Doctorate of Chiropractic degree (D.C.) in 1977 from the Canadian Memorial Chiropractic College in Toronto.
Definition of chiropractic
Anatomy
First Visit
Chiropractic Treatment
Chiropractic Treatment & Management of Headaches
Conditions Treated At Dr. Fuller's Clinic
Motor Vehicle Accidents (MVAs)
Weight Training Injuries & Management
Nutrition Corner
Orthotics
Origins
Research & Other Updates
When To Consult A Chiropractor
Laser Therapy & Phototherapy
 
In late 2011 the New Brunswick Chiropractic Association sponsored a competition of the World Strongman Champion League which was broadcasted in 58 countries and during which local chiropractors treated competitors.

Weight training or weight lifting dysfunctions (pain, stiffness, weakness of joints and/or muscles) can be caused by a lack of recovery and recuperation after exercise which results in microtrauma (small amounts of muscle damage) and then macrotrauma (large degree of damage) that prevents training.
 
Macrotrauma can affect the muscles, nerves or joints and create a biomechanical failure of normal function and movement.
 
Types of weight training DYSFUNCTIONS :
 
1)
JOINT DYSFUNCTION means there is abnormal motion of a joint or the joint became compressed (“imbrication”) or separated.
Any joint is comprised of muscle, tendon, ligament, bone, and meniscus or cartilage.
Heavy downward pressures during weight training cause compression of the bones and cartilage as well as of nerve receptors called mechanoreceptors and nociceptors. This happens with squats, deadlifts, standing shoulder presses.
These effects reduce the tone and strength of muscles that pass over a joint.
A weight training tearing injury occurs from a strain or twist that injures muscles, tendons, ligaments and cartilage of joints, and results in inflammation and weakness of  muscles that cross the joint. Injury to a ligament from overload will alone cause reflex tightening of adjacent muscles and weakness (Solomonow in Spine 1998;23:2552). As an example, improper squatting can sprain the knee ligaments which will result in weak hamstrings and/or quadriceps thigh muscles. Each problem must be treated adequately.
2)
MUSCLE DYSFUNCTION means that muscle tissue becomes damaged, tries to heal with scar tissue, leaving muscle imbalance with the muscle(s) staying in a shortened tight state, hence weak and deconditioned. This can only be diagnosed by some one trained to perform proper resisted muscle testing for finding weaknesses. The scar tissue (adhesions) form between the sheaths or fasciae of adjacent fibre bundles in the muscle (Barnes in Journal of Bodyworkand Movement Therapies 1997,1(4).  These “adhesions” restrict the ease and even the range of motion of muscles and joints. This is how the “wear and tear” process begins unless corrected. Such people experience the same pain in the same place when training.
Many people deal with this simply by resting or avoiding that exercise, which reduces inflammation but does NOT change the fibrous adhesion !
Adhesions must be treated by a knowledgeable person with soft tissue techniques.
Dr. Fuller can determine exercises to “train around” an injury during the time in which it is receiving treatment. One example would be pain in the upper part of the lats when doing pulldowns with a lat machine…. While undergoing chiropractic treatment, one could still do bent over rowing with dumbbell.
A “trigger point” is also a type of muscle dysfunction in which a portion of a muscle is tight and tender, and when palpated generates pain elsewhere (like a trigger on a gun shooting a bullet). For example when the infraspinatus shoulder muscle has a trigger point, it can weaken the deltoid muscle during the action of flexion (lifting upward) according to Simon in New Trends in Referred Pain & Hyperalgesia 1993. Dr. Fuller has charts of the entire body which were originated by medical doctors, Travell, Rinzier and Sola in the 1950s. A common example is excessive tension in the upper trapezius muscle which when palpated can generate shooting pain to the side of the head, and such persons may be much more aware of headache than neck pain.
(see also the section on “repetitive strain {overuse} injuries”).
3)
NERVE DYSFUNCTION means compression on a nerve reduces the action potentials of the nerve.
A nerve can become stretched or compressed (pinched). A common scenario is a person feeling that they hurt their while overstressing during training and noticing in following days that the same exercises seem harder to do than usual. Many people expect at this point that it will fix itself, but may find the next week that another body part such as a thigh doing a leg press is weak, then perhaps the hip feels weaker, then the entire leg. Usually this requires chiropractic treatment to correct the pressure on any affected nerves.
4)
BIOCHEMICAL DYSFUNCTION results from overtraining and/or a deficiency of nutrients.
Chronic stress due to overtraining can cause fatigue, weakness, and vulnerability to injury.
Extremely strict diets are seen in some competitive athletes and contribute to biochemical weakness. Expert advice is required to determine adequate intake of protein as well as all other nutrients including vitamins and minerals (eg.vitamin C, B vitamin complex, zinc are necessary for adequate hormone production by the body).
Nutritional supplements are important and should be combined with a knowledgeably healthy diet. One should strive for one gram of protein for each pound of lean body mass. Your lean body mass can be calculated by using skinfold calipers. Some weigh scales also now calculate your body fat which can then be subtracted from body weight to arrive at lean body mass. The best quality protein is found in chicken, lamb, organic beef, fish (especially herring, mackerel, salmon), turkey, almonds, walnuts, pumpkin seeds, sesame seeds, macadamia (or butters made with these nuts & seeds), eggs & skim milk, plain yogurt, kefir, whole grain bread, lentils, soy, green peas, dried beans, sweet potatoes, enriched cereals (note…. unless you need to diet or are allergic to these). For those people with concerns about food allergies, Dr. Fuller recommends food allergy testing which must be done outside of Canada and has referred patients to a medical doctor in Toronto, Dr. Z. Rona to requisition these, (milk, eggs, wheat, melons being the most common). 
Lots of vegetable salads too as these can be varied and made to look and taste attractive, eg. cabbage, combined with apple slices, walnuts, alfalfa sprouts covered with olive oil, sea salt and freshly squeezed grape juice.
Common sense concepts to remember ….. avoid alcohol, nicotine, fried food, junk food (fries, ice cream, pastries, burgers, croissants, most muffins, donuts, pop, candies, cookies, cakes, processed meats and cold cuts, cheeses, whole milk, sweetened dairy produces, white bread, pasta, sweetened cereals (most are, read the labels), chips. It is best to eat small every 2-3 hours since if you wait many hours, your body conserves fat plus you then you tend to binge and eat too much. Drink up to 2 litres of water daily. Consider a juicer to make vegetable juices, remembering that these are very concentrated. They must be drunk slowly in small quantities and preferably within hours of being juiced. Fruits can also be juiced but remember that they are higher in calories, as are even carrot juices!
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  What about specific nutritional supplements for building a better body?
1)
