundamental aspect of good rehabilitation – Kinetic Chain Relationships. Since injury or weakness in one area of your body always affects the function of numerous other related areas, we ensure that our routines take into account direct muscular connections, muscle antagonists, fascial connections, as well as the fact that tissue restrictions affect the primary mechanisms of energy storage and release. See “Shoulder to Hand – a Kinetic Chain” on page 31.

       Our exercise routines always consider how the core of your body acts as the power generator for your entire body. This is true even for movements of your neck, shoulders, arms, hands, legs or feet. No matter what the action, you need a strong stable core to be able to transfer energy to your extremities. See “Involving Your Core” on page 22.

       Our exercise routines also address the development of your elastic power or the ability of your muscles, ligaments, tendons, and fascia to store and release energy. The ability of your soft tissues to store and release energy is dependent upon the quality of your soft tissues. Low-quality tissues are full of adhesions, scar tissues, and knots. These tissues do not store or release energy efficiently. High-quality tissues can move easily through their full range of motion, are not restricted or adhesed, are capable of long periods of endurance, and are not easily injured. One of the primary goals of our exercise routines is to provide you with a means for improving your overall tissue quality. See “Principle 2: Good Tissue Quality = Good Performance” on page 12.

       Aerobic warm-ups are an integral component of all of our programs. It doesn’t matter if we are dealing with a jaw, neck, shoulder, back, or leg injury; aerobic training is essential. By developing your aerobic system you increase your circulatory function and your ability to produce energy on demand. Aerobic exercise does this by increasing the density of capillaries in your muscles, and the density of mitochondria (your personal energy factories) in your cells. See “Improving Cellular Function with Aerobic Exercises” on page 17.

       And finally, one of our primary goals is to give you effective strategies for increasing strength without further injuring yourself. The exercise routines we provide in these books are similar to ones that we provide to our patients. These routines have been successfully tested and improved over time, and will help you to strengthen your body in a gentle and progressive manner.

      I hope you stick to the routines, enjoy this book, and benefit from your improved health. I am sure you will achieve great results.

      All the best in health!

      Dr. Brian Abelson

       Rehabilitating an Injury

      When you are looking for resolution from injuries, restrictions, or reduced function, you should always ensure that your solution takes into account the kinetic chain for that structure.

      People often assume that their injury occurred at the time that they first noticed symptoms (pain, discomfort, or inability to perform an action), but this is often not the case. Other than when an injury is caused by acute trauma, the actual cause of many injuries is often unknown. This is due to the slow insidious nature of many soft-tissue injuries.

      With many injuries, symptoms (pain and discomfort) are often the very last thing to surface. In actuality, the conditions that led to the injury may have existed for a long time before the symptoms manifested. In some cases, our patients have undergone years of micro-trauma before the first noticeable symptom appeared.

      For example, if you injure a muscle in your arm, your body immediately compensates by using surrounding structures to support, and sometimes to perform, the activity that is normally carried out by this muscle. This compensation may initially only affect the surrounding muscles, ligaments, tendons, and connective tissues.

      Problems arise when the initial injury does not resolve, causing the supporting structures to also become stressed or injured. This creates a cycle of ongoing compensations which in turn leads to reduced neurological function (due to impingement upon neurological structures) and increased inflammation (due to increased biomechanical tension, micro-tears, and inflammation).

The Cumulative Injury Cycle

      One of the best explanations of this ongoing injury process was first postulated by Dr. Michael Leahy, the developer of Active Release Techniques® (ART), in his Cumulative Injury Cycle¹. The Cumulative Injury Cycle describes the major factors that lead to the initial injury, and explains how these injuries are perpetuated.

      Whether the injury is the result of an acute trauma, repetitive motions (RSI injuries), or internal tissue pressure, the result is often the same.

      Each of these factors leads to a proliferation of fibrous tissue (scar tissue). Once this fibrous tissue forms, muscles become weaker, friction increases, inflammation increases, oxygen transport and distribution diminishes, and a cycle of dysfunction is created.

What Can You Do About This?

      Fortunately, there is a lot you can do to break this cycle of injury. The initial phase of an injury is known as the Inflammatory Phase. With acute injuries, R.I.C.E should be used within the first 48 to 72 hours.

       R = Rest to prevent further damage. But not too long a rest as immobilization can result in scar formation. See Benefits of Rest - page 219 for more information.

       I - Ice to reduce swelling, inflammation, and pain. See Cold Therapy - page 214 for more information.

       C = Compression to provide support, reduce swelling, and reduce bleeding.

       E = Elevate the injured area above the heart-level to reduce swelling and bleeding.

Without exercise, the probability of the collagen being laid down in a random manner and forming scar tissue is very high. Scar tissue is limited in its function, reduces movement, decreases circulation, and reduces sensation. The greater the amount of scar tissue, the greater the reduction in function of your muscles and other soft-tissues.

       Injury Recovery

      The second phase of injury recovery is known as Proliferative Phase and is characterized by the laying down of new collagen. This phase can start within two days of the injury and can last up to six weeks.

      It is extremely important to be exercising during the Proliferative Phase as this will ensure that new collagen is laid down in the same fibre orientation as your muscle tissue, and that the new collagen does not inhibit relative motion between tissue layers.

      The third and final stage of injury recovery is known as the Remodeling Phase and can last from three weeks to twelve months. During this phase the new collagen fibres remodel in proportion to the stress placed upon them. It is critical that you continue to exercise during this