{"id":2697,"date":"2016-12-21T05:32:34","date_gmt":"2016-12-21T04:32:34","guid":{"rendered":"https:\/\/www.totalcoaching.com\/blog\/?p=2697"},"modified":"2016-12-09T18:55:30","modified_gmt":"2016-12-09T17:55:30","slug":"shoulder-assessment","status":"publish","type":"post","link":"https:\/\/www.totalcoaching.com\/blog\/shoulder-assessment\/","title":{"rendered":"Step-By-Step Shoulder Assessment to Prevent Client Injury"},"content":{"rendered":"","protected":false},"excerpt":{"rendered":"","protected":false},"author":17,"featured_media":2738,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","tve_updated_post":"<div class=\"thrv_paste_content thrv_wrapper tve_empty_dropzone\"><p>My shoulders and I have a challenging relationship. <\/p><p>We\u2019ve been through numerous separations. This led to two sessions of counseling to help us serve the other better and maintain a closer relationship without the attachment issues we\u2019ve had in the past. <\/p><div style=\"width: 598px\" class=\"thrv_wrapper tve_image_caption img_style_lifted_style2\">\n<span class=\"tve_image_frame\">\n<img class=\"tve_image\" alt=\"Shoulder Assessment\" style=\"width: 598px\" src=\"\/\/www.totalcoaching.com\/blog\/wp-content\/uploads\/2016\/12\/client-injuries.jpg\" width=\"598\" height=\"300\">\n<\/span>\n<\/div><p>I believe, in the medical world, this is known as multiple shoulder dislocations and repeated surgery.<\/p><p>I admit it. It was my fault. I\u2019ve abused my shoulders with a cocktail of rugby, regularly being the smallest guy on the pitch, and for some time, a lack of knowledge about how to care for them. Maybe the hypermobility didn\u2019t help, so they have to take some responsibility for our predicament too!<\/p><p>It\u2019s safe to say I\u2019ve done my fair share of rehab. And, as a professional strength and conditioning coach, I've also screened hundreds of athletes in a wide variety of sports. <\/p><p>Personally, I train in <a href=\"http:\/\/homefitnessguru.net\/calisthenics\/calisthenics-shoulder-workout-with-results\/\" target=\"_blank\" class=\"\">calisthenics<\/a> which puts a demand and intensity on my shoulders matched by few other sports or activities. As a result, <span style=\"background-color: rgb(239, 232, 88);\">I\u2019ve learned a lot about these very complicated joints and why they need special attention for me, for you, and for your clients.<\/span><\/p><h2 class=\"\"><span class=\"bold_text\">About the Shoulder<\/span><\/h2><div class=\"thrv_wrapper thrv_custom_html_shortcode\" style=\"margin-bottom: -20px !important;\"><iframe src=\"\/\/giphy.com\/embed\/iCcBPQuH2dyUg\" width=\"600\" height=\"340\" frameborder=\"0\" class=\"giphy-embed\" allowfullscreen=\"\"><\/iframe><p><a href=\"http:\/\/giphy.com\/gifs\/pull-up-grip-strength-back-day-iCcBPQuH2dyUg\"><\/a><\/p><div class=\"tve_iframe_cover\"><\/div><\/div><p class=\"italic_text tve_p_center\">The shoulder is impressive, but it requires special care!<\/p><p><span style=\"background-color: rgb(239, 232, 88);\">The shoulder is the most mobile joint in the human body, but this great capacity for movement comes at the cost of stability.<\/span> <\/p><p>Most people will know that the shoulder is a <a href=\"http:\/\/www.daviddarling.info\/encyclopedia\/B\/ball-and-socket_joint.html\" target=\"_blank\" class=\"\">ball and socket joint<\/a>, and it is this architecture that gives it the range of movement. The hip is the same type of joint, but you rarely meet someone who has dislocated their hip unless they're someone who is eligible for a free bus pass. <\/p><p>Or, you have met me. Thanks to my hypermobility, I\u2019ve dislocated that joint too!