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     The Official eNewsletter of TODAY! Fitness

vol. 2009 issue 12



Shoulder Pain

After I published the article on elbow pain in the September issue of this eNewsletter, I got a few emails asking me about shoulder problems.  Unfortunately, in the last year, I've gotten to experience a torn bicep tendon in my left arm, as well as prominent acromialclavicular arthropathy in my right arm... both of which have caused me more than a little shoulder pain that I've had to work through and rehab. 

Your shoulder joints move every time you move your arms.  The shoulder is a ball-and-socket joint with three main bones: the upper arm bone (humerus), collarbone (clavicle), and shoulder blade (scapula). These bones are held together by muscles, tendons (connecting muscle to muscle), and ligaments (connecting muscle to bone). The shoulder joint has the greatest range of motion of any joint in the body. Because of this mobility, the shoulder is more likely to be injured or cause problems. The acromioclavicular (AC) joint, which lays over the top of the shoulder, is also easily injured.

Shoulder problems can be minor or serious. Symptoms may include pain, swelling, numbness, tingling, weakness, changes in temperature or color, or changes in your range of motion. Shoulder injuries most commonly occur during sports activities, work-related tasks, projects around the home, or falls. Home treatment often can help relieve minor aches and pains.

Some people will have a tendency to ignore the pain and "play through" a shoulder injury, which only aggravates the condition, and may possibly cause more problems. People also may underestimate the extent of their injury because steady pain, weakness in the arm, or limitation of joint motion will become almost second nature to them.

When to call your doctor
If you are unsure of the cause of your shoulder pain, or if you do not know the specific treatment recommendations for your condition, you should seek medical attention. Treatment of these conditions must be directed at the specific cause of your problem. Some signs that you should be seen by a doctor include:

  • Inability to carry objects or use the arm
  • Injury that causes deformity of the joint
  • Shoulder pain that occurs at night or while resting
  • Shoulder pain that persists beyond a few days
  • Inability to raise the arm
  • Swelling or significant bruising around the joint or arm
  • Signs of an infection, including fever, redness, warmth
  • Any other unusual symptoms

Orthopaedic surgeons group shoulder problems into the following categories.

Instability - Sometimes, one of the shoulder joints moves or is forced out of its normal position. This condition is called instability, and can result in a dislocation of one of the joints in the shoulder. Individuals suffering from an instability problem will experience pain when raising their arm. They also may feel as if their shoulder is slipping out of place.

Impingement - Impingement is caused by excessive rubbing of the shoulder muscles against the top part of the shoulder blade, called the acromion. Impingement problems can occur during activities that require excessive overhead arm motion. Medical care should be sought immediately for inflammation in the shoulder because it could eventually lead to a more serious injury.

It is important to make an accurate diagnosis of the cause of your symptoms so that appropriate treatment can be directed at the cause. If you have shoulder pain, some common causes include:

  • Rotator Cuff Tear
    Rotator cuff tears occur when the tendons of the rotator cuff separate from the bone. Surgery is sometimes necessary for this condition.
  • Frozen Shoulder
    Also called 'adhesive capsuliitis,' this is a common condition that leads to stiffness of the joint. Physical therapy and stretching are extremely important aspects of treatment.
  • Calcific Tendonitis
    Calcific tendonitis is a condition of calcium deposits within a tendon -- most commonly within the rotator cuff tendons. Treatment of calcific tendonitis depends on the extent of symptoms.
  • Shoulder Instability
    Instability is a problem that causes a loose joint. Instability can be caused by a traumatic injury (dislocation), or may be a developed condition.
  • Shoulder Dislocation
    A dislocation is an injury that occurs when the top of the arm bone becomes disconnected from the scapula.
  • Shoulder Separation
    Also called an AC separation, these injuries are the result of a disruption of the acromioclavicular joint. This is a very different injury from a dislocation!
  • Labral Tear
    There are several patterns of a torn labrum and the type of treatment depends on the specific injury.
  • SLAP Lesion
    The SLAP (Superior Labrum, Anterior Posterior) lesion is also a type of labral tear. The most common cause is a fall onto an outstretched hand.
  • Arthritis
    Shoulder arthritis is less common than knee and hip arthritis, but when severe may require a joint replacement surgery.
  • Biceps Tendon Rupture
    A proximal biceps tendon rupture occurs when the tendon of the biceps muscle ruptures near the joint

