Skeletal Anatomy part 1 | 17-actions of the shoulder | Axial vs Appendicular & Joint Structure |

Curious about how your shoulder works and why it sometimes gets injured? This episode promises to unlock the mysteries of shoulder anatomy and the types of joints involved, from synarthrotic to diarthrotic. We'll also demystify the axial and appendicular skeletons, crucial knowledge for any certified personal trainer aiming to excel. We emphasize why practical skills in anatomy, programming, and client acquisition are more valuable than just a textbook certification.

Next, we tackle the often overlooked subject of injuries and pain assessment. Learn about the key factors leading to injuries, the significance of proper training, and how to prevent and manage injuries effectively. We explore the biopsychosocial model of pain and underline the importance of recognizing red flags that necessitate a referral to a physical therapist. Our comprehensive level two certification program, which includes hands-on learning, ensures that fitness professionals are well-equipped to assess and address client injuries.

Finally, we dissect the shoulder joint in even greater detail, covering the shoulder girdle, glenohumeral joint, scapulothoracic pseudo-joint, acromioclavicular joint, and sternoclavicular joint. Understand the mechanics behind these joints, the potential for abnormal movement, and the importance of joint health for effective training and injury prevention. As we celebrate the podcast's growth with over 40,000 downloads, we reflect on the importance of continuous learning and community engagement. Join our Qualified Personal Trainers community on Facebook for more resources and support.

Want to ask us a question? Email email info@showupfitness.com with the subject line PODCAST QUESTION to get your question answered live on the show!

Our Instagram: https://www.instagram.com/showupfitnessinternship/?hl=en
TikTok: https://www.tiktok.com/@showupfitnessinternship
Website: https://www.showupfitness.com/
Become a Personal Trainer Book (Amazon): https://www.amazon.com/How-Become-Personal-Trainer-Successful/dp/B08WS992F8
Show Up Fitness Internship & CPT: https://online.showupfitness.com/pages/online-show-up?utm_term=show%20up%20fitness
NASM study guide: ...

Transcript

Speaker 1: 0:01

Welcome to the Show Up Fitness Podcast, where great personal trainers are made. We are changing the fitness industry, one qualified trainer at a time, with our in-person and online personal training certification. If you want to become an elite personal trainer, head on over to showupfitnesscom. Also, make sure to check out my book how to Become a Successful Personal Trainer. Don't forget to subscribe, rate and review. Have a great day and keep showing up. Forget to subscribe, rate and review. Have a great day and keep showing up. Howdy y'all. Welcome back to the Show Up Fitness Podcast. Today we're going to be talking about shoulder anatomy, part one. We're going to get into the joint structure, the different types, the synarthrotic, amphrathrotic, diarthrotic joints. What type is the shoulder? What is going on? 206 bones in the human body? We're going to look into the axial appendicular skeleton and really help you level up your knowledge as a qualified, certified personal trainer.

Speaker 1: 0:57

Just finished our second week of the in-person internship to get your show up fitness CPT. 90% of textbook trainers quit within the first year Over the weekend. The PT collective they just shut down. They're basically the equivalent of what show up is doing here in the States. Over there in the UK, luke is one of the original founders. He had some great people on his team. He had a great initiative over there trying to address the same problem. 90% of textbook trainers quote within the first year. I actually learned that through the PT collective, probably 10 years ago. That was the first time I saw that statistic. So what did I do? I went out there and tested it. Met with managers at Equinox 24, crunch now lifetime interviewed them what is your turnover? And I came up with that same statistic in my book how to Become a Successful Personal Trainer.

Speaker 1: 1:51

Volume two is gonna be out here shortly. I know I keep on saying that. I promise it will be Over combined 15,000 people, 90% quit within the first year. Why is that? Because they have a fucking textbook certification and that's why we've dubbed it a level zero. They do not set you up for long-term success. The three areas that you need to be focusing on a trainer business skills, people skills, the trade skills. You don't get that in a textbook. The trade skills are not even proficient to call yourself a professional. Some textbooks say there's four actions of the scapula, some say there's six. There's fucking eight.

