You’ve finished your assessment and have your first Training session scheduled with your client, now what? Hopefully, you have obtained a decent amount of information so that you can sit down and make a plan of attack to get the ball rolling in the right direction. While the overall direction of your training will be dictated by what your client’s goals are (fat loss, increasing performance for their sport, increasing their function for daily living, etc …) addressing and/or working around shoulder injuries is going to typically follow the same set of principles. As we discussed in the previous article, the shoulder complex needs an adequate amount of mobility and the requisite amount of motor control to provide the stability so that performance can be optimized. But, what does that look like when the rubber meets the road and you have to apply all of this into a training session and an overall program? Charlie Weingroff, a physical therapist, athletic trainer, and strength coach, (most popularly known for his work Training = Rehab) has a quote that resonated with me and I still think about when programming for my clients. "Get long, get strong, train hard." - Charlie Weingroff, DPT, ATC, CSCS A simple, elegant, and effective philosophy of what you as a fitness professional need to provide for your clients. During my assessment, one of my main goals is to establish 1) what’s tight and 2) what’s weak? Whether you look at things through a biomechanical lens or a neurological lens, a major tenant in a good training program is to lengthen what’s tight and to strengthen what’s weak. In Dr. Weingroff’s quote, get long simply means lengthen what is tight, get strong means strengthen what is weak, and train hard should be pretty self-explanatory. Now, there are many different strategies to lengthen structures or decrease tightness/tone and there are many different implements that can be used to get strong; quite frankly it doesn’t necessarily matter which of those strategies or implements you use. The important thing is that you know why you are doing something and then you do it as well as you possibly can. In order to know why you are doing something, you must gather data, create a plan, execute the plan, and then regather data. Think of this article as an aid to help you in the creating a plan stage.

Theory

While each person is different and needs to be treated as such, there are definitely some commonalities seen across the population. There are a few different constructs that attempt to describe commonalities seen amongst people in regards to determining whether or not a specific joint or area of the body needs more mobility and/or stability. The joint-by-joint approach was brought to light by Gray Cook and the folks over at Functional Movement Systems. This is a wealth of information that can help you identify the movement strategies that are necessary at each individual joint of the body. However, I personally like the information and observations that were gathered and put together by Dr. Vladimir Janda, a physician that was deeply interested in pain syndromes of the locomotor system. He has synthesized some of this into constructs known as the Upper-Crossed Syndrome and Lower-Crossed Syndrome to propose a model of the relationship between tonic (prone to tightness) and phasic (prone to weakness/inhibition) musculature. By looking at the neurological and muscular systems, he observed that some muscles are more prone to being tight and some are more prone to being weak.    

Tonic Muscles (Prone to Tightness)	Phasic Muscles (Prone to Weakness)
Pectorals (Major and Minor)	Serraturs Anterior
Upper Trapezius	Rhomboids (Major and Minor)
Levator Scapulae	Lower Trapezius
Scalenes	Deep Neck Flexors
Sternocleidomastoid	Upper Limb Extensors
Upper Limb Flexors

Derived from: Assessment and Treatment of Muscle Imbalance: The Janda Approach. Page, Frank, Lardner. 2010. By no means is this list rigid and everyone falls into this paradigm, but it does help to illuminate some commonalities that you will likely see and be able to observe during an evaluation and throughout your client’s training. This is not meant to replace an assessment, but rather to give insight into how things correlate to each other and how they can result in pain or dysfunctional movement.

Application

So, all of this is fine and dandy, but how does it fit into actually applying it to training? The main area that I use this information in regards to my programming is with what I call movement prep. You may call it a warm-up, and while that is perfectly fine with me, I like the connotation of movement prep because it sets the foundation for the meat and potatoes of the training program. Employing specific strategies to prepare yourself for the movements that you are going to perform during your workout and throughout your training cycle can help to optimize your movement and minimize your predisposition to dysfunction and injury. Movements like pressing and pulling in both the horizontal and vertical planes, should take up the majority of your training energy and will often give you the most carry-over to athletic or lifestyle pursuits, but putting yourself in the best possible position for those movements is important.

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