Whey protein (a by-product of making cheese) contains carbohydrates including lactose as well as minerals such as calcium, proteins such as alpha-lactoglobulin, beta-lactoglobulin, serum & albumin lysozyme, immunoglobulins (A,G,M), lactoferrin, branched-chain amino acids (valine, isoleucine, leucine). This combination of proteins is better than that found in egg whites, and is well tolerated by asthmatics, those with lactose intolerance, or for replacing or supplementing baby formulas. Some people are allergic to whey protein, while others may need to resort to digestive aids such as pepsin, bromelain, apple cider vinegar or betaine.
Taking individual amino acids as supplements has merit since some amino acids (ie. protein) found in food can be high in fat. Furthermore, as we age we do not digest food as well so this inhibits our ability to absorb amino acids from food.
2)
One of the most useful of these amino acids for building stronger bodies is L-glutamine which comprises more than 50% of the amino acids in the body.
It is useful to take 6,000-18,000 mg after exercising since heavy exercise reduces the body’s store of glutamine by 50%. Glutamine can also help increase the immune system’s strength whether you are an athlete or not.
3)
L-ornithine stimulates the release of the natural growth hormone that increase muscle mass and reduces body fat. This amino acid is not found in proteins, is produced by the body, and be helpful in dosages of 3,000-6,000mg/day.
4)
L-arginine also increase muscle mass and reduces body fat. It helps the body to manufacture nitric oxide which relaxes muscles in the arteries’ blood vessel walls and helps the body to eliminate undesirable ammonia that is produced with exercise. L-arginine also helps one’s energy and immune system strength. It is found in foods such as sunflower seeds, nuts, corn, carob, brown rice, oats, sesame seeds, peas, wheat, raisins (which are high in sugar content), and eggs. Consider 6,000-12,000 mg/day
5)
Gamma amino butyric acid (GABA) helps to increase levels of growth hormone from the pituitary gland and this increases muscle growth as well as reducing body fat. Consider 3,000-6,000 mg/day.
6)
Valine, leucine, isoleucine are the “branched chain amino acids.”  These are important for repair of muscles, blood sugar control, and calm emotions. Consider 1,500-6,000 mg of leucine and 800-3,000 mg/day of valine and isoleucine.
7)
Creatine monohydrate is a natural substance found in the body and in food is in salmon, steak, tuna, lobster, and lamb. It has many benefits that have been well documented in scientific research. Benefits include more powerful muscle contractions during repeated bursts, as well as faster muscle recovery, increased lean weight and muscle size. Creatine monohydrate converts in the body to creatine phosphate which supplies energy to muscles and reduces build up of lactic acid and ammonia, both of which are toxic by-products of exercise. Consider 0.3 grams per kilogram of body weight daily.
8)
Tribulis terristris is a herb that naturally increases the pituitary hormone called luteinizing hormone which stimulates the production of testosterone. The net result is faster recuperation from exercise, increased muscle growth and strength, better lean mass, better immunity, lower cholesterol levels, better mood and libido. Consider 750-1,500 mg/day.
9)
Zinc is a mineral needed by the body to produce testosterone, insulin, and growth hormone. Obvious signs of zinc deficiency include hair loss, night blindness not responsive to vitamin A, washboard fingernails, and white spots on nails. Zinc is found in poultry, eggs, liver, meat, oysters, whole grain bread, and may need to be supplemented at 3-50 mg/day.
10)
Chromium picolinate is essential for good insulin production and good lean body mass and fat loss. Chromium is depleted during heavy exercise and although it is not known if chromium directly helps better body mass, a hair mineral analysis can assess your levels. Chromium is found in mushrooms, oysters, apples, prunes, nuts, whole grains, meats, cheese, egg yolks, asparagus and brewer’s yeast.  You may consider 600-800 mg/day.
11)
Magnesium is a mineral that is important for strong function of the muscles and heart and blood vessels. It is a catalyst for calcium absorption necessary for bones and teeth, which is why it is commonly found in supplements containing calcium in a ratio of about 1:3 (or about 400 mg/day). Good food sources are nuts, whole grains, legumes, nuts, leafy green vegetables, green foods such as spirulina, chlorella.
12)
Vitamin C reduces muscle damage after exercise (as well as increasing the immune system strength). Vitamin C is partly essential for production of growth hormone, testosterone, and insulin. Vitamin C is an antioxidant so it helps endurance during exercise. It is safe to take at least 3,000 mg daily unless the bowels are irritated. It is found in broccoli, red peppers, citrus fruits, tomatoes and strawberries
13)
Co-enzyme Q10 protects against muscle injury and fatigue as well as helping any body system requiring oxygen. Consider 100-200 mg/day.
14)
MSM (methyl-sulfonyl methane) is a naturally occurring organic source of sulfur which is a critical part of many amino acids, enzymes, hormones. MSM improves circulation, reduces inflammation, build up of lactic acid and muscle soreness. In combination with vitamin C, MSM generates the same benefits as glucosamine sulfate for joint health.
15)
Proteolytic enzymes such a trypsin and chymotrypsin help digest proteins and the recovery of muscle exertion. Bromelain from pineapple and papaya can also help.
16)
L-carnitine does not build bigger muscles but improves energy metabolism of exercise-induced pain and damage in muscle. It can be taken at 1,000-2,000 mg/day.
17)
Saw palmetto is not a body building supplement but can be used to offset undesirably high levels of testosterone and enlarged prostate.
18)
Stinging nettle root is a herb like saw palmetto in balancing testosterone levels and is used in treatment of benign prostatic hyperplasia,  arthritis, and allergies.  Consider 500 mg/day or 2 teaspoons of tincture.
19)
Proanthocyanidins (pycnogenols) are from grape seed extract and pine bark extract and are in the bioflavonoids family so they provide strong antioxidant properties that helps prevent exercise damage (300mg or more/day).
20)
A study of 3,254 male smokers ages 50-69 were followed for 19 years and it was reported that men with the highest serum alpha-tocopheral (vitamin E) levels had a 28% lower risk of total and cause-specific mortality that did those with lowest levels, and a 21%,29% 30% lower risk of deaths due to cancer, cardiovascular disease, and other causes (American Journal Clinical Nutrition 2006;84(5):1200.
21)
A study of 3,254 people ages 39-85 followed from 1989-1995 showed that higher serum levels of caretenoids with pro-vitamin A activity significantly reduced the risk of mortality from cardiovascular disease and colorectal cancer (Asian Pacific Journal of Canver 2006;7(4):533.
22)
A study of women over a 2 year period concluded that aging women who the lowest levels of selenium had a significantly higher (54%) risk of death.
{Pyruvate and conjugated linoleic acid have no proven benefits at this time}. 
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No grain, no gain
Researchers (American Journal of Clinical Nutriton 2003;78)5):920 studying 75,000 U.S. women ages 38-63 during one year found that women who consumed more high-fibre whole grain foods, including brown rice, whole grain breads and cereals were 49% less likely to gain weight, and on average were 9 pounds lighter that their non-grain-eating nurse colleagues.
Common sense should remind everyone to eat a breakfast and lunch, light health snacks through the day, and evening meal about 3-4 hours before retiring to sleep, never eating any meals quickly or in large amounts. If you find the urge to eat again in mid evening for example, prepare a big plate of cut up broccoli, celery, peppers (green, red, yellow, orange). These pointers alone help weight management and general metabolism.
 