Speaker 1: 2:30

Imagine going to a therapist an actual, respected professional and trying to gain respect from them when you say there's four, they're going to look at you like you're a fucking idiot, because most trainers are. Oh my God, you're so mean. Get your panties and your jockstrap out of a bundle. You want to turn your passion for fitness into career, don't you? Well, why do so many trainers talk shit about this industry? It's because no one is leveling up. It's so hard to make money? No, it's not. How's your sales? Tell me the 17 muscles around the shoulder. That doesn't matter. Your clients want results Absolutely they do. But they want a confident trainer. And guess where confidence comes from? Understanding programming. And how do you understand programming? Become great at anatomy? How do you become great at anatomy? You invest time, you intern under therapists, you go to weekend seminars, you gain hands-on experience.

Speaker 1: 3:21

How does the average trainer get certified? I always chuckle at this because it's still the case today. You read a textbook which you don't understand, and then you take a test six months later and you post in your story oh my God, I'm certified inside. You're like what the fuck did I just do? I am absolutely clueless and I'm not mocking you. I just know what you're going through because I've counseled thousands of trainers. And guess what? The ones who are successful. What do they do? They buckle down and invest in understanding anatomy, programming, movement, competency, so their business skills increase because they're confident. Clients want confidence and competence. The average trainer lacks them both. So how are you going to level up your confidence and your competence? You got to learn your anatomy and that's what I'm going to teach you today. Textbooks are going to teach you how to pass their little stupid little textbook certification with a multiple choice test At Show Up Fitness. We empower you to understand programming, anatomy, sales, the assessment, client acquisition those are the things that are going to set you up for success. So you need to spend some time. Every hour that you learn anatomy, you should be spending three to four hours mastering it by yourself, going over the actions and the muscles and seeing them on YouTube, hearing them as you are now.

Speaker 1: 4:41

So let's begin with skeletal anatomy. The basic unit for the skeleton is what's called an osteon. An osteocyte is the single cell of bone. A student here at the in-person in Santa Monica went and got her DEXA scan. This is an expensive form to determine your body composition as well as BMD, which is bone mineral density, when you have a standard deviation that's negative greater than 0.5, 0.5 to 1.5 is called osteopenia. Greater than 1.5 is osteoporosis. It's reversible. But we want to have strong bones and you're going to get strong bones by drinking chocolate milk. No, you need to lift heavy weights In the beginning. First month neuromuscular communication understand the movement, optimize that by overloading. You get down to about 10 reps. Strengthen the connective tissue. After a month you're going to get down to eight, six reps, five reps, which would be about 85%. Doing that regularly, three, four times a week. Over the course of six months you're going to notice a significant change in your bone mineral density.

Speaker 1: 5:47

That test is going to give you a lot of information. It's like 70, 80 bucks but you could check it every six months, along with your blood chemistry levels. And what you're doing there is setting yourself apart from all the other trainers, because you could require your clients to do this. It could be part of your assessment from all the other trainers. Because you could require your clients to do this. It could be part of your assessment. My assessment is $200. And here's why because I'm going to require you to go get a DEXA scan. You need to go get your blood chemistry. I have a partnership with this place over here. You can go on there. Normally it's 80 bucks. It's only going to be 50. I will analyze the information with you.

Speaker 1: 6:20

What does gynoid obesity mean? Android obesity, what does visceral fat mean and how do you measure up against a healthy individual? Gynoid is pear-shaped. Android is apple-shaped. Guys more than likely store excess adiposity and visceral fat around their gut.

Speaker 1: 6:39

Visceral fat isn't bad, it's not good. It's just what it is. It protects our organs from rubbing up against one another. When you have too much, it's bad. It's not good, it's just what it is. It protects our organs from rubbing up against one another. When you have too much, it's bad. If you were to have not enough, that's bad. Being underweight is just as bad as being overweight. They have complications. It's the Goldilocks effect, as is with hormones. We got to get away from that vocabulary. Visceral fat is bad, this is good. Organic is good, this is bad. Get away from that terminology.

