The exercises that Kuhn provided can be viewed as a partial list of exercises that might be appropriate for treating an individual with RCIS. We offer modifications to 3 of the proposed exercises and discuss factors used by athletic trainers and physical therapists to establish initial exercise selection, intensity, and periodic modification of an exercise program that were not discussed by Kuhn. Based on current evidence, the anterior shoulder stretch in the proposed protocol might not be the most effective way to stretch the pectoral muscles. When performing the stretch as described in the protocol, the individual is instructed to place his or her hands at shoulder level on either side of a door or corner and to lean forward. This might be a preferred position to initiate pectoral muscle stretch if the individual is unable to perform stretching with the arm elevated as a result of pain; however, evidence3 indicates that changing the position of the upper extremity so that the individual's hand is above the head with the shoulder in 90° of abduction and 90° of external rotation likely provides a more effective stretch.
Intensity: The best exercise intensity for CFS/ME patients is low intensity and low-impact, at least in the beginning. IF post exercise malaise occurs, try not to skip workouts, just go back to a lower intensity and less duration. Please note that I do consider cleaning one of those daily activities that can be harder on the fibro body than structured exercise. Do not determine your ability to exercise on difficulty with cleaning, bending, stopping, starting, etc that is involved there.

When stress is chronically induced, as in NFO and OTS, two specific mechanisms could occur: first, when corticosteroid levels are chronically too high, a hypersensitivity of the receptors will occur, this can lead to a disinhibition of CRHproducing neurons, which in turn will lead to an intensified release of ACTH (as seen in the second exercise bout in the NFO athletes). When the chronic stress situation continues and glucocorticoid receptors are chronically activated (which occurs in post-traumatic stress disorder17 and depression),25 a blunted ACTH response to CRH will occur.28
More recently, exercise was regarded as a beneficial force in the 19th century. After 1860, Archibald MacLaren opened a gymnasium at the University of Oxford and instituted a training regimen for 12 military officials at the university. This regimen was later assimilated into the training of the British Army.[145] Several mass exercise movements were started in the early twentieth century as well. The first and most significant of these in the UK was the Women's League of Health and Beauty, founded in 1930 by Mary Bagot Stack, that had 166,000 members in 1937.[146]

In the realm of fitness, three-month workout programs dominate the landscape. You’ve even seen plenty of them in our magazine over the years. Are they effective? Absolutely. But we’re going to let you in on an interesting secret: It doesn’t necessarily take 8 or 12 weeks to get your feet wet in the gym. Not that you’ll be a seasoned vet after four weeks, but if you can just get that first month under your belt, you’ll get yourself over the proverbial hump, where so many fail and give up, and set the stage for a lifetime of muscle gains.
The European Commission - DG EAC - Directorate General for Education and Culture - has dedicated programs and funds for HEPA - Health Enhancing Physical Activity projects[134] within its Horizon 2020 and Erasmus+ program, as research showed that too many Europeans are not physically active enough. Financing is available for increased collaboration between players active in this field across the EU and around the world, the promotion of HEPA in the EU and its partner countries and the European Sports Week. The DG EAC regularly publishes a Eurobarometer on sport and physical activity.
In extreme instances, over-exercising induces serious performance loss. Unaccustomed overexertion of muscles leads to rhabdomyolysis (damage to muscle) most often seen in new army recruits.[88] Another danger is overtraining, in which the intensity or volume of training exceeds the body's capacity to recover between bouts. One result of detrimental overtraining is suppressed immune function, with an increased incidence of upper respiratory tract infection (URTI). An increased incidence of URTIs is also associated with high volume/intensity training, as well as with excessive exercise (EE), such as in a marathon.[89] Marathon training requires the runner to build their intensity week to week which makes them more susceptible to injury the more they increase their mileage. A study shows that in the last 10–15 years up to 90% of marathon runners have suffered a physical injury from their training.[90]
The baseline testing included clinical examinations, physical tests and questionnaires about health and lifestyle. Age and sex were obtained from the National Population Registry. A previously described questionnaire provided information on physical