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What team open baseball the first 60 years?. How many president threw out the first pitch? Who was the first?

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Presentation on theme: "What team open baseball the first 60 years?. How many president threw out the first pitch? Who was the first?"— Presentation transcript:

1 What team open baseball the first 60 years?


3 How many president threw out the first pitch? Who was the first?

4 Eleven - Taft

5 What did Truman do differently?

6 First Southpaw

7 Opening day Snow Fight Unfortunately, Opening Day has also been marred by riots and civil disobedience. At the start of the 1907 season, the New York Giants opened against the Phillies following a heavy snowstorm. In preparation for the game, groundskeepers were forced to shovel large drifts of snow onto the outer edges of the field in foul territory. After falling behind 3-0, the disappointed fans at the Polo Grounds began hurling snowballs onto the playing field, disrupting play. As the melee progressed, chaos ensued and fans began rushing onto the field to continue the snowball fight. After being pelted, Home plate umpire Bill Klem had enough and called a forfeit in favor of the Phillies.

8 Rehabilitation of Shoulder Instability

9 Ligamentous/capsular laxity (non-contractile)

10 Treatment strategies Bracing Taping Muscle strengthening Proprioceptive/kinesthetic training Neuromuscular dynamic stability

11 Posterior instability response better than anterior instability

12 Scapulothoracic Exercises 4 Core Exercises (Mosley) 1. Scaption with the thumb up for the upper trapezius

13 Scaption (abduction in the scapular plane of 30-45 degrees forward in the horizontal plane) or flexion;

14 2. Press up for the lower trapes, latissimus doris and teres minor

15 3. Push up with a plus for the serratus anterior

16 4. Scapular Retraction for the Middle Trapezius and Rhomboids

17 Glenohumeral Exercises Townsend 4 Core Exercises 1. Scaption with the thumb down (up) empty can or full can for the supraspinatus

18 2. Press ups for the lower trapezius, latissimus dorsi and teres major

19 3. GH flexion for the anterior deltoid and the coracobrachialis

20 4. External Rotation with horizontal extension for the infraspinatus, teres minor, and posterior deltoid

21 Rotator Cuff Exercises (30/30/30 Position) 30 degrees of abduction 30 degrees of scaption 30 degrees of diagonal tilt

22 30 degrees of abduction Used to protect the rotator cuff and prevent wringing out effect on the supraspinatus tendon

23 Second 30 degree position places the arm into scaption Protects the anterior inferior capsule Prestretches the posterior rotatator cuff muscles External rotation muscles are the weakest of the 6 directions of the GH joint

24 30 degree diagonal tilt Prevents a posterior internal impingement and is more comfortable than the transverse plane position when performing GH rotation exercises

25 Studies show that adducting muscle activity will increase the space of the subacromial space

26 Summary reason to use the 30/30/30 Prevents the wringing out effect Scaption position protects the anterior inferior capsule The scaption position is a functional arc of motion for the shoulder Comfortable positions to do ER/IR exercises GH adduction increases the width of the subacromium space

27 Advance the patient to the 90/90 position to advance the rotator cuff strengthening program if the patient need to use the arm in overhead activities

28 Total Arm Strengthening Exercises (TAS) Biceps and triceps cross the GH joint can contribute to dynamic stability of the GH joint

29 Exercise Progression Continuum Multiple-angle isometrics submaximal effort Multiple-angle isometrics maximal effort Short arc exercises submaximum effort Short arc exercises maximum effort Full ROM exercises submaximum effort Full ROM exercises maximum effort

30 Cross Education Training?

31 10-15% increase in strength on the contralateral side

32 Bilateral deficits?

33 Total strength is less than sum of each individually

34 Systematic Variable Range Repetition E2C

35 Eccentric to concentric

36 Deceleration and acceleration impulses create more muscle tension Increasing progressive ranging exercises the intensity of exercises is increased at the additional angle

37 Progressive Range of Motion Protects the soft tissue healing structures

38 As heal add more ROM

39 Time rate of force development Ability to develop force rapidly (FT fibers)

40 Contra-Coup Concept of shoulder stability (C3-S2)

41 Common Thought ER most important and the subscapularis for anterior instability

42 Contra-Coup Concept Subscapularis contraction cause anterior translocation of the humeral head Infraspinatus contracture causes posterior translation of the humeral head Use GH: IR:ER is 3:2 or ratio 100%:66%

43 Neuromuscular Proprioceptive/Kinesthetic Deficits (Functional Neuromuscular Dynamic Stability Functional Stability is dependent on neuromuscular dynamic control

44 Stage 1: Proprioception and Kinesthetic Exercises (baseline for Dynamic stability) Diminish Pain and Inflammation Normalize motion Restore proprioception and kinesthesia Establish muscular balance

45 Stage 2: Dynamic (Proactive) Stabilization Exercises Restore muscular balance Enhance dynamic functional stability Rhythmic stabilization

46 Stage 3: Reactive Neuromuscular Control Improve muscular power and endurance Enhance dynamic stability thru proprioceptive and kinesthesia Improve reactive NM abilities Rhythmic stabilizations

47 Stage 4: Functional Skill Movements and Activities Maintain shoulder joint complex muscular balance Maintain reactive NM dynamic stability Gradual return back to activities

48 Summary Heavy Focus on dynamic stabilizers and neuro muscular control

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