Speaker 1: 7:08

When you understand the fundamentals, you're really going to build up your confidence. You're going to look across your competition and say, wow, no one's doing this. No one is requiring their clients to do blood pressure and explain to them what this means. Top number is systolic, bottom number is diastolic. Here's what your number is. You are prehypertensive. That's not a good thing. They call it the silent killer for a reason. Then the client looks at you and goes huh, thank you for explaining that to me, because a doctor has never done this. You must be some type of hybrid ninja turtle trainer, because no trainer has done this before. They put me on a BOSU ball, throw my hands above my head and tell me I'm broken. My lats are overactive. I don't know what the fuck that means. And they told me I have pronation distortion syndrome. I feel like a freak. Well, you should feel like a freak because they're making you feel like a freak. That vocabulary is nonsense. Never scare your clients. Do blood pressure, do a DEXA scan. Understanding the fundamentals is what's going to separate you from the masses, and I say that so much so you should focus on it.

Speaker 1: 8:15

The osteon is the basic unit. There's 206 bones in the human body. The smallest bone is in your ear Incus, malus and stapes. These are part of the vestibular system. The smallest bone is in your ear. It's the incus, malus and stapes. These are part of the vestibular system. The largest bone is your femur More than 50% of your bones in the human body reside in your hands and your feet.

Speaker 1: 8:33

You have eight carpal bones in each hand and then, when you go more distal, you have your metacarpals and then your phalanges and for your feet you have the tarsals. There's seven in each foot. We can sprain ligaments. A ligament is connecting bone to bone. We can strain muscles or tendons. Muscle to bone is a tendon. We can break bones. The most broken bone in the human body is your clavicle. The second one is your wrist bones, because when you fall and you catch yourself, you snap the radius, which is one of your elbow bones, as is the ulna. The carpals can break as well, but those are the most common broken bones your clavicle and your radius.

Speaker 1: 9:15

When you fall, you have different types of fractures that can happen, like a green stick fracture. Think of if you have an old stick and you snap it. It snaps easily, like a pencil versus a green stick. If you try to snap it, it doesn't snap all the way, so docs will need to go in there and break it for you. Typically happens with young kids, as does a nursemaid's injury which is like a pulled elbow. My little Tasmanian of a devil two-year-old son was running holding my hand and all of a sudden he stopped and went the other direction and so it snapped and kind of pulled his elbow, didn't break it, but we had to go to the hospital and I'm freaking out thinking, great, they're going to think I beat my kid, but he's just a little Tasmanian devil and he's running all over the place. He's a psycho. I love it. That's the great things about kids is they're just free spirit, running all over the place. Try not to curb it, let them be free. But we had to go to the hospital. Luckily, just a couple of days in the stint he was all right.

Speaker 1: 10:10

These are injuries that can happen to bones. You need to understand injury processes and also pain, because when a client comes in we can do a lot, but you need to be positive with that experience. These are things that we really dissect in the level two, the biopsychosocial model of pain, educating how injuries happen. Injuries happen because too much volume, intensity, the frequency, trauma. It can be because of force or control. You hurt yourself during a bench press because you didn't go through the full range of motion for your entire training. One time you go too heavy, you enter a range of motion you're not used to. And now the weight accelerates where you don't have control and you fuck up your shoulders. So what do you do? You blame the bench press. That's a bad exercise, it's going to up your shoulder. So what do you do? You blame the bench press? That's a bad exercise, it's going to hurt your shoulder. No, you don't know how to fucking bench press, or the person teaching you doesn't know how to bench press. These are complicated movements. You need to work with a qualified instructor, coach, trainer who understands these exercises and movement patterns. These are things that we teach you. With the show up fitness CPT the level two, we get a lot into the pain stuff so you're able to recognize if the client in front of you is trainable.

Speaker 1: 11:22

You can do tests to find and discover red flags. If you need to refer out to your teammate who's a physical therapist, you can do so. We just did a test on a student in La Jolla. He had some shoulder issues so I went through his range of motion. He could put his hands above his head. That's great. That's a check. Put his hand behind his back. Can he lift his hand off his low back? He could Check. But then when we put his arm across his other shoulder and lifted his elbow, which is an internal rotation test. It slightly hurt how did I know? Because he grimaced, and so then we talked about it. I learned that he's capable of doing pushups. He can bench 225 for seven, eight reps. He'll start to experience it at the end. That's great.