Treatments for shoulder pain

The treatment of shoulder pain depends entirely on the cause of the problem. Therefore, it is of utmost importance that you understand the cause of your symptoms before embarking on a treatment program. If you are unsure of your diagnosis, or the severity of your condition, you should seek medical advice before beginning any treatment. Some typical treatments of shoulder pain include:

  • Rest: The first treatment for many common conditions that cause shoulder pain is to rest the joint, and allow the acute inflammation to subside. It is important, however, to use caution when resting the joint, because prolonged immobilization can cause a frozen shoulder.

  • Ice Application: Ice packs are among the most commonly used treatments for shoulder pain.

  • Stretching: Stretching the muscles and tendons that surround the joint can help with some causes of shoulder pain. 

  • Physical Therapy: Physical therapy is an important aspect of treatment of almost all orthopedic conditions. Physical therapists use different modalities to increase strength, regain mobility, and help return patients to their pre-injury level of activity.

  • Anti-Inflammatory Medication: Nonsteroidal anti-inflammatory pain medications, commonly referred to as NSAIDs, are some of the most commonly prescribed medications, especially for patients with shoulder pain caused by problems such as arthritis, bursitis, and tendonitis.

  • Cortisone injections: Cortisone is a powerful medication that treats inflammation, and inflammation is a common problem in patients with shoulder pain. Discuss with your doctor the possible benefits of a cortisone injection for your shoulder pain condition.

  • Surgery:  Shoulder surgery is the final treatment, yet sometimes necessary when non-surgical treatments are not enough.

For those of us that have already experienced this type of injury, you are probably already aware of what's bothering you and why... unless you're stubborn like me and keep putting off the doctor : (  Do yourself a favor and check it out so that you can get to the point of recovery that much quicker... good luck!


Elite Bodyweight Exercise of the Month!

Step and Knee

Ok, raise your hand if you want to do something about your belly and butt... yeah, I thought so.  Those areas are usually on a lot of peoples Christmas lists!  The bodyweight exercise this month incorporates a step up with a knee raise.  Stepping up works your butt and thighs, while the knee raise adds a little abdominal extra to the motion.  You'll also find this exercise in some of the step-aerobic classes where brisk motion and higher repetitions will also add some cardio benefits.  This exercise can be performed on a step, chair, bench, or even a set of stairs.  The higher the step, the more challenging it becomes and the more you'll feel your hiney the next day!


Target:  butt and abs (gluteals and rectus abdominis)

Count:  4 count

Description:  Standing in front of the step, step completely onto the step/box with one foot, step up and raise the opposite knee up as high as you can.  Step down and bring the step leg down behind you for a toe touch.  I recommend repeating for 10 repetitions on the same leg before switching to the other leg.  It's good practice to maintain good arm motion during the exercise also for additional motion and effort.

Kettlebell Training

The Kettlebell is a cast iron weight, which resembles a basketball with a handle.  A Russian exercise device used for more than 100 years, Kettlebells have long been a favorite in that country for those seeking a special edge in strength and endurance.

In the twentieth century Soviet science discovered that repetition Kettlebell lifting is one of the best tools for all around physical development. In a multi-year study of college students In 1983 (Voropayev), a group that just lifted kettlebells showed better scores in every fitness test compared to a control group that followed the typical military oriented training regime.

In addition to their many mentioned benefits, the official
Kettlebell lifts also develop the ability to absorb ballistic shocks. The ballistic blasts of kettlebell exercise become an excellent conditioning tool for athletes from rough sports like kickboxing, wrestling, and football. The extreme metabolic cost of high rep Kettlebell workouts will put your unwanted fat on a fire sale.

Do-it-yourself Kettlebell design

This design can be used as an adjustable kettlebell, allowing weights up to 35 lbs. 


