A Negative Sulcus Sign?

Any time you attend a conference, you are going to learn some things and unfortunately you are simply going to be unable to retain all of the nuggets shared. So while you do pick up some new skills, there will be some valuable pieces of information that get missed.

So with that being said, the other day I received my DVD copy of the Optimal Shoulder Performance course I attended in November. While watching it, I experienced one of those “I completely missed that” moments. It involved proper execution of the sulcus sign.

For those unfamiliar with this test, here is a video showing execution of the test:

One of the keys when doing this test is head position. In this video, the patient is looking straight ahead – and this is the correct position. Mike Reinold did a nice of job of demonstrating and explaining what can happen if the patient is looking toward the shoulder being tested.

People get curious and want to see what in the world is going on with their shoulder. We, even as the ever educating professional, may even want to show them what is or is not going on with their shoulder and encourage them to look at the shoulder as we do the test.

While this sounds innocent enough, as Mike explains, turning the head causes the upper trap and additional muscles around the shoulder to tighten and tense up. As a result, when you perform the sulcus sign on the patient with the head turned toward the tested shoulder, you most likely will get a negative result. The tightening of the muscles causes motion to be reduced and the real result of the test is possibly altered. Therefore, you could end up with a false negative test while proper execution of the test may actually reveal a positive finding.

Make sure the patient is looking straight ahead as shown in the video. As a result, the shoulder musculature will be relaxed and a true test result will be generated.

One of many great tips on the DVD I figured I’d share. So remember – tell the patient to look straight ahead and relax – you’ll get a much more accurate test result.

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Ordered the DVD Set – Optimal Shoulder Performance

I ordered my copy of Optimal Shoulder Performance yesterday. I attended the course in November and look forward to reviewing the material and relearning some of the great information that may have passed me by initially.

One comment about this product and other multimedia presentations in regards to Athletic Trainers and CEUs that most people in our profession have a poor handle on.

Most ATCs are misinformed about what educational materials they can actually utilize in order to acquire their CEUs. They simply think that if an educational course does not have CEUs assigned to it or is offered by a non-approved provider, that they can’t get CEUs for it. So they pass the opportunity by and miss out on a potentially great learning experience.

Unfortunately, this is incorrect. Educational materials such as DVDs or seminars sponsored by non-approved providers can count toward your CEU total under Category D. Each ATC can acquire 20 CEUs in this category every three years.

I wrote a detailed post on this subject previously and you can also check out the BOC guidebook for Continuing Education here.

So don’t disregard those Category D opportunities.

And make sure you order a copy of the Optimal Shoulder Performance DVD as well – you won’t be disappointed.

Take care and have an awesome Easter!!!

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The Bodyblade and Internal/External Rotation Strength – Study Review

I am a packrat. I’ll admit it.

And for all of you who are packrats, this post and probably several others in the future will serve as a rationalization as to why it is okay to be a packrat.

I have an old collection of Journals of Athletic Training and you know, it is good to go back and review some of the work that has been done in the past. They also make for great blogging material.

So today I will talk about a study that was published in the July-September 2006 issue of the Journal of Athletic Training. The study was entitled Flexible Foil Exercise and Shoulder Internal and External Rotation Strength and was conducted by Daisuke Sugimoto and Peter Blanpeid.

The goal of the study was to compare the effects of rotator cuff strengthening between Theraband and The Bodyblade. The real premise was to determine the capabilities of the Bodyblade to be utilized in strengthening of the rotator cuff.

Many of us utilize a Bodyblade for core stabalization, proprioception, muscular endurance and host of other purposes. So determining if utilizing this device in traditional rotator cuff strengthening seems like a reasonable endeavor.

Forty asymptomatic subjects completed the study and traditional standing internal and external rotation strengthening was conducted using traditional resistance bands and the Bodyblade. The program lasted for 8 weeks. Those training with the resistance bands progressed each week from Yellow to Red to Green to Blue starting with 3 sets of 10 and then moving to 3 sets of 20 for each resistance level before moving to the next level of repetitions and resistance.

As for the Bodyblade training, subjects trained with the Classic model for 4 weeks starting at 2 x 30 seconds in week 1, 2 x 40 seconds in week 2, 2 x 50 seconds in week 3, and 2 x 60 seconds in week 4. From weeks 5-8, the subjects upgraded to the Bodyblade Pro model and then repeated the same resistance progression for both internal and external rotation.

The conclusion of the study revealed that strength training for 8 weeks using the Bodyblade did not improve shoulder internal and external rotation strength.

I commend the researchers for performing this study. They do note that there were some limitations associated with this study. That being said, this is a popular item in rehabilitation clinics abroad and study was a worthwhile effort. As you read through the study,  you may formulate your own questions about the study.

Overall, I am not sure if we as clinicians use the Bodyblade for strength training in the traditional sense. I think we use this device for proprioception, functional strengthening, endurance training and the like so I am not overly surprised by the results of the study.  And yet, it is certainly a topic of interest.

What are your thoughts about the study? How do you use the Bodyblade with the shoulder complex? Did the results of the study surprise you? Do you know of any more recent studies that may contradict these results?

I am interested in your thoughts and comments.  Please share.

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