Speaker 1: 12:02

I don't need to refer out. This is in my wheelhouse so then I can do some other screens in case it were to be a red flag, which would usually be indicative of a loss of strength. So on his right hand, if I shake it, let's say it's fairly strong. On the left hand, when I shake it, it's significantly less. So you could do like a grip strength. If he's pulling like 120 on one and 60 on the other, because that's a significant decrease between the limbs, if it was just like 10, 15, even 20%, I'm not worried about it. I would ask him if he's been to a therapist. Does he have radiating pain, numbness?

Speaker 1: 12:37

It never hurts to refer out, but we know our lane and the more you work with therapists and shadow gain that experience, you're going to be qualified in understanding your capabilities and not overstepping your boundaries, and so then you can do some soft tissue mobilizations into the infraspinatus, the pec, minor upper traps. Do some elbow work if you feel like it's appropriate, and then do some strengthening exercises. This is what we laid out and we're implementing within our level two Hands down. This is gonna be the best certification in the fitness industry. Our level one already is eons ahead of all the other ones because you actually learn about this industry programming, anatomy, the assessment. Now you get into the level two, you're gonna truly be a competent professional and we're really excited to launch that during these seminars. You're going to get that hands-on portion. You cannot get your level two certification until you have a hundred hours under a show up fitness approved physical therapist and you've gone into some type of hands-on learning. That's what the industry needs. That's what we're providing.

Speaker 1: 13:43

Now, before we get into the 17 actions of the shoulder, we need to give a quick little summary to make sure you have that understanding of the skeletal system. We talked about the osteon, the basic unit. We have the appendicular and the axial skeleton. Remember there's 206 bones in the human body. Axial is making reference to the 80 bones of the spine. We have 33, and then the rib cage and the sternum and then we have bones that are coming out of the peripheral. That's going to be like your humerus and your femur. That's part of the appendicular. There are 126 bones in the appendicular skeleton.

Speaker 1: 14:17

Now, before we get into those four shoulder joints that we discussed in class, we need to have an understanding of what joints are. So there are three types of joints of the human body. We have synarthrotic, which are not movable, amphrothrotic, which are semi-movable, and then diathrotic, and those are the ones that we usually make reference to when it comes to shoulder anatomy, because they are freely movable. Now the first one, your synarthrotic joints. You can see that in your skull we have sutures that allow for the six cranial bones to mold into one another, creating these immovable joints. So as we age, obviously our skull is not going to grow anymore, but when we're born, there's a certain capacity for the brain to grow and these joints to grow. We also have some immovable joints in our teeth and then we have our amphithrotic joints.

Speaker 1: 15:09

That's going to make our spinal column, as well as the pubic symphysis. Remember, we have the ilium, the ischium, in the pubic bones we are sitting on our butt bones also referred to as the ischial tuberosity. If you palpate the anterior superior iliac spine. Those are those little bony protuberances of the pelvis. That's your ilium. And then you're going to have your pubic symphysis, so your pubic bone on the right side and left side. They come together forming a ligament, and during childbirth it increases because we produce a pretty cool hormone from the ovaries called relaxin Sounds like you're chilling, you are relaxing and it allows for that ligament to improve its laxity. So it's going to increase in a couple millimeters, allowing for the birth canal to open.

Speaker 1: 15:56

Now this part of your amphithrotic joints, and then we move into the freely movable diathrotic joints and that's going to be pretty much everything that we are familiar with as personal trainers. They typically are going to have synovial fluid in this joint capsule. Maybe if you go to the doctor and your knee is swollen, they'll go and release some fluid. They're getting into that synovial fluid. They may be taking something from a bursa sac. This is all part of the joint capsule. So as trainers, we should know the four joints of the shoulder. We have the shoulder girdle, which is just going to be the clavicle, the scapula and the sternum, whereas the shoulder joint is going to be the glenohumeral joint, which is the humerus and that glenoid cavity.

Speaker 1: 16:44

If you are following along and you're grasping a little bit of this, I'm impressed, because I'm just talking about anatomy. It's very difficult to truly understand. You're going to need to get into some sort of anatomy textbook to see, and, or even better would be, to have the skeleton in front of you. Don't go out there and kill anyone and do some weird dommer shit. I'm talking about getting a skeleton where you can see the bones.