<\/p><p>But for most people, the hip is securely packed into a deep socket and surrounded by thick ligaments and an arsenal of large, strong muscles to support it. <\/p><p>The shoulder, on the other hand, is different. The head of the bone in the upper arm (humerus) articulates with the glenoid fossa on the scapular. Together they become the <a href=\"https:\/\/www.shoulderdoc.co.uk\/article\/1177\" target=\"_blank\" class=\"\">glenohumeral joint<\/a>.<\/p><div class=\"thrv_wrapper thrv_custom_html_shortcode\"><blockquote class=\"twitter-tweet\" data-lang=\"en\"><p lang=\"en\" dir=\"ltr\"><a href=\"https:\/\/twitter.com\/hashtag\/Anatomy?src=hash\">#Anatomy<\/a> of the <a href=\"https:\/\/twitter.com\/hashtag\/Shoulder?src=hash\">#Shoulder<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/Joint_Capsule?src=hash\">#Joint_Capsule<\/a> <a href=\"https:\/\/t.co\/DTT8TgRoGW\">https:\/\/t.co\/DTT8TgRoGW<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/mendmeshop?src=hash\">#mendmeshop<\/a> <a href=\"https:\/\/t.co\/z77NWe8ztm\">pic.twitter.com\/z77NWe8ztm<\/a><\/p>\u2014 MendMeShop (@MendMeShop) <a href=\"https:\/\/twitter.com\/MendMeShop\/status\/749764945563226112\">July 4, 2016<\/a><\/blockquote>\n<code class=\"tve_js_placeholder\">[tcb-script async=\"\" src=\"\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"][\/tcb-script]<\/code><\/div><p><span style=\"background-color: rgb(239, 232, 88);\">The mobility-stability relationship arises because the glenoid fossa is very shallow, like a saucer, as you can see in the image below<\/span>. Therefore, the humeral head has plenty of freedom to move, but there is not much to stop it from migrating into dysfunctional positions or slipping out the edge of the confines of the saucer.&nbsp;<\/p><div style=\"width: 598px\" class=\"thrv_wrapper tve_image_caption img_style_lifted_style2\">\n<span class=\"tve_image_frame\">\n<img class=\"tve_image\" alt=\"Shoulder joint\" style=\"width: 598px\" src=\"\/\/www.totalcoaching.com\/blog\/wp-content\/uploads\/2016\/12\/shoulder.png\" width=\"598\" height=\"437\">\n<\/span>\n<\/div><p>Dysfunction in and around the shoulder can cause faulty joint arthrokinematics,&nbsp;leaving it susceptible to impingement, <a href=\"http:\/\/www.weightlossforall.com\/how-to-deal-with-weightlifting-shoulder-pain.htm\" target=\"_blank\" class=\"\">pain<\/a>, instability, and trauma. Many people will deal with shoulder issues due to <a href=\"http:\/\/www.builtlean.com\/2016\/05\/02\/fix-bad-posture\/\" target=\"_blank\" class=\"\">poor posture<\/a>, repetitive stress, poorly structured training programmes and previous injury. <\/p><p><span style=\"background-color: rgb(239, 232, 88);\">Shoulder dysfunction is extremely common today due to our lifest<\/span><span style=\"background-color: rgb(239, 232, 88);\">yles. And because of its susceptibility to injury, we need to know how to assess and programme accordingly, keeping it safe and functioning well.<\/span><\/p><h2 class=\"\"><span class=\"bold_text\">Assessing the Shoulder<\/span><\/h2><p>In most training programmes, it is likely you will intend on doing some form of <a href=\"https:\/\/www.fitnessblender.com\/videos\/kellis-abs-and-upper-body-strength-training-workout-chest-back-arms-and-abs-superset-workout\" target=\"_blank\" class=\"\">upper body training<\/a>; therefore, we need to know whether it is safe to load the shoulder joint, at what intensity, and if we need to do any <a href=\"https:\/\/drjohnrusin.com\/bulletproof-your-shoulders-8-prehab-rehab-upper-body-exercise\/\" target=\"_blank\" class=\"\">corrective training<\/a> first. <\/p><p>So my headline priority from the screening and assessment process is to understand two things: <span style=\"background-color: rgb(239, 232, 88);\">how the shoulders behave in an integrated, full-body movement and what they do in more isolated actions.