Shoulder Rehabilitation

Shoulder Rehabilitation

Anatomy

The Shoulder is made up of the humerus, scapula, and clavicle. The joints of the shoulder include the glenohumeral, sternoclavicular, and acromioclavicular.   Muscles acting on the shoulder are1:

Shoulder Injuries

External impingement occurs when the rotator cuff and bursae are impinged in the subacrominal. Internal Impingement occurs when the supraspinatus and infraspinatus tendons being compressed into the posterior superior aspect of the glenoid during a throwing motion. Other injuries include rotator cuff injuries because the rotator cuff is such an important component of the shoulder. The rotator muscles are responsible for maintaining stability of the shoulder joint.

Phase One of Rehabilitation

The main goal during phase one to regain flexibility. This can be done by daily heating and stretching. Increasing range of motion can be done through physical therapy and using exercises such as pendulums, wall crawls, and pulleys.

Phase Two of Rehabilitation

The main goal of phase two is to strengthen the parts of the shoulder. Daily physical therapy exercises are necessary for this phase along with continuing heating and stretching. The most coming strengthening exercises are wall circles, serratus punches, wall push-ups, and 8-way therabands.

Phase Three of Rehabilitation

Phase three focuses on building endurance. This is important in then return to play protocol because the shoulder not only needs to be strong enough but be able to endure a full workout. Some of the common endurance exercises are Bosu ball push-ups, chest fly’s, and weighted shoulder flexion.

Return To Play

Once all of the phases have been completed the patient should slowly be allowed to return to play after a physician's approval.

References

1Robinson, J. (2014). Show menu. Retrieved June 04, 2016, from https://www.shoulderdoc.co.uk/article/1177

Plasticity and Brain injuries Part Two

Plasticity and Brain injuries Part Two

Effects of a Traumatic Brain Injury

      In the previous blog, I discussed what plasticity is and how it affects the brain. In this blog I will discuss traumatic brain injuries and how plasticity reacts and rehabilitates the brain.

Severe brain injury insults and brain injuries cause rapid cell death, and this disrupts the functional circuits, in the affected regions. After the brain tissue is injured there is a possibility of recovery from insults associated with cell death, because of a regenerative process like plasticity. After plasticity is activated there is a higher chance of recovery. Depending on the magnitude of the injury the brain can suffer from tissue damage, disruption of internal circuits, and disruption of cognitive, other higher functions, and crucial sensory-motor functions. Recovery of damaged brain cells includes three phases: phase one is cell activation, phase two is regaining functional cell plasticity, and phase three is neuroanatomical plasticity leading to the formation of new neural pathways3.

Plasticity Reaction to a Brain Trauma

        The brain is a dynamic organ that has a natural ability to adapt and change with time. Even after the brain has been injured, the brain is able to change by setting up new pathways and connections between neurons that carry the messages back and forth in our brain. We now know the brain is able to create new neurons in in certain sections of the brain, although no one knows the exact purpose or extent. Plasticity of the brain occurs during every stage of development in someone’s lifecycle. “Plasticity is more likely to occur when there is stimulation of the neural system, meaning that the brain must be active to adapt. Changes do not occur without exposure to a stimulating environment that prompts the brain to work. These changes do not occur quickly. That is one of the reasons that recovery goes on for months and sometimes years following TBI2”.

Rehabilitation of a Brain Injury

        In today’s age, traumatic brain injuries have become much more common in society than before, but there is more knowledge about brain injuries and how to treat them.

According to the Centers for Disease, Control, & Prevention, every year about 1.7 million people suffer a traumatic brain injury in the United States; of them, almost 80% get treatment and leave the emergency department1.