Caveat The foregoing is not intended as specific advice for all persons and should be reviewed by a knowledgeable medical doctor.
 
TRAINING too often and too hard, inadequate rest/sleep, and doing only the same exercises also contribute to overall weakness.
 
1) BENCH PRESS can be a safe and useful exercise IF performed with proper form, control and without any mechanical and/or inflammatory conditions. Anyone with joint, muscle, or tendon stiffness and inflammation should include a chiropractor to identify need for treatment and exercise modification.
 
Bench pressing involves primarily the pectoralis major but also the pectoralis minor, serratus anterior, anterior deltoid, and triceps brachii.
 
Improper bench press such as bouncing the bar off the chest, arching the lower back off the bench, using too much weight can cause shoulder tendonitis and joint impingement, wrist strain/tendonitis and joint dysfunction, elbow strain/tendonitis and joint dysfunction, and muscle imbalances such as the flexor and pronator groups of muscles being too overdeveloped.
The muscles, nerves and joints may need be treated to restore strength BEFORE rehabilitation exercises. Rehabilitation alone will result in the pain recurring when the person resumes exercising. For bench pressing problems, the anterior deltoid, pectoralis major and subscapularis are common muscle problems needing treatment.
The infraspinatus muscle is usually weak in such persons and needs rehabilitation with tubing or weights, taking the lower arm from a down position upward with the upper arm kept horizontal.
While lying on the back on a bench, the feet should be firmly on the floor (or if legs too short, then feet positioned on top of items that enable firm planting of feet.  There should be no more than a small arch in the low back.
The hips (and head) should never elevate off the bench during pressing as this changes the angle of the exercise from flat to declined, and also puts undue stress on the lumbar spine.
Keep the shoulder blades retracted back on the bench rather than rolling shoulders upward as you fatigue during straightening of the elbows. Such improper form will cause overdevelopment of the anterior deltoids and lead to deltoid pressing which will later lead to poor posture and shoulder irritation.
It is important to visualize squeezing the pectorals together without the shoulder blades moving up off the bench. It is also helpful to visualize the “lats” (latissimus dorsi muscles that span from back of shoulders down the back to the pelvic bones) to help push and stabilize the upper body during upward pressing.
The best grip is one that places the forearm at right angles to the floor when in the lowered position. This usually means hands on the bar slightly wider than shoulder width apart with elbows out to the side. A closer grip involves more work by the triceps, a wider grip more of the pectorals.
A grip should involve “pronation’ of the wrist meaning palms in the direction of the floor, with wrists not bent too far backward.
Breathe in slightly more than usual when lowering the weight, breathe out on the way up especially near the end of pushing up. This is important to avoid any blacking out.
Dumbbells (loose weights) have the advantage over barbells of allowing greater stretch and development of the pectorals. It is important to think about reversing the direction of the weights as they approach the chest downward. Quickly reversing the direction uses the stored energy of your contraction effort to give a greater force in the upward or concentric contraction.
2) Improper SQUATS – poor form, too much weight, poor concentration can cause knee strain, tendonitis, bursitis, as well as same of the feet, ankles, hips, spine. A well-performed squat involves the upper body parallel with the lower legs, knees aligned over the feet, toes pointing forward, knees not turned in or out.. Any difficulties in performing these properly and/or painlessly should be assessed by a chiropractor as to any indicated treatment, then appropriate stretching and strengthening exercises of the ankles, legs, hips. Do NOT rest a barbell on the spinous processes of the upper back but rather on the big muscles such as traps. Some places have equipment that does not require resting a barbell on the upper back but rather padded “yoke” resting on the shoulders while the person holds onto a stable stand in front of them (invented by former Mr. Universe, Frank Zane and called a ‘Leg Blaster’… Dr. Fuller has one in his clinic for rehab). Do not do squats in bare feet, but rather in good supportive shoes, possibly with custom orthotics if indicated while bearing so much weight.
Some people may need to avoid squats but can benefit from seated recumbent bike cycling, and/or seated thigh extensions with weights to exercise the thighs and legs.
3)Wide grip PULLDOWNS on lat machine behind the neck – this should be done in front of the face, NOT behind the neck, and can cause shoulder impingement as well as rotator cuff tendonitis, neck disc problems, contusion of the lower neck spinous processes. Pain experienced near the outer part of the shoulder blade can indicate tightened latissimus (“lats” are the large fan-like muscles seen when body builders stand straight).
4)Standing barbell upright ROWING – do NOT do at all as this greatly irritates the shoulder A/C joints. “Rowing” to develop the lats and serratus anterior can be done safely by kneeling on a bench and leaning over with a dumbbell, then pulling it upward in the action of manually starting a gas lawnmower or snowblower. Also safe for most people is use of a “rowing machine” in a gym
5) The shoulder’s A/C (acromioclavicular) joint often gets affected with weight training and instability of it is often due to weakness of the subclavius muscle (determined via resisted muscle testing), requiring soft tissue therapies and possibly temporary taping over the A.C joint. If the A.C joint is found by the chiropractor’s assessment to be “fixated” or stiff, it may require manipulative therapy to restore normal joint play flexibility.
6) Overhead press – if this is difficult or painful, causes include shoulder joint injuries (A/C or ball & socket joint), weak anterior deltoid muscle in particular as well as other shoulder muscles.
7) Lifting up sideways (abduction) can be restricted by shortened (tightened) infraspinatus (back of shoulder) and pectoralis major (chest) muscles. If these muscles are shortened, the posterior (rear) deltoid will become weak.
A knowledgeable chiropractor also checks the freedom of movement of the shoulder blade (scapula) as it glides over the rib cage If the A/C (acromioclavicular) joint has been sprained, this will cause the mid deltoid muscle to become weak. The A/C joint may need taping for a period of time, then possibly manipulative therapy.
 If the glenohumeral (ball & socket) joint should become displaced forward due to shortened muscles, that joint needs to be manipulated by a chiropractor and/or stretched to allow the rear deltoid to work properly.
Lifting dumbbell weights up sideways for many people should be done while leaning slightly forward. A knowledgeable chiropractor can determine if you are one such person. This develops primarily the middle deltoid muscle. I do not recommend lifting weights up sideways with the thumb pointing downward as it will cause compression damage of the A/C joint over time.
8) Strengthening the posterior deltoid muscle is done by sitting on edge of a bench with dumbbells held under the bench then raising them up sideways until arms are parallel to the floor. This also strengthens the rhomboidei muscles between the shoulder blades and helps a lot to offset rounded shoulders or “hunchback.”
9) “Pec flyes” are typically done while seated in a “pec deck” machine in some gyms to strengthen the pectoralis muscles of the chest. This is effective but has the drawback of being a “one size fits all” problem as some people have longer or shorter arms and the machine will not allow full excursion for some people. Therefore, a better option is lying on the back with arms outward with light dumbbells and bringing the arms up together above the chest. Note that the elbows should be kept slightly bent during this since straight elbows can sustain unnecessary elbow joint strain. This exercise can also be done while lying at 45 degree incline and decline benches. Doing so will emphasize development of the upper and lower portions of the pectoralis major respectively.
Caveat …. While the foregoing indicate that certain muscles are “primarily” emphasized during certain exercises, it is implied that there are always other agonistic (helper) muscles that also contribute.
 