Speaker 1: 17:06

So let's take a look at the glenohumeral joint, the most freely movable. You're going to have the head of the humerus, the most proximal aspect, articulating with the head of the glenoid. The glenoid is going to be like this little golf ball and the T is what I made reference to earlier. The ball would be the humerus whereas the T would be the glenoid, and they articulate nicely to allow for a lot of range of motion With the posterior joint, which is going to be the scapula thoracic. Now, this one's unique because they'll call it a pseudo joint Technically doesn't have synovial fluid but articulates with the glenoid humeral joint, allowing for that arc of 180 degrees of range of motion.

Speaker 1: 17:45

We get about 120 from the glenoid humeral joint and the scapular thoracic is going to give roughly 60. For every two degrees of range of motion the glenohumeral gives up. You're going to get one degree from the scapular thoracic and then, moving superiorly, we're going to have the acromioclavicular joint and that's going to be the anterior clavicle articulating with the posterior scapula. You can feel your collarbonebone and if you were to move distally it's going to hit a little ridge and if you go back, that's going to be the scapula, the clavicle. So you have the ac, the acromial head of the scapula, articulating with the clavicle and then, if we move closest to the midline, you're gonna have the sternoclavicular joint and that's going to be your collarbone articulating with the sternum.

Speaker 1: 18:31

Those are the four joints of the shoulder. They're very complex. It's not just as simple as your acromioclavicular GH. There's a lot of stuff inside that allows for movement and sometime that we will get range of motion when we shouldn't. So, for example, your AC joint could be a little swollen because it's moving where it really shouldn't be.

Speaker 1: 18:51

The glenohumeral or the scapular thoracic should have that range of motion but whether it's through repetition or, who knows, maybe a contusion or something, it's going to get swollen because there's movement where there shouldn't be. I've worked a lot with clients and they'll have some type of swelling. I'll take a photo, send it over to our physical therapist and say what's going on. That's common to see some type of swelling in the AC joint because it shouldn't be moving very much and it is. And so if you have a joint that shouldn't be moving very much but it is, that means it's stealing that range of motion because the other joint should be moving and that's what they call that joint by joint approach. Not always the case, but it is a good fundamental strategy to understand. The glenohumeral joint should have a great range of motion and if we can't get there for whatever reasons, it may be through stiffness or a lack of range of motion through our daily activity of living, who knows? That's your job as the practitioner to determine why it is moving or not moving enough, and then another joint will pick up that slack Not always a good thing.

Speaker 1: 19:53

So let's take a look, for example, in the lower body, the hip. We should be able to get into all three points of motion. But we treat the hip like it's a hinge joint. It's just sagittal based but it should be able to get frontal and transverse. So if we constantly stick in that sagittal plane, it's common to experience some type of knee issues because the body is locking it down. It wants to get into all three planes but we're just keeping it into the sagittal plane. So the knee will be affected because of the hip. That's the same scenario that I'm referring to at the shoulder. Think of the glenohumeral joint like the ball and socket of the hip, because it is a ball and socket, Whereas the AC joint think of it kind of like the knee in that sense, where it should be stable and not moving. So those are the four joints.

Speaker 1: 20:38

Now let's take a look at the actions of the humerus. There are nine. In the sagittal plane we can bring our arm forward and above our head. That's going to be flexion behind the body's extension. Knowing these degrees of motion is why I hate bench dips, because you're bringing the humerus significantly past that 60 to 70 degrees of humeral extension, which is bringing it behind the body. I've seen trainers at big box gyms literally put their hands above the shoulder to have their client's elbow go above 90 degrees for that bench dip. That is idiotic. We should not be doing that exercise.

Speaker 1: 21:13

For the most part, in the frontal plane we have abduction going away and then we have adduction, bringing it back in In transverse. We have four actions external rotation and internal rotation, or lateral rotation and medial rotation. If you were to stand with your back against a wall and go to 90 degrees of abduction and you try to get your hand flat on the wall, that's external rotation. We should be able to do that and then come down to roughly 90 degrees of internal rotation. Together that arc is important and we'll have episodes in the future with physical therapists giving a further explanation on that. And then we also have horizontal adduction as seen as a chest fly and horizontal abduction as seen with a reverse fly.

Speaker 1: 21:58

And the last one is going to be scaption, the scapular plane. And that's the natural plane that the scapula sits on. It's not just directly on your rib cage or super protracted, it's at this 45 degree angle. Technically you're going to be horizontally adducted 30 degrees inside of the frontal plane and it's just a nice living environment for that scapula. So to picture, this military press textbook is going to be 90 degrees with your elbows flared. I like your elbows to be tucked more to 45 degrees. It's a lot more shoulder friendly.