        In the past, when someone had severe brain injuries and fell into a semi-coma or a coma, they did not have very high chances of surviving before any neurological recovery because there was not life support devices yet. The doctors also did not know that the brain could heal itself, allowing someone to survive a brain injury1. Until recent years doctors perceived the brain as a static organ, not having the ability to change or heal. Now that doctors understand that the brain is not a static organ they now understand that it is possible for an injured or missing part of the brain to either regrow neural pathways or allow the other side of the brain to take over. Because of this a patient who suffered from a traumatic brain injury may be able to relearn how to walk, talk, or other daily tasks depending on the severity of the injury. Speech and physical rehab is very important for a patient with a brain injury to start as soon as possible to start the plasticity process.  The first six to 12 months after a traumatic brain injury provide a good indication of how the patient will in the future1.  

1Landaue, E. (2011, May 5). The brain's amazing potential for recovery. CNN Health. Retrieved from http://www.cnn.com/2011/HEALTH/05/05/brain.plasticity.giffords/

2Novack, T. (2002). Understanding tbi: Part 1 - what happens to the brain during injury and the early stages of recovery from tbi?. Retrieved from http://www.msktc.org/tbi/factsheets/Understanding-TBI/What-Happens-During-Injury-And-In-Early-Stages-Of-Recovery

3Wieloch, T., & Nikclich, K. (2006). Mechanisms of neural plasticity following brain injury. Current Opinion in Neurobiology, 16(3), 258-264. Retrieved from http://ac.els-cdn.com/S0959438806000626/1-s2.0-S0959438806000626-main.pdf?_tid=7641226c-50fc-11e3-9d98-00000aab0f6c&acdnat=1384853279_4fe8856a9d89702b9226a07d8a78fd9e

Level 5 of Leadership: The Pinnacle

Level 5, the pinnacle of leadership. This is the level of leadership that all leaders strive to reach at some point in their life. This level is a culmination of leading well on all other four levels, but also requires a high degree of skill and some amount of natural leadership ability.1

Pinnacle leaders have a uniqueness about them, they are a cut above, they seem to have success follow them wherever they go.1 Most leaders don't reach this level until later in their career. The individual that manages to reach the pinnacle level, lead so well and for so long that they create a legacy in the organization they serve. Not only do they alter the organization they work in, but they also transform the industry they work in.1 This individual has mastered the art of developing leaders into level 4 leaders.

Let’s look at an example of a leader that has mastered all 4 levels of leadership and sits at the top of "pinnacle leaders", John Wooden. Coach Wooden was the legendary basketball coach for the UCLA Bruins back in the 1960’s and 1970’s. Wooden won 10 NCAA titles during his last 12 season with the Bruins, including 7 in a row from 1967 to 1973. Beyond the many wins and championships, Coach Wooden left a major impact on the game of basketball but more importantly the lives of those around him. To this day his impact is still felt around the sports world, he was a tremendous leader. 

Here are some guidelines to facilitate your growth once you have reached this level and to help others navigate to becoming level 4 leader. If you have not read my previous articles on leadership, give them a read so that you too can possess the steps to improving your leadership skills.

Leadership Guideline:

1. Be humble and teachable.
2. Maintain your core focus.
3. Create a solid inner circle to keep you grounded.
4. Do only what you can do.
5. Create a supercharged leadership development environment.
6. Create room at the top.
7. Develop your top leaders.
8. Plan your succession.
9. Plan your legacy.
10. Use your leadership success as a platform for something greater.

References:

1Maxwell, J. C. (1960). The 5 levels of leadership: Proven steps to maximize your potential. United States: Center Street

Level 4 of Leadership: People Development

As we continue to progress through the different levels of leadership, make sure you, if you haven't already, check out my previous blogs on leadership. These blogs also provide insight on how to have an impact on your team, organization, or company by applying these characteristics to your daily life. In this blog, I will share with you the characteristics of the fourth level of leadership.

People Development

    On level 3 the emphasis was on personal productivity and getting results from the individuals around you. The ability to create a high-productivity team, department or organization indicates a higher level of leadership ability than most others display.2 To reach the elite level of leadership, the leader must transition from a producer to a developer, a developer of people that is. Some of the best coaches to ever coach are people developers. Pat Summitt, a Hall of Fame inductee and a pioneer of women's college basketball who guided the Tennessee Volunteers to eight national titles in her 38 seasons at the university, mastered the fourth level of leadership. Not only is she the all-time NCAA winningest head coach of both men’s and women’s basketball, but she also graduated 100% of her basketball players.3 That fact alone speaks volumes to how great she was at developing young women.