What about training with dumbbells and barbells versus fixed machines?
Training with dumbbells and barbells allows one to better develop small synergistic (helper) muscles. Machines offer more safety but restrict one to fixed ranges of motion (some people have longer and some shorter arms and legs) and reduced stabilization.
What is “rotator cuff syndrome?”
The true rotator cuff is made of the supraspinatus, infraspinatus, subscapularis, and teres minor muscles.
It is the muscles and tendons which keep the ball end of the upper arm bone (humerus) in the socket (glenoid fossa of the glenohumeral) joint.
Normally, 3 of the rotator cuff muscles (teres minor, infraspinatus, subscapularis) pull down on the humerus enough to prevent jamming of the humerus against the ‘socket.’
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First it should be noted that many shoulder problems either involve only some of or none of these muscles !
Dr. Fuller’s approach, after taking a relevant history, is to perform standard orthopaedic, neurological, and range of motion tests. Then, he may perform as many as 21 resisted muscle tests of the upper extremity, including the rotator cuff muscles. One must understand that some muscles are prime movers while others are secondary helper muscles and others are stabilizers. For example, when doing a bench press, the pectoralis group are the primary movers, and the deltoids and triceps are helpers, while subscapularis and the rotator cuff group stabilize the shoulder blade and chest wall. However, during lat bar pushdowns, the triceps is prime mover. If it is observed that the shoulder blade pulls away from the body when the arm is elevated sideways, there is a shortened subscapularis muscle which needs treatment to loosen it up to normal tone. This tightened up subscapularis muscle is often caused by bench pressing which is often only felt as pain in the front of the shoulder. A dysfunctional subscapularis muscle results in weakness and injury to the supraspinatus muscle due to impingement at the A/C joint.
Once the subscapularis regains its normal tone from hands-on treatment, it can be strengthened by a pulley system in which the arm pulls the cable downward from the front at a 45 degree angle turning the arm inward then all the way back behind the body. If one observes the arm to be turned inward while hanging at rest, this may indicate a weak teres minor muscle, and which is a frequent cause of difficulty in reaching behind the back.
The supraspinatus muscle is weak in 90% of shoulder cases and is the most common cause of crepitus (joint noise) in a shoulder. If it is very weak, the person will lean their body to the side when starting to lift the arm sideways; this person may also be unable to hold the arm up at parallel to the floor. This muscle has a very poor blood supply so is slow to heal and is a small deep muscle, hard to access with direct treatment. Once treatment has restored normal tone and strength, it can be further strengthened with any of pulley, dumbbell or tubing by holding the arm at 45 degree angle away from the body and at 45 degrees up from floor level, then with elbow kept straight, raise upward up to shoulder height (Dr. Fuller recommends keeping the thumb facing downward during this exercise but not during free weight lifting). The infraspinatus and teres minor muscles are best strengthened by using a pulley system or rubber tubing (Therabands) which retain tension throughout the exercise, unlike dumbbells. It is performed by turning the arm outward from inward against resistance.
Rotator cuff muscle training and rehabilitation should be done at the end of workout since they would be too exhausted to help properly as they are required  during heavier actions with bigger muscles. Unless contraindicated, another exercise involves sitting with the elbow supported and raising the bent elbow with a very light dumbbell from down in front to upward facing the ceiling.
Other causes of shoulder problems?
The main chest muscle, the pectoralis major has 2 portions (clavicular and sternal) which often become shortened from lots of bench pressing and other pressing activities. If the pectoralis is shortened and tight, one will observe the arm to hang with the palm of the hand facing backward instead of toward the side of the body. The pectoralis tightness can be normalized by chiropractic hands-on muscle relaxation as well as by standing facing a door frame and stretching the chest (this requires specialized instruction on technique).
If the pectoralis minor muscle is shortened, one will see the shoulder blade “winging out” sideways accompanied by the ball and socket joint rolling forward, and often the upper/middle back hunching over. These all combine to cause potential pinching of nerves, even before doing exercises.
One technique of taking some stress from the pectorals is to use a narrow grip which forces more work onto the triceps muscle during the initial stages of pressing off the chest (although the pectorals and anterior deltoid also work). The triceps contributes less force during the latter stages of pushing upward. Generally speaking, the safest grip is one in which the forearm is perpendicular to the floor at the bottom of the lift.
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What are “tears” of ligaments ?
A tear in a ligament is called a “sprain.”  A tear in a muscle is called a “strain” and tear that pulls a tendon off the bone is called an “avulsion.”
A tear involves sudden pain and possibly hearing a “snap” followed by muscle “guarding” or seizing up to protect the body part injured. The pain of a tear will subside but without experienced management, the pain will return upon using the injured area and even degeneration and arthritis can follow.
A complete tear must be surgically repaired. It is estimated that 90% of tears and tendonitis involve the supraspinatus tendon.
What is shoulder impingement?
Impingement means that the ball of the humerus (more specifically the greater tubercle) is bumping into the acromion process on the undersurface of the clavicle (collar bone). 