<\/span> From that, I can understand what <a href=\"http:\/\/www.sports-injury-info.com\/shoulder-anatomy.html\" target=\"_blank\" class=\"\">musculature \ufeff\ufeff\ufeffand structures<\/a> are likely over and underactive, enabling me to put specific exercises in the programme to address the client's individual issues.<\/p><h3 class=\"\"><span class=\"bold_text\">Integrated Movement Screening<\/span><\/h3><p>My go-to screening tool here is the overhead squat <span class=\"bold_text\"><span class=\"underline_text\">without<\/span><\/span> the use of a dowel or very light bar. <\/p><p>The reason for that is I\u2019ve seen athletes over the years use it to crank up some tension in the upper body, helping them to stabilise and create a better body position. <span class=\"bold_text\">Take the bar out, and the shoulders are free to do as they please, giving me more information.<\/span><\/p><p>I recommend an integrated movement like the <a href=\"https:\/\/dsstrength.com\/the-best-damn-overhead-squat-mobility-article-period\/\" target=\"_blank\" class=\"\">overhead squat<\/a> because I want to see how the shoulders interact with the kinetic chain when other joints are moving at the same time. <span style=\"background-color: rgb(239, 232, 88);\">The body is smart and will find the path of least resistance, so shoulder health needs to be assessed in context with everything else.<\/span><\/p><p><span class=\"bold_text\">Here\u2019s an example:<\/span> The muscle origin of the <a href=\"https:\/\/www.freetrainers.com\/exercise\/muscle\/lats\" target=\"_blank\" class=\"\">latissimus dorsi<\/a> is on the ilium of the pelvis and inserts onto the anterior humerus, having made a connection with the spine and scapular along the way. <\/p><p>With the shoulders flexed and the hands overhead, the lats are in a lengthened state. In a contracted state, they extend the shoulder, internally rotate the humerus, and arch the lower back. Imagine being put in handcuffs.<\/p><div style=\"width: 550px; margin-bottom: 20px !important;\" class=\"thrv_wrapper tve_image_caption aligncenter img_style_lifted_style2\">\n<span class=\"tve_image_frame\">\n<img class=\"tve_image\" alt=\"squat with good form\" style=\"width: 550px;\" src=\"\/\/www.totalcoaching.com\/blog\/wp-content\/uploads\/2016\/12\/Textbook-overhead-squat.png\" width=\"550\" height=\"365\">\n<\/span>\n<\/div><p class=\"tve_p_center italic_text\">A textbook overhead squat<\/p><p>To set up the overhead squat, ask the client to raise their hands over their head, thumbs facing behind them (external shoulder rotation) and get the biceps inline with the ears. <\/p><p style=\"margin-bottom: 30px !important;\"><span style=\"background-color: rgb(239, 232, 88);\">If movement is optimal, they should be able to do this in a standing position without losing control of the spine and arching the back or lifting the rib cage.<\/span> <\/p><p>The next stage is to see if the client can maintain that alignment when they go into the squat movement.<\/p><p>As the overhead squat is initiated, other forces begin to act on the pelvis that may place an additional demand on the lats. <span style=\"background-color: rgb(239, 232, 88);\">The brain is trying to complete the squat movement, and if it can\u2019t do it whilst maintaining optimal joint position, it will make adjustments to create more \u2018space\u2019 to play with.