These types of leaders invest their time, energy, money, and thinking into growing others as leaders.2 This practice of identifying and developing people compounds the positives of their organization because bringing out the best in a person is often a catalyst for bringing out the best in the team.2 Following this equation, will provide the blueprint to developing others for success.

This shift from production to people development can be a difficult transition, especially if you are a highly productive person that is used to getting the dirty work done. Be mindful that this change can revolutionize any team and provide a bright future. To prep you for the final blog on leadership, here are a few things to remember:

• The Highest Goal of Leadership Is to Develop Leaders, Not Gain Followers or Do Work.2
• To Develop Leaders, You Must Create a Leadership Culture.2
• Developing Leaders Is a Life Commitment, Not a Job Commitment.2

References:

1Harris, B. (2016). The bison way. Cultivating a culture of champions. Retrieved May 30, 2016, from http://strengthperformance.com/video/the-bison-way-cultivating-a-culture-of-champions

2Maxwell, J. C. (1960). The 5 levels of leadership: Proven steps to maximize your potential. United States: Center Street

3Voepel, M. (2016) Legendary Lady Vols coach Summitt dies at 64. Available at: http://espn.go.com/womens-college-basketball/story/_/id/16577486/legendary-tennessee-lady-vols-coach-pat-summitt-dies-64 (Accessed: July 2, 2016)

Health Benefits from Laughter

www.sheknows.com

In my previous blog we discussed laughter is the best medicine. When you start to laugh, it doesn’t just lighten your load mentally, it actually induces physical changes in your body. Laughing can reduce stress levels and have both short-term and long term benefits.1

According to Life Gaiam, there are 7 health benefits from laughter:2

1.       Laughing lowers blood pressure

Not only does laughing lower blood pressure, but it may also reduce the risk of stroke and heart attacks.

2.       Reduces stress hormone levels

Laughing can reduce the level of stress hormones that your body produces and it may result in higher immune system performance.

3.       Fun ab workout

When you are laughing you are expanding and contracting your abdominal muscles. Add laughter to your next ab workout.

4.       Improves cardiac health

Laughter is also a great cardio workout! It gets your heart pumping and burns calories.

5.       Boosts T-cells

T-cells are specialized immune system cells, when you laugh you activate T-cells that immediately begin to help you fight off sickness.

6.       Triggers the release of endorphins

Endorphins are the body’s natural painkillers. By laughing, you can release endorphins, which can help you ease chronic pain and make you feel good all over.

7.       Produces a general sense of well-being

Laughter can increase your overall sense of well-being such as increasing your mood and spirits. Doctors have found that individuals who have a positive outlook on life tend to fight diseases better than those who tend to be more negative.

As previously mentioned, laughter can provide short-term and long-term benefits.1 Laughter enhances your intake of oxygen-rich air, stimulates your heart, lungs, and muscles, and increased the endorphins that are released by your brain. Laughter can also stimulate circulation and aid muscle relaxation, both of which can help reduce some of the physical symptoms of stress.1 Overall, laughter can improve your mood. Many people experience depression, sometimes due to chronic illnesses and diseases. Laughter can help lessen depression and anxiety and may make you feel happier. Laughter can also make it easier to cope with difficult situations and help you connect with other people.1 My favorite reason for laughing is that laughter can bring people together, may it be over some silly joke or a funny video it’s all fun and everyone is happy. Smile and laugh a little more!

References:

1Mayo Clinic. (2016, April 16). Stress relief from laughter? It’s no joke. Retrieved from: http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relief/art-20044456

2LaMeaux., E.C. (N.D.). 7 health benefits of laughter. Gaiam Life. Retrieved from: http://life.gaiam.com/article/7-benefits-laughter