Causes include muscle weakness such as those which are supposed to pull the “ball” of the arm bone downward into the socket as the arm is lifting upward.
Some people simply have genetically reduced space is this area, but most commonly inflamed (swollen) tendons, usually from overuse, take up more space than normal and this impairs lifting especially above shoulder height. Two of the worst activities to cause this are butterfly style swimming, and ball throwing with the arm turned outward then propelling inward.
What is “contracture”?
When a muscle stays in a shortened, tightened state, it will develop lack of flexibility and resists being stretched, and this is the main cause of “joint contracture.”
Such tightened muscles typically develop fibrous adhesions or “fibrosis” as a result of improper training. This is quite common when people exercise with weights and they enjoy lifting in the directions of flexion and adduction….. this means lifting in the ways that we shovel for example. This results in overdeveloped pectorals, biceps and other muscles that perform these actions, but also underdeveloped “external rotators” primarily the shoulder’s teres minor and infraspinatus muscles.
These latter two can be strengthened by tubing or very light weights pulling from inward to outward, preferably while lying on one’s side but they may well also require chiropractic treatment. It is essential that one get expert instruction on the exact technique for doing this, for example do not lift the arm up off the body, do not increase the bend in the elbow (keep it at 90 degree angle). It is Dr. Fuller’s experience that the “internal rotators” need hands-on stretching and loosening muscle treatment as well as stretching exercise instruction.
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What is frozen shoulder (also called adhesive capsulitis)?
The is the most advanced stage and result of untreated tendonitis, strains, joint dysfunction, and bursitis in that order.
It is certainly the most challenging stage of shoulder dysfunction and always requires a great deal of effort by both the person and treatment by an experienced chiropractor. In difficult cases a cortisone injection may be necessary to derive some temporary reduction in inflammation to accelerate the treatment process.
What sports are particularly stressful for the shoulders?
High velocity sports such as tennis serves, cricket “bowling”, ball throwing, and martial arts place tremendous duress on the rotator cuff and other shoulder muscles responsible for rapidly decelerating the shoulder.
Types of arm curls :
1.
“Preacher curl” involves sitting and with arms resting at a 45 degree angle on padding, flexing the weight up toward the face.
2.
Standing barbell curl stresses the mid range of the biceps brachii muscle; greater development can be achieved by continuing upward so that the weight is at shoulder height.
3.
“Concentration curl” stresses the last range of flexion the most.
These three emphasize the short head of the biceps and the brachialis muscles.
4.
Seated incline dumbbell curl puts more stress onto the long head of the biceps.
5.
Dumbbell hammer curls (curls with thumbs facing up) and E-Z curl bar with reverse grip wrist extensions emphasize development of the brachialis.
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Arm extension (straightening)
The “triceps” muscle can also become shortened and tight which reduces ability to flex or curl the arm as well as the strength in such exercises.
A shortened triceps can cause tingling, numbness, and/or weakness in the arm, forearm or hand as the long head of the triceps can compress the radial nerve.
A weak triceps is identified by trouble when locking out the end of the bench press or overhead or other press.
Tightness and weakness of the triceps requires hands-on therapy after which specific exercises should be understood :
1.
Lie on back on a bench and press bent elbows upward with an E-Z curl bar. This strengthens mainly the long or “lazy” head of the triceps. This is not unlike the effect of a close-grip barbell bench press.
2.
Dumbbell “kickbacks” require bending over and straightening the elbow from hanging down with a weight to up to horizontal, emphasizing the medial , lateral and long heads of triceps…. If you only have time for one triceps exercise, this is the one.  
3. The narrow-grip triceps pushdown with a lat bar pulley emphasizes the lateral head of triceps.
4.
If one’s shoulders are strong and stable enough, doing “dips” with dipping parallel bars is an excellent triceps exercise. If such bars are not available, try doing dips with hands on a bench behind you.
Back strengthening
1. Shrugs with dumbbells without rolling the shoulders around strengthen the upper trapezius muscles
2.
While seated on the end of a bench, bend over holding dumbbells between the legs, then raise them up sideways to parallel with the ground. This develops the rhomboid muscles between the shoulder blades as well as the shoulders’  posterior deltoids and middle trapezius.
3.
The rhomboid muscles can be also strengthened by doing seated cable rowing, both with one arm at a time, then together. This helps give endurance to people who do a lot of deskwork. If the palms are facing upward or inward on a specially designed handle and arms close to the body, this emphasizes work on the lats and rhomboids. If the palms are facing downward on a stick type handle, this develops the posterior deltoid, middle trapezius and rhomboids more
4.
The “Superman” exercise involves arching upward preferably while resting on an exercise ball, then raising one arm up, then the other arm.
5.
The latissimus dorsi muscles of the back are strengthened by doing “lat pulldowns.” It is recommended that the lat bar be pulled down in front of the face in order to not impinge the ball and socket shoulder joints, as well as to gain maximum contraction of the lats.
6. Lower back – an analysis should be conducted by your chiropractor to observe curvatures and weaknesses:
 