<\/span> <\/p><div style=\"width: 550px; margin-bottom: 20px !important;\" class=\"thrv_wrapper tve_image_caption aligncenter img_style_lifted_style2\">\n<span class=\"tve_image_frame\">\n<img class=\"tve_image\" alt=\"squat with posterior tilt\" style=\"width: 550px;\" src=\"\/\/www.totalcoaching.com\/blog\/wp-content\/uploads\/2016\/12\/Arms-forward-with-rounded-back.png\" width=\"550\" height=\"379\">\n<\/span>\n<\/div><p class=\"tve_p_center italic_text\">Overhead squat with posterior tilt<\/p><p>For example, if the hamstrings are tight and can\u2019t lengthen sufficiently to maintain a normal spine position, the pelvis will tuck underneath (posterior tilt) and create a pull on the lats. The result is that the arms may fall forward. <\/p><div style=\"width: 550px;\" class=\"thrv_wrapper tve_image_caption aligncenter img_style_lifted_style2\">\n<span class=\"tve_image_frame\">\n<img class=\"tve_image\" alt=\"squat with anterior tilt\" style=\"width: 550px;\" src=\"\/\/www.totalcoaching.com\/blog\/wp-content\/uploads\/2016\/12\/Arms-forward-with-back-arch.png\" width=\"550\" height=\"388\">\n<\/span>\n<\/div><p class=\"tve_p_center italic_text\">Overhead squat with anterior tilt<\/p><p>Alternatively, if the lats are short, trying to keep them overhead might lead to an <a href=\"https:\/\/www.theptdc.com\/2014\/06\/5-steps-dealing-anterior-pelvic-tilt\/\" target=\"_blank\" class=\"\">anterior tilt<\/a> or an arching in the lower back. The limitation in range of movement is compensated for by the ilium moving closer to the shoulders.<\/p><p>Because the lats connect the shoulder to the pelvis, the overhead squat enables us to easily identify how the shoulder is affected as part of the global movement pattern. <\/p><p>Its interaction with the other joints involved (ankle, knee, hip) helps us to build a top level picture as to whether there is a shoulder issue or if something else is the root of a movement compensation. <\/p><p><span style=\"background-color: rgb(239, 232, 88);\">We are effectively asking why there is a movement compensation at the shoulder, not just what the movement compensation is.<\/span> <\/p><blockquote class=\"\" style=\"margin-bottom: 30px !important;\">Using the above example, you could be hammering away at shoulder range of movement when <a href=\"http:\/\/stretchcoach.com\/articles\/hamstring-stretch-video\/\" target=\"_blank\" class=\"\">fixing the hamstrings<\/a> might solve the problem.<\/blockquote><p>I\u2019ve focused on lat overactivity to illustrate a point, but the other main musculatures to be aware of that could affect shoulder health and range of movement are the pectorals and posterior cuff.<\/p><h3 class=\"\"><span class=\"bold_text\">Isolated Movement Assessment<\/span><\/h3><p>Based on the results of the global movement assessment, we can drill down to the details. Here are a few tests that might add some depth to the picture:<\/p><h3 class=\"\"><span class=\"bold_text\">1. Wall Elevation Test<\/span><\/h3><div class=\"thrv_responsive_video thrv_wrapper rv_style_lifted_style2\" data-overlay=\"0\" data-type=\"youtube\" data-embed_type=\"inline\" data-url=\"https:\/\/www.youtube.com\/watch?v=7XvBR9V4Plc\" data-embeded-url=\"https:\/\/www.youtube.com\/embed\/7XvBR9V4Plc\" data-autoplay=\"0\" style=\"margin-bottom: 30px !important;\" data-rel=\"0\" data-modestbranding=\"1\" data-showinfo=\"0\">\n<div class=\"tve_responsive_video_container\" style=\"display: block;\">\n<div class=\"video_overlay\"><\/div>\n<iframe src=\"https:\/\/www.youtube.com\/embed\/7XvBR9V4Plc?rel=0&amp;modestbranding=1&amp;controls=1&amp;showinfo=0&amp;fs=1&amp;wmode=transparent\" frameborder=\"0\" allowfullscreen=\"\" style=\"display: block;\" data-src=\"https:\/\/www.youtube.com\/embed\/7XvBR9V4Plc?rel=0&amp;modestbranding=1&amp;controls=1&amp;showinfo=0&amp;fs=1&amp;wmode=transparent\"><\/iframe>\n<\/div>\n<\/div><p><span class=\"bold_text\">What is being assessed:<\/span> Lat length<\/p><p><span class=\"bold_text\">Method:&nbsp;<\/span>Client stands with feet together against a wall, with their knees in a quarter squat position. They are instructed to take the hands overhead and touch their thumbs against the wall.