  1. 1-1"x 6" steel nipple (handle, external diameter is 1 and 1/4")
  2. 2-1" 90 degree elbows (connect handle to vertical pieces)
  3. 2-1"x 4 1/2" steel nipple (vertical pieces), longer vertical pieces will allow the use of larger, heavier plates
  4. 2-1" 'T's
  5. 1-1"x12' steel nipple (through plates)
  6. 2-1' end caps
  7. 6-5 pound standard barbell plates (make sure the 3/4" pipe goes through all of these, the hole in some of my 5 pound plates are too small to use)

As with some dumbbells, always verify that your collars (or end caps) are tight before using.

Product Review:  GYMBOSS

If you are like me and find yourself working out solo, ensuring that you are giving yourself enough rest between sets can sometimes be a challenge.  I picked up the GYMBOSS interval timer for just that purpose.  It's small (about the size of a little pedometer or pager), has a clothing/belt clip, and the one-touch operation is very convenient.  Besides the countdown timer with alarm that I use regularly for weight training and coaching, I've also used it for cardio intervals so that I can easily do high intensity for 30 seconds, lower intensity for a minute, and repeat through that cycle for the duration of my session. 

Purchase the Gymboss Interval Timer

The GYMBOSS has the following features:

  • One or two different time intervals from 2 seconds to 99 minutes

  • Auto mode keeps repeating through intervals
  • Set up to 99 rounds
  • Manual mode acts as countdown timer
  • Stopwatch Function
  • Alarm by beep, vibration, or both
  • Alarm duration of 1, 5, or 10 seconds
  • Size of a small pager
    (1 3/4 x 2 1/4 inches)
  • Water and shock resistant
  • AAA battery required

The GYMBOSS typically sells for $19.95 which I have found to be very reasonable.  Check it out if you're interested!

Try This

S T R E T C H !  Yeah, I know, when time is a factor, flexibility training is the first thing that is cut out.  I was never one to stretch regularly... that is until I started getting older and experiencing joint injuries that could be avoided by regular stretching.  Simple stretches like stretching your forearms can prevent elbow injuries, hamstrings and hip stretches can help with low back pain, and shoulder stretches are key to improving and keeping a good range of pain-free motion.

Stretching does not take a great deal of effort.  It's really just a matter of doing it.  I prefer not to stretch as part of my workout, but rather to do my stretches afterwards at my desk or watching tv with the family.  Problem areas should be stretched several times per day.  For total body stretching, it's good to get into a routine and to hit all the body parts in order.  I like to work top-down, starting with my neck, then working all the way down to my ankles.  Stretching should not be painful.  You should stretch to the end of your comfortable range of motion, hold for 8-10 seconds, pause, and then try to stretch a little further for another 8-10 seconds.

Try this for a week or 2, once or twice a day, and take note of how much better your body is feeling!  Click here for some basic stretches.

It's Go Time!

Yo Yo Yo... Merry Christmas!  Well, not yet... but it will be here before we know it!  Have you been good this year?  Surely you're not one of those people that are waiting for New Years to start being good, right?

There are a ton of fitness gifts out there, but be careful when you ask for recommendations.  Personally, I don't think these gifts are universal.  Since motivation plays such a big role in the ability to adhere to a workout and keep things going... you need to understand what makes the "giftee" tick.  Just because you, or one of your friends recommends a gift, doesn't guarantee it will be useful for everyone.  Motivation, daily routine, fitness level, and other factors have a huge impact on the type of fitness stuff that someone is going to use and get benefit from.  What are you asking Santa Claus for this year? 

Thank you all for reading as well as the emails and comments that I get regarding fitness questions and article ideas!  This issue concludes my 4th year of this little newsletter and I continue to have fun putting it together each month.  I'd like to wish everyone a happy and healthy holiday season as well as lots of luck in EXCEEDING YOUR POTENTIAL and surpassing your goals for 2010!   

For prior issues of this newsletter go to  

Exceed Your Potential!

Pete Mazzeo, CPT


"Every choice you make has an end result" - Zig Ziglar

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