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This can reveal swayback due either to weak erector spinae muscles or weak hamstrings that allow forward tilting of the pelvis.
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If the psoas muscle is weak on one side, walking is shorter in stride on the weak side, and if weak on both sides, multiple problems can arise
- With the spine and inguinal ligaments.
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If the quadratus lumborum muscle is weak, it will become shortened and result in jamming of lumbar spine facet joints which gives rise to pain
- During axial loading exercises such as squat and deadlift.
- If the gluteus maximus is weak, it will inhibit squats, deadlifts, and lead to knee instability.
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If the gluteus medius is weak, the pelvic bone (ilium) will appear higher on that side and lifting that leg up sideways will be weak.
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The muscle group along the side of the thigh (tensor facia lata or iliotibial band) if weak will cause pain in the hip and outside of the knee
- Which gives less support and strength during squatting or running.
- A treatment and training programme would be proposed by your chiropractor to…….. relax any muscle tightness, joint stiffness, and train muscles as appropriate.
This training could include -
a) The “deadlift” with weight resting on the heels, with the bar as close to the body as possible. One should be monitored to ensure emphasis on extending (arching) the lower back when standing up from the floor but  not hyperextending the back at the top, then curling the entire spine forward on the way done.
b) Seated cable rowing (keep knees slightly bent), arms start position is not fully forward but rather with arms just barely fully straightened then pulling shoulder blades together.
c) One arm dumbbell rowing with one knee on a bench, arm with dumbbell pulls upward emphasizing tightening of shoulder blade.
d) Roman chair – with thighs resting on padded chair, one curls the spine fully forward with head nearing the floor, then arching fully upward.
This is highly beneficial especially for lumbar intrinsic extensor muscles and generates no axial load. For those who are not advanced enough top do this, simply lie face down on the floor and try arching upward (caution, if this immediately causes low back pain, it may indicate need for chiropractic treatment to improve stiffness of facet joints. For others, it may well be better to discard these and perform instead…………beginner’s then more advanced side bridges, “bird dogs”“Turkish get-ups,” and curl-ups as instructed by your chiropractor.
e) Standing dumbbell lunges with one leg ahead of the other. If the forward leg is too far forward with some people it will create or reveal sacroiliac joint dysfunction, requiring treatment.
f) Hanging leg raises – while arms are supported in a specially designed “chair” the knees are kept bent at 90 degree angle while the person focuses on pulling the thighs and hips upward toward the chest. Do not allow the legs to hand down straight and then pull upward as this works the psoas muscle mostly rather than the abdominals (this also helps the back).
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Thighs
Once again your chiropractor should assess for imbalances, dysfunction of knee, ankle, hip, and weakneses.
In the absence a true anatomical short leg, the presence of an ilium (pelvic bone) that is rotated backward and sitting lower can indicate a weak rectus femoris muscle on that side (part of the quadriceps group on front of the thigh). Other parts of the quadriceps are the vastus lateralis and vastus medialis obliquus (VMO) , which if weak can cause abnormal position and/or stiffness of the kneecap as it glides over the femur thigh bone.
Frequently a patient with this situation complains only of knee pain. After effective treatment, then design appropriate exercises …..
Front of thigh (quadriceps) has 4 portions which are strengthened with squats and leg presses before seated leg extensions.
If the person can do deep squats with weights, this develops the VMO and helps to stabilize the knee.
When doing thigh extensions with weights, if one turns the toes outward, this strengthens the VMO more.