<span class=\"bold_text\"><\/span><\/p><p><span class=\"bold_text\">What to look for:&nbsp;<\/span><span style=\"background-color: rgb(239, 232, 88);\">Can the client get their thumbs to the wall whilst maintaining a normal curve in the spine?<\/span> If the thumbs don\u2019t touch the wall, the lower back arches, or the rib cage excessively elevates, there may be limitations in lat length.<span class=\"bold_text\"><\/span><\/p><h3 class=\"\"><span class=\"bold_text\">2. Supine Internal Rotation<\/span><\/h3><p><span class=\"bold_text\">What is being assessed:<\/span> Length of posterior structures (combination of posterior cuff length, teres minor and infraspinatus, and restrictions in the posterior capsule).<\/p><p><span class=\"bold_text\">Method:<\/span> With the client lying flat and supine, move the elbow to a position at 90 degrees to the body. Place your hand on the shoulder to stabilize the glenhumural joint and prevent protraction of the shoulder blade. <\/p><p>Instruct them to try and take their hand as close to the floor\/bench as they can (internal rotation). Measure the angle of the forearm in relation to the starting point (vertical forearm) with a <a href=\"http:\/\/www.topendsports.com\/testing\/tests\/goniometer-flex.htm\" target=\"_blank\" class=\"\">goniometer<\/a>.<\/p><div class=\"thrv_responsive_video thrv_wrapper rv_style_lifted_style2\" data-overlay=\"0\" data-type=\"youtube\" data-embed_type=\"inline\" data-url=\"https:\/\/www.youtube.com\/watch?v=EFGulY8GpD4\" data-embeded-url=\"https:\/\/www.youtube.com\/embed\/EFGulY8GpD4\" data-autoplay=\"0\" style=\"margin-bottom: 30px !important;\" data-rel=\"0\" data-modestbranding=\"1\" data-showinfo=\"0\">\n<div class=\"tve_responsive_video_container\" style=\"display: block;\">\n<div class=\"video_overlay\"><\/div>\n<iframe src=\"https:\/\/www.youtube.com\/embed\/EFGulY8GpD4?rel=0&amp;modestbranding=1&amp;controls=1&amp;showinfo=0&amp;fs=1&amp;wmode=transparent\" frameborder=\"0\" allowfullscreen=\"\" style=\"display: block;\" data-src=\"https:\/\/www.youtube.com\/embed\/EFGulY8GpD4?rel=0&amp;modestbranding=1&amp;controls=1&amp;showinfo=0&amp;fs=1&amp;wmode=transparent\"><\/iframe>\n<\/div>\n<\/div><p><span class=\"bold_text\">What to look for:&nbsp;<\/span><span style=\"background-color: rgb(239, 232, 88);\">Clients should be able to achieve more than 70 degrees of internal rotation.<\/span><span class=\"bold_text\"><\/span><\/p><h3 class=\"\"><span class=\"bold_text\">3. Supine External Rotation<\/span><\/h3><p><span class=\"bold_text\">What is being assessed:<\/span> Pec length (primarily pec major)<\/p><p><span class=\"bold_text\">Method:&nbsp;<\/span>With the client lying flat and supine, move the elbow to a position at 90 degrees to the body. Stabilise the glenohumeral joint with your hand and ask them to try and touch the floor\/bench with the back of the hand without extending the wrist. Measure the angle of the forearm in relation to the starting point (vertical forearm) a goniometer.