Speaker 1: 22:32

Those are the nine actions of the humerus. Now let's take a look at the eight yes, eight for the scapula. If you look at your NASM textbook, they say four, ace, they say six. That is hogwash. There are eight. We can go up and down elevation depression we can go away, which is protraction or scapular abduction. We can come back towards the spine, which is retraction or adduction of the scapula, and then we have upward rotation, as seen with the military press. So the humerus is abducting while the scapula is upwardly rotating. Together, getting that range of motion and the antagonistic movement would be adduction of the humerus with downward rotation of the scapula, and then we have an anterior tilt and a posterior tilt. Those are the eight actions of the scapula.

Speaker 1: 23:21

Now, today was inspired from a podcast from Dr Galpin. I interviewed him and did a podcast and he is one sharp cookie. And if you want to really dive into what it's like to go through a college course with a professor who's really, really sharp and entertaining, that's what his podcasts are like. And so I got motivated because, like damn, this guy is so sharp. Not only he doesn't use word fillers, but the information is just really encapsulating. And I'll just be listening to this. I mean, you know what I need to continue to provide information for trainers and not just make fun of them. I know I can get them my little rants and do that, but I need to do better at giving information that is more thorough. And so if today was a little overwhelming, good, go back, listen to it again. Get into the basics. A little overwhelming, good, go back, listen to it again. Get into the basics, the basics of the skeletal system, the osteon osteocytes. What's going on there?

Speaker 1: 24:15

When we build bone, you have these specialized cells called the osteoblasts. When we break bone down as we age, we have osteoclasts. In the show up fitness slides we have audios that you can listen to from Dr Kramer, my professor at UConn, and that's where, again, I heard Galpin talking like yeah, he reminded me so much of Kramer. It was just fun to learn. There's a great audio clip from Dr Kramer breaking down bone, mineral density and how we build our bones up. Get into that first deck of slides. Those are videos, one through four. We have 22 that are on demand and you can listen to that clip and he does a great job of explaining.

Speaker 1: 24:57

And when we're younger, the blasts are more active and as we continue to resistance train, we keep them active. And then, as we age, the class can become more active, which is not good. That's how osteoporosis and penia kick in. So then you need to get into the axial versus appendicular. And then the joints. You probably haven't heard of the synarthrotic joints, the amphrathrotic joints, the diarthrotic joints. Take a look at them, up your knowledge, nerd out on this shit, because it's going to give you the confidence to network with other medical professionals, because that's what we are. You should understand this stuff to a point that you can have a conversation with the therapist and talk about oh, your glenohumeral joint has roughly this amount of degrees of motion, and can you tell me a little bit more? I'm trying to get a better understanding of that arc. With the glenohumeral joint and the scapula thoracic, they'll be like, wow, that's pretty impressive. Most trainers have no idea what the hell that is. Let me show you, and that's what we're encouraging with these relationships. So let me know what you thought about today.

Speaker 1: 25:59

I'm always trying to improve. I'm looking at my SWIFT strengths and weaknesses. We're coming up. 11 days is going to be one year with the podcast, so I'm going to do a huge reflection, taking in that swift strengths, weaknesses things that I can improve, implement, innovate. What are my fears? Trajectory, where do I want to be?

Speaker 1: 26:18

Threats within the podcast scape, we have over 40,000 downloads, which is pretty significant. That puts us in the top 2%. I'm really proud of that, but I'm also very competitive. So how can I get to the 0.1%? How can we get more reviews, more exposure? Maybe we need to have games and contests. I want to help you become better, so your feedback is really important. I appreciate y'all more than you know. I'm proud of you. I'm that devil and the angel on your shoulder. The devil in the sense that gets you out of your comfort zone. Do things that make you uncomfortable. Go up to managers and ask how you can become the top trainer. Go talk to people on the gym floor. The angel side is also bringing in great instructors to help provide the best community out there. Get into the Qualified Personal Trainers community on Facebook. Let us know what your favorite podcast is so far and how we can continue to make more of them and remember big biceps are better than small ones and keep showing up.