Training the for the arthritic shoulder...

Hello all,

I have a new client coming in. He is 65 and though he hasn't been diagnosed with arthritis, he complains of joint pain in his right shoulder and has difficulty with shoulder abduction above the head. He does a lot of work in the woods around his home--woodchopping. He also complains of a generally tense back; he couldn't pinpoint the tension to one area. He said that he would like to work on his back strength.

I'm planning on doing an overhead squat (having him raise the arm from the front), single leg balance, push, and pull assessments to see if I can piece together anything about muscle imbalances. Depending on how these go, I have some ideas to choose from:

SMR:
Lats and back
Maybe a chest opener

Stretches:
Supine assisted flexion and internal/external rotation (with elbow bent) or sliding arm on table assisted flexion (can bend elbow to do ER)
Wall assisted abduction to test ROM
Ball lat stretch
Towel or band assisted external rotation stretch (towel might be difficult if he can't do overhead well)
Pectoral doorway stretch

As he wants to stay active with his work in the woods, I'd like to make sure we're getting some core in (bridges, cobra/back extension, ball crunch, maybe cable rotations if they don't cause the shoulder pain).

Resistance:
1) Freemotion/Cable Cross seated and/or standing chest press within comfortable ROM
2) some kind of row (I'd like to get to standing, not sure where he'll be at with balance and core)
3) Dumbbell or cable scaption
4) Cable or band internal/external rotation (again depending on pain)
5) Tricep pull downs
6) Cable or dumbbell curls

Restrictions:
I thinking no lateral pull downs or wide pull overs. Might be able to do a close grip pull over or down in time but this is not something I would try on the first go around.

Does anybody have an input or suggestions? Has anyone else run into similar issues with the shoulder? How did you handle them? Will take any and all advice. Want to make sure I'm thinking this one through because the shoulder is a tricky joint... And, yes, I understand that the assessments will likely alter this. I just want to go in with some ideas.

Thank you!

If he has not been properly diagnosed, then the smart thing to do would be to refer out to a medical professional. Playing around with something that you cannot be absolutely sure of is extremely high risk and you do not want to put your career in jeopardy for that. Plus, after he is diagnosed you will have a better idea of what exactly you can do with him without worsening the condition.

[QUOTE=Damini;975778043]If he has not been properly diagnosed, then the smart thing to do would be to refer out to a medical professional. Playing around with something that you cannot be absolutely sure of is extremely high risk and you do not want to put your career in jeopardy for that. Plus, after he is diagnosed you will have a better idea of what exactly you can do with him without worsening the condition.[/QUOTE]

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First off having a doctor check it out would be smart. Everything you have there seems just like what I would do/recommend. I will say make sure you do the SMR for the lats and do chest openers. Also don't do to many chest exercises as it could tighten the chest preventing range of motion. Also consider prone cobras and exercises such as the bird dog and superman. Also explain that if anything causes pain (theres a difference between a muscular burn and actual pain) to let you know and stop that exercise.