1. GRADY J. HARDEMAN, M.ED., LAT, ATC, CSCS A.L. BROWN HIGH SCHOOL KANNAPOLIS, NORTH CAROLINA 28083 Plyometric and Closed Kinetic Chain Exercises For The Upper Extremity

2. Closed Kinetic Chain (CKC) Exercises An exercise movement pattern where the distal aspect of the extremity is fixed to an object that is either stationary or moving. DISCLAIMER Closed Kinetic Chain Exercises Should Be Performed In Conjunction With Open Kinetic Chain Exercises

3. Rational For Using Plyometric and Closed Chain Exercises For Rehabilitation 1. Increase Muscle Co-Contraction 2. Incorporates Multi-joint Movements. 3. Aids in the restoration of “Neuromuscular Control” that is lost due to injury. 4. Enhances mental preparation for return to sport. 5. Makes the rehabilitation experience fun and meaningful. (BE CREATIVE)

4. Important Questions to Consider What are you trying to accomplish? Achieving total arm strength means training the entire kinetic chain. What was the initial injury? Avoid stressing the joint capsule when necessary. (Anterior/Posterior Instability) Closed kinetic chain exercises are contraindicated when joint compression forces should be kept at a minimum. (Labral Pathology, Acromioplasty) Are the selected exercises phase appropriate?  Is it to early in the rehabilitation process to begin?  Begin with four points of contact and progress to two points of contact as athlete gains strength

5. Wall Push Up Start PositionDown PhaseExtreme Position

6. Wall Push Up Key Point  Extreme Push Up  Increased scapular protraction after full elbow extension. Progression  Add Medicine Balls  Add Resistance  Add a Plyometric Component

7. Push Up Variations Up PhaseDown Phase

8. Push Up Key Point  Focus on adding the extreme protraction at the top of the push up.  Activates Serratus Anterior muscle. Progression  Begin with modified push up.  Advance to regular push up.  Add unstable surface. Extreme Position

9. Press Up

10. Plyometric Push Up Start PositionFinish Position

11. Plyometric Push up Key Point  Advanced Exercise  Must be able to complete Wall push ups, and Regular Push ups prior to initiating this exercise Equipment Needed  Soft Medicine Ball Progression  May begin with just two points of contact.  Progress to four points of contact.

12. Upper Body Step Up Start Position Middle Position Finish Position

13. Upper Body Step up Equipment  6”-8” Step or box  Progress to an Unstable Surface  (Dyna Disc, Med Ball, etc…) Volume  Perform sets of 8-12 reps. Important Notes  Monitor for pain and/or fatigue.  SET THE CORE!!!!!

14. Wheel Barrow Walk w/Agility Ladder

15. Agility Ladder Equipment  Agility Ladder  Extra Set of hands Variation  Side to Side  Front to Back  Carioca  Progress to Wheel Barrow  This is where the extra set of hands comes in to play.

16. Wax On/Wax Off Two Points of ContactFour Points of Contact

17. Wax On/Wax Off Equipment  Slide Board (Flat Smooth Surface)  Clean Socks  PhysioBall Progression  Begin with four points of contact.  Progress to two points of contact.  Keep one arm stationary and move the opposite arm in clockwise and counter clockwise pattern.  Move both extremities simultaneously.  Add PhysioBall to increase proprioception component.

18. Thank You Contact Information hardemag@kannapolis.k12.nc.us 704-202-8597 415 East First Street Kannapolis, NC 28083