Caution : -people who have had anterior cruciate ligament surgery (ACL) should not do leg extensions as this exercise contracts the quadriceps, pulls the tibia forward and stresses the repaired ACL. However, graduated squats and leg presses are fine as they require co-contraction of quadriceps and hamstrings hence decreasing tension on the front of the tibia and allows ACL to heal.
Squats can be done with feet fairly close together, or a wider-than-shoulder width stance with feet turned out 10 degrees and carrying weight on the heels, keeping the knees over the ankles and going down until the thighs and just below parallel with the ground.
While these exercises do emphasize the front of the thigh, they do stress the back of the thigh also.
The back of the thigh (hamstrings) have 3 sections. Weakness of the inner or medial may show as bowlegged appearance while weak lateral hamstrings may display as knocknees.
The main strengthening exercise is lying face down and curling the legs up with weight resistance. Please reduce the weight by at least 60% compared to the weight used when doing quads extensions.         
Lower leg muscles
These are the soleus and gastrocnemius muscles.
To strengthen the “gastroc” muscles, do standing yolk exercises with weight on shoulders and standing up on toes.
The soleus is strengthened when the knee is bent to 90 degrees such as sitting with weight on the thighs then stepping up on toes.
Turning the toes outward during these actions strengthens the peroneal muscles while turning inward strengthens the tibialis posterior muscle.
Expert exercise enthusiasts also do “donkey raises” in which they are leaning forward and standing up against resistance such as another person on the back.
Of course, in addition to these, many people benefit from yoga, Pilates, and other forms of exercise. Choose a form of exercise that you feel you can look forward to doing regularly and safely. There are also many CDs and such on the market which instruct people in the comfort of their homes on yoga, Pilates, weight training, and many other sports.
What about rubber tubing, pulleys, cables for resistance training?
For most people these are also excellent, especially as these forms of exercise require a constant force throughout the entire range of movement.
However, some people who are rehabilitating from an injury often cannot tolerate this constant type of exertion until further recovery.
Cables attached to weights often enable one to pull in directions that are not possible with loose weights.
Loose weights (dumbbells and barbells) imply an initial starting force, sometimes even jerking, then other muscles may take over (eg. lateral dumbbell raises of use the trapezius, supraspinatus and middle deltoid muscles to different degrees throughout the action).

