The injury or shoulder pain can be considered one of the most present symptoms in most sports, especially those in contact, such as rugby, American football, soccer or basketball, to “launch” as may be the basaball, or of impact with the tool as in the case of the tennis and volleyball.
Prevention Shoulder
For many years the proprioceptive training has been identified only and exclusively for the lower limbs without ever put too much attention also to the upper limbs and in particular to the shoulder joint. The phase of rehabilitation or prevention of shoulder always includes a series of tutorials that provide improved proprioceptive abilities, especially after serious injury that can be dislocated shoulder, and exercises to improve the expression of strength, which in turn will generate greater stability.
Due to these two important characteristics are both very helpful to use a FluiBall ® that can range from 0.5kg to 3kg maximum for rehabilitation and upgrading of the joint. The continued instability generated by the fluid to the entire place of the ball and the weight of the implement will allow us then to process simple exercises that allow to proceed in parallel on both the physical strength and stabilization.
Therefore the possibility to use the FluiBall in a situation of functional recovery is mainly due to the choice of specific exercises for the type of injury encountered by the athlete or by the patient.
The weight of the overload must be such as not to cause imbalances that would in turn cause other problems as classic back pain or other more substantive issues and symptoms of inflammation cervical.
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Among the main complaints in volleyball, those are definitely at the top of the shoulder.
This complex, pluriarticolare and inherently unstable, it is often ipersollecitato during exercises commonly performed by players of volleyball.
The continuous repetition of attacks and strokes, often performed incorrectly and without proper warming up, leading over time to the onset of degenerative diseases. If we add to these considerations the fact that time devoted to the work of prevention and weight lifting for this articulation is always reduced, that we understand why the shoulder pain is more and more present, not only in professional athletes but also in those of average level and in children, where often the weight of the ball is higher than the force applied.
There are many diseases that can occur at the shoulder; among the most common are:
– DEGENERATIVE DISEASES
-Tendinitis of the supraspinatus
Infraspinatus tendinitis-BLOCK
-PROBLEMS IMPINGEMENT
-NERVE INJURY
MUSCLE INJURY-insertional
-VASCULAR PROBLEMS.
Among the pathologies found in volleyball we can certainly cite the supraspinatus tendinitis that generates importance and pain during the loading phase of the beat and attack. It will usually pain radiating down the front. Among the major alarm bells for this condition, is the “classic” reduction of the power of the gesture of attack.
The IMPINGEMENT is a disease found mainly in the beginners in which the shoulder appears unstable: We’ll have weakness of the muscles of the rotator cuff and pains especially in the movement of abduction between 30 and 60 degrees.
The MUSCLE INJURY are usually found at the insertional and the muscles most affected are the deltoid muscle and interscapular.
Nerve damage, fortunately are not frequent in the volleyball player, if not due to dislocation of the shoulder.
We have said that the shoulder is a complex joint particularly unstable, but how can we intervene to prevent pains that lead to reduction in force and expressed as an increase in pain?
The project is in final stage of medical and physiotherapy, but prevention is always the first place, as well as the correction of technical movements.
OBJECTIVES OF:
AVOID MUSCLE IMBALANCE: the nature of the technical gesture “closing”, the first place we put the hyperactivity of the pectoral muscle that will have to be countered by proposing specific stretching exercises after each training session.
SHRINK CAPSULAR: specific exercises mobilization and stretching, they’re going to reduce this effect.
MUSCLE weakness of the scapula. Many volleyball players with deficits at the level of the muscles of the shoulder blade, and then propose specific exercises that act on these muscles so as to work in the best way around the shoulder complex.
RULES ‘OF INTERVENTION:
EXERCISES PROPRIOCEPTIVE
STRETCHING CAPSULAR
MUSCLE STRETCHING
Rubber Bands
ENHANCEMENT TARGETED (not on all the muscles)
SPECIFIC MASSAGE
WORK IN WATER
TECHNICAL CORRECTION OF GESTURE.
VIDEO RELATED TO PROPOSE A SEQUENCE OF SIMPLE EXERCISES WITH ELASTIC TO BRING IN THE HEAT.
Take a few minutes to properly activate all the muscles that will be stressed during training then.
Recall that the speed of execution is important, just as crucial is the range of motion used.
EXTRAROTAZIONI WITH ELASTIC RESISTANCE
INTRAROTAZIONI WITH ELASTIC RESISTANCE
PULLEY
Lowers: muscle G.Pettorale
Lowers: muscle G.Dorsale
The exercises, which you propose before every workout, they are suitable for athletes of all ages, of course using elastic resistance appropriate. We recommend for each exercise to do at least two sets of 15 repetitions. Recall that the proposed exercises should be performed WITHOUT PAIN!