<span class=\"bold_text\"><\/span><\/p><div class=\"thrv_responsive_video thrv_wrapper rv_style_lifted_style2\" data-overlay=\"0\" data-type=\"youtube\" data-embed_type=\"inline\" data-url=\"https:\/\/www.youtube.com\/watch?v=peJDzyOuxzg\" data-embeded-url=\"https:\/\/www.youtube.com\/embed\/peJDzyOuxzg\" data-autoplay=\"0\" style=\"margin-bottom: 30px !important;\" data-rel=\"0\" data-modestbranding=\"1\" data-showinfo=\"0\">\n<div class=\"tve_responsive_video_container\" style=\"display: block;\">\n<div class=\"video_overlay\"><\/div>\n<iframe src=\"https:\/\/www.youtube.com\/embed\/peJDzyOuxzg?rel=0&amp;modestbranding=1&amp;controls=1&amp;showinfo=0&amp;fs=1&amp;wmode=transparent\" frameborder=\"0\" allowfullscreen=\"\" style=\"display: block;\" data-src=\"https:\/\/www.youtube.com\/embed\/peJDzyOuxzg?rel=0&amp;modestbranding=1&amp;controls=1&amp;showinfo=0&amp;fs=1&amp;wmode=transparent\"><\/iframe>\n<\/div>\n<\/div><p><span class=\"bold_text\">What to look for:&nbsp;<\/span>Clients should be able to achieve at least 90 degrees of external rotation. Performing this test on a bench is therefore beneficial if ranges are in excess of this.<span class=\"bold_text\"><\/span><\/p><div class=\"thrv_wrapper thrv_custom_html_shortcode\"><blockquote class=\"twitter-tweet\" data-lang=\"en\"><p lang=\"en\" dir=\"ltr\">Using <a href=\"https:\/\/twitter.com\/hashtag\/hangs?src=hash\">#hangs<\/a> as an assessment and practice of <a href=\"https:\/\/twitter.com\/hashtag\/external?src=hash\">#external<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/rotation?src=hash\">#rotation<\/a>: <a href=\"https:\/\/t.co\/VJQdvI1CRQ\">https:\/\/t.co\/VJQdvI1CRQ<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/shoulder?src=hash\">#shoulder<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/control?src=hash\">#control<\/a> <a href=\"https:\/\/twitter.com\/hashtag\/rehab?src=hash\">#rehab<\/a> <a href=\"https:\/\/t.co\/Cc5bTGbo1p\">pic.twitter.com\/Cc5bTGbo1p<\/a><\/p>\u2014 Christine Ruffolo (@ruffolous) <a href=\"https:\/\/twitter.com\/ruffolous\/status\/734468748464128000\">May 22, 2016<\/a><\/blockquote>\n<code class=\"tve_js_placeholder\">[tcb-script async=\"\" src=\"\/\/platform.twitter.com\/widgets.js\" charset=\"utf-8\"][\/tcb-script]<\/code><\/div><h2 class=\"\"><span class=\"bold_text\">Analyzing<\/span> <span class=\"bold_text\">the Findings<\/span><\/h2><p>These tests are pretty simple and will help you build a picture of the health of the shoulder and it\u2019s readiness for training. Getting a picture of the global movement pattern, and then using a process of elimination using the isolated movements, will help you to be more specific with your programming.<\/p><p><span style=\"background-color: rgb(239, 232, 88);\">If clients do not perform well in any of the tests, I recommend you incorporate specific corrective exercises into the training programme as a priority.<\/span><\/p><h2 class=\"\">Concluding Tips<\/h2><p>To wrap this up I\u2019m going to offer 3 quick take-home messages tips based on what I have experienced and learnt:<\/p><p><span class=\"bold_text\">Tip #1:<\/span> Use <a href=\"http:\/\/www.laurensfitness.com\/2014\/02\/14\/save-your-shoulder-with-tennis-ball-massage\/\" target=\"_blank\" class=\"\">se\ufeff\ufeff\ufeff\ufefflf-massage<\/a> and mobility techniques regularly to improve range of movement in restricted tissues or structures.<\/p><p><span class=\"bold_text\">Tip #2<\/span> Everyone needs to do <a href=\"http:\/\/seannal.com\/articles\/training\/rear-deltoid-exercises.php\" target=\"_blank\" class=\"\">posterior shoulder strengthening<\/a>. Our lifestyles mean we spend a lot of time in protracted positions. Getting healthy shoulders is about creating balanced range of movement and strength from front to back. So, strengthen the mid\/low traps, rhomboids, and external rotators.