Benefits of exercise?

As an example, a study of 5,500 men and women was reported in Medicine & Science 2003;35(2)270 which concluded that men who had the best cardiovascular fitness based on treadmill tests were 35% less likely to die from cancer, while obese women with the highest body mass index were 1.5 times more likely to die from some form of cancer.

Exercise quantity or quality?

A 12 years study from 1986-98 on 50,000 men aged 40-75 reported in Journal of the American Medical Assn 2002;288(16):1994 determined that higher amounts of exercise did translate into reductions of coronary heart disease (30% less than sedentary men) .High intensity exercise lowered risk for coronary heart disease by 17% more than low intensity exercise (high intensity included running, weight training, rowing). A faster paced was more beneficial than slow pace, regardless of duration.

Children and exercise?

One study reported in Archives of Paediatrics & Adolescent Medicine 2003:157(2):185 discovered that on average, 9 year olds only took 2 physical education classes per week instead of the recommended five, and while in those classes they only averaged five minutes of vigorous exercise. Make sure your child exercises enough in school and after school.

REPETITIVE OVERUSE AND STRAIN INJURIES AND SYNDROMES (Cumulative trauma disorder)

Repetitive strain injuries are caused by repeated physical movements that cause repeated damage to muscles, ligaments, tendons, nerves, fascia, circulatory vessels,  and other soft tissue tissues. These body “tissues” become irritated and inflamed, reducing circulation to them and creating tiny tears. The body reacts to this by making scar tissue to stabilize the area and the longer it does not get effectively treated and returned to normal, the harder it is to correct. Often these same people have jobs or other activities which are hard to avoid and continue to add more insult, sometimes becoming permanent. Repetitive strain injuries account for 67% of all occupational injuries (according to the U.S. Department of Labour Bureau of Statistics 2001). These “injuries” cost the U.S. economy $110 billion each year for medical costs, lost wages, reduced productivity.
Types of repetitive strain injuries carpal tunnel syndrome, ulnar nerve tunnel syndrome, tarsal tunnel syndrome, Achilles tendonitis, tennis and golfer’s elbow, plantar fasciitis, shoulder tendonitis/bursitis/adhesive capsulitis/frozen shoulder/rotator cuff syndrome, chondromalacia patellae, Having said the foregoing, Dr. Fuller recommends that every person who suspects that they may have such a condition, must seek medical opinion as to whether there are more serious causes such as arthritis, diabetes, high blood pressure, kidney failure, underactive thyroid, hormonal problems to name a few. The repetitive overuse and injury results in tight (tense) muscles that quickly become weak. These weakened muscles and tissues then cannot withstand similar continued use more inflammation develops. The reduced circulation of blood means less oxygen to all tissues which means the body increases production of mRNA and alpha-1 procollagen, which in turn leads to formation of scar tissues and adhesions which in turn cause further restrictions, inflammation.
Poor muscle function and imbalance, and microscopic swelling…. the muscles become less able to perform.  People who attempt to overcome these Performance problems such as lifting weights, only aggravate the adhesions… it is essential that they receive treatment which corrects the adhesions and tight muscles.
While stretching exercises will only stretch the tissues above and below the adhesion area, such exercises are fine after effective treatment.
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