In future articles we will discuss other types of surgery to the shoulder of volleyball.
Physical Therapist Giovanna Malchiodi
Born ‘s April 11, 1986 in Milan.
Member, CEO of Physical Education Preparation, head of ePhysio.
Physiotherapist Igor Gorgonzola now at Novara (Volleyball Series A) and at Novara Baseball (IBL1 category).
He works freelance for the company iPhysio which he owns.
She has a degree in Physical Therapy at the University Amedeo Avogadro of Novara.
Graduating in Sport and Exercise Science at the University San Raffaele Hospital in Milan
The patellar tendinitis is the most frequent pathology among overload syndromes of the athletes who play sports jump (especially volleyball, basketball) running (athletics) or with sudden braking and acceleration like the Tennis.
The pain is usually localized at the level of insertion of the inferior pole of the patella although occasionally symptoms may occur upon insertion of the distal tendon (near the tibial tubercle) or on the tendon quarticipitale (at the point of insertion on the proximal pole of the patella) (Image from: Brotzman – Rehabilitation in orthopedics).
The onset of the disease is usually insidious: the pain is usually triggered activity during repeated jumping or running and disappears after a short period of rest. Usually returns to the resumption of the activity.
During each workout , the constant stress on the tendon due to the repetition of the sporting gesture , procure microtrauma to the tendon. If workloads were excessive , the subject was predisposed or recovery time were not adequate , you may experience disorders of the patellar tendon . To monitor even the playing surface : hard surfaces appear to be related to an increased incidence of symptoms .
Should it be a pain of this kind at the level of the knee , it is essential to act immediately in order to avoid unnecessary complications.
In 1973 , Blazina and collaborators have proposed a classification of tendinitis.
The objective of the proposed classification, is to formulate an appropriate treatment plan.
For those working in the gym, watching the classification , will understand immediately what is the level of seriousness of the problem in order to intervene in the most suitable way .Only athletes in phases 1 and 2 respond well to conservative treatment , unlike those in phase 3 that have a response variable and those in phase 4, which are usually intended for surgical intervention .
We’ve seen the classic classification of tendinitis, but what is the action on the field ?Here we propose a very schematic way , a few tips to use in the gym. Recall that in order to provide appropriate treatment , it is essential from a correct diagnosis. So please do not improvvisarvi doctors or physiotherapists, but only use the table to figure out what is the best therapeutic approach .
Fisioterapista Giovanna Malchiodi
Nata l’ 11 Aprile 1986 a Milano.
Socio, CEO di Preparazione Fisica Education, responsabile della sezione ePhysio.
Fisioterapista presso la società Igor Gorgonzola Novara (Pallavolo serie A) e presso Novara Baseball (categoria IBL1).
Svolge attività di libera professione presso la società iPhysio di cui è titolare.
Laureata in Fisioterapia presso l’Università Amedeo Avogadro di Novara.
Laureanda in Scienze Motorie e Sport presso l’Università S. Raffaele di Milano.
Hands up who has never had a trauma to the ankle? !
Young and old , athletes and non-athletes who did not have a bias?
I decided to open the directory ePhysio analyzing the ankle sprain , one of the most frequent events in those who practice physical activity at any level.
The ankle sprains account for about 10-30 % of all sports injuries , increase the frequency of the situation in sports and in sports that require jumping ( volleyball, basketball, soccer, dance) .
A 2005 Australian study , published in the journal Sports Medicine and performed on athletes with ankle injuries , showed that in the majority of subjects , the symptoms resulting from trauma (pain in the first place) , persisted for more than two years from the injury itself if the subjects had not carried out an adequate program of physiotherapy and riatletizzazione .
This explains the importance of providing sports programs – especially the specific prevention and early intervention trauma to the ankle .
In sports distortions arise mainly from :
-> Direct contact with the opponent ;
-> Relapse after the jump .
The distortion is defined as a lesion capsule – ligament of varying severity , but without loss of mutual relations between the articular heads .
The distortions of the ankle can involve : medial ligament compartment ( medial collateral ligament , deltoid ligament ) injury to a solicitation forced valgus and pronation of the foot. The lateral ligament compartment ( lateral collateral ligament , anterior and posterior tibiofibular ligament ) injury from stress in varus foot .
The lesion may consist only in the distraction of the capsule and ligaments (sprains of First Instance ), or in their total or partial tear ( distortion 2nd and 3rd degree ) .