<\/p><p><span class=\"bold_text\">Tip #3:<\/span> In my own experiment (n=1), I have found an incomparable benefit of training the shoulder more holistically through calisthenics movements for a number of reasons. <a href=\"https:\/\/www.healthambition.com\/top-5-hand-grip-exercises\/\" target=\"_blank\" class=\"\">Maximal grip exercises<\/a> activate the shoulder stabilizers. <\/p><p>Performing strength-based movements that contain a maximal grip component then works the prime movers. Exercises that require you to hang (pull ups, active hang, leg raises, skin the cat, rows, etc.) do all this at the same time. <\/p><p style=\"margin-bottom: 30px !important;\"><span style=\"background-color: rgb(239, 232, 88);\">I am confident that the shoulder should be trained as an integrated unit where stability and strength are used concurrently and not as independent functions.<\/span>&nbsp;Standard training methods, resistance machines, and a lot of rehab-style exercises do not incorporate both components.<\/p><p>The result of my experiment is following multiple dislocations and surgeries I can do a <a href=\"https:\/\/www.totalcoaching.com\/blog\/how-to-do-a-human-flag\/\" target=\"_blank\">human flag<\/a>. In this move, the arm is overhead and externally rotated which is the exact position I used to dislocate in. It is also under huge stability and strength strain. <\/p><blockquote class=\"\" style=\"margin-bottom: 30px !important;\">Screening and assessing clients adds a huge amount of value to the service you offer, the program you write, and the results your clients get. <\/blockquote><p>Having done all the TheraBand exercises in the book, the only thing that has made my shoulders bombproof in recent years is <a href=\"http:\/\/schoolofcalisthenics.com\/\" target=\"_blank\" class=\"\">calisthenics<\/a>. I\u2019m happy to report my shoulders and I are now closer than we\u2019ve ever been, both figuratively and literally.<\/p><p> If you want to explore how you can use calisthenics to give your clients a new stimulus, and train the shoulders in a fun and engaging way, check out our <a href=\"http:\/\/schoolofcalisthenics.com\/product\/beginners-guide-calisthenics-ebook\/\" target=\"_blank\" class=\"\">FREE Beginner's Guide to Calisthenics<\/a> or check out our website at&nbsp;<a href=\"http:\/\/schoolofcalisthenics.com\/\" target=\"_blank\" class=\"\">http:\/\/www.schoolofcalisthenics.com<\/a>.<\/p><h3 class=\"tve_p_center\">Did you find this useful? Share the knowledge by using the buttons below!<\/h3><\/div>","tve_custom_css":"","tve_user_custom_css":"","tve_globals":{"e":"1","font_cls":[]},"tcb2_ready":0,"tcb_editor_enabled":0,"tve_landing_page":"","_tve_header":"","_tve_footer":""},"categories":[1,73],"tags":[],"_links":{"self":[{"href":"https:\/\/www.totalcoaching.com\/blog\/wp-json\/wp\/v2\/posts\/2697"}],"collection":[{"href":"https:\/\/www.totalcoaching.com\/blog\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.totalcoaching.com\/blog\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.totalcoaching.com\/blog\/wp-json\/wp\/v2\/users\/17"}],"replies":[{"embeddable":true,"href":"https:\/\/www.totalcoaching.com\/blog\/wp-json\/wp\/v2\/comments?post=2697"}],"version-history":[{"count":35,"href":"https:\/\/www.totalcoaching.com\/blog\/wp-json\/wp\/v2\/posts\/2697\/revisions"}],"predecessor-version":[{"id":2739,"href":"https:\/\/www.totalcoaching.com\/blog\/wp-json\/wp\/v2\/posts\/2697\/revisions\/2739"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.totalcoaching.com\/blog\/wp-json\/wp\/v2\/media\/2738"}],"wp:attachment":[{"href":"https:\/\/www.totalcoaching.com\/blog\/wp-json\/wp\/v2\/media?parent=2697"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.totalcoaching.com\/blog\/wp-json\/wp\/v2\/categories?post=2697"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.totalcoaching.com\/blog\/wp-json\/wp\/v2\/tags?post=2697"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}