Edinburgh, Scotland
Thursday 22nd December 2011
This morning I had breakfast with Tom Kelman, my friend & osteopath who I recruited when I was Head of Medical Services at Hearts FC.  Tom came late to osteopathy after a successful career in engineering & approaches the profession with a considered enthusiasm for the theory & philosophies on which osteopathy is based.

Unfortunately, a couple of years back Tom injured his right shoulder, which eventually required surgery & unfortunately, his time under anaesthetic was probably not the surgeon's finest hour.  As a result Tom has been struggling to satisfy the demands of his work & has endured frustration in addition to sleepless nights trying to managing the aftermath of the operation.  In addition, it would be fair to say (as I have on talking to Tom on numerous occasion), that Tom struggles with perseverance with rehab programmes & in turn this has lead to flirtations with several approaches to manual therapy, exercise therapy & indeed a revision of the surgical procedure with another specialist.

One of Tom's complaints now is that his rotator cuff feels very week & fatigues quickly during exertion.  As a result we got to discussing some of the rehabilitation approaches I use or have used when working with the athletic populations I have been involved with & the approaches I have seen employed during my travels around the world.  One of the programmes I now use & adapt are those initially prescribed for baseball pitchers by the L.A. Dodgers team physician, Frank Jobe & perhaps not surprisingly are collectively called "Jobe's Exercises"!

Given that the rotator cuff complex of muscles, put simply, stabilise the upper arm in the shoulder socket, whilst allowing the vast range of movement, the exercises can be used in part to address impingements, tendinopathies, bursitis, altered movement patterns between the shoulder blade & the top of the arm (scapulo-humeral rhythm), depending on the differential diagnosis.  

An example of an adapted Jobe's Exercise programme I recently compiled for another patient can be accessed by clicking the link below.  The exercises should be conducted with light weights, or if you prefer, resistance band.  However, you must remember that you can't objectively quantify the resistance when using resistance band, which has implications for baseline measurement, progress quantification & programming.

Another example of a Jobe's programme, compiled by the Richmond Bone & Joint Clinic, PA., which I downloaded from the internet can be reviewed by clicking the link below:

If you have any other variations on the theme, please share them with me using the comments box below.

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