Reference image: Brotzmann – Rehabilitation in Orthopaedics )
The majority of ankle injuries ( nearly 90% ) involve the capsular structures – ligament . The graph below show the incidence of various injuries in sports.
At the medical level , we can divide the distortion mechanism in reverse , in three grades :
* Grade I : partial tear of the ligament astragalar peroneal Front ;
* Grade II : astragalar peroneal ligament injury Anterior and Peroneus heel ;
* Grade III : injury LPAA , LPC , and ventualemnte astragalar peroneal ligament Posterior interosseous ligament .
The event distortion is due to external forces that overload the structures osteo – deputies to ligamentous joint stability is also necessary to remember that the foot is one of the regions of the body that provides the greatest number of proprioceptive information , the anatomical damage will be joined then issues type receptor . The subjective consciousness of the spatial position of the static and dynamic leg will in fact be damaged due to trauma : if the treatment is not adequate , there imbattetemo in a phenomenon of functional instability of the ankle predisposing to further recurrences.
It will be the primary goal of the physical therapist, the coach and athletic trainer , try to prevent the sprain , and when the trauma occurs , intervene as early as possible correctly and preventing the onset of functional instability and consequent other trauma
Our intervention will be crucial because the majority of patients recover completely , but in about 20-40% appear pain and chronic instability .
The prevention can be either Primary or Secondary.
The first will aim to prevent trauma to occur and to minimize the maximum risk factors , secondary prevention will instead have the objective of preventing relapse or ensure that , in a person who has suffered a trauma , it is not repeated.
We talked about the importance of providing a specific workout that goes to minimize the risk factors , but how can we intervene?
When we talk about prevention for the ankle joint , we must remember that the ankle is not an articulation ” in if” but is in close connection with other joints , the first of the knee joint . The work will then quote a lot in common with the work for other diseases of the lower limb , especially the complex of the knee joint .
provide an adequate warming up : Each workout should begin with a warm-up involving all the joints ;
propose motion exercises and stretching will be useful to perform during the heating of motion exercises for hand : dorsiflex , plantiflettere the foot and perform circling in both directions allow you to begin training in the best way . At the end of the session to remember to do stretching exercises for the calf muscles . Stretching should last at least 20 seconds and must be done bilaterally. If the proposed training has provided running and jumping exercises , we recommend you perform the exercise at least three times .
use appropriate footwear : perform workouts with unsuitable footwear could increase the risk of injury . Avoid shoes with soles too low or that do not provide adequate support arch .
evaluate the biomechanics of walking, where appropriate, propose the use of orthotics specific . Sometimes it is sufficient to observe the wear of the sole of the shoes , to see if the rest of the foot is correct or not. In some cases the use of a specific footbed can prevent overload pathologies (eg, stress fractures and Achilles tendon problems ) and traumatic problems (eg, ankle sprains ) .
provide adequate recovery time : to monitor the number of jumps proposed during a single workout and in daily and weekly programming , will prevent the problems of overload in all the joints of the ankle.
correction of technical movements : we said that among the causes of sprains are the fallout from the jumps. We observe our athletes and teach them to fall by the jumps in the form bipodalic .
weight control : the extra pounds increases the stress on the joints ; monitor the weight of the athletes can avoid a mild sprain , become high-grade .
selective muscle strengthening : to propose a concentric and eccentric strengthening of the peroneal muscles , anterior and posterior tibial and sural triceps , will allow us to move better , reducing the risk of injury.
realization of functional bandages quotes : by assessing the physical therapist .
proprioceptive exercises : to propose the use of bosu exercises and proprioceptive tablets but also free body ..
We have seen what are the factors on which we can intervene to prevent ankle sprains , it is crucial to remember , however, that in athletes is essential to provide a specific work of riatletizzazione proposed with the aim to prevent relapse.
In future articles we will discuss how INTERVENE IN THE FIELD:
What is the first action to be taken in the event of a sprain ?
How to make a compression bandage ?
Proprioceptive .. how to propose it ?
What is a functional bandage ?
Stay tuned and we’ll find out ..
Fisioterapista Giovanna Malchiodi
Nata l’ 11 Aprile 1986 a Milano.
Socio, CEO di Preparazione Fisica Education, responsabile della sezione ePhysio.
Fisioterapista presso la società Igor Gorgonzola Novara (Pallavolo serie A) e presso Novara Baseball (categoria IBL1).
Svolge attività di libera professione presso la società iPhysio di cui è titolare.
Laureata in Fisioterapia presso l’Università Amedeo Avogadro di Novara.
Laureanda in Scienze Motorie e Sport presso l’Università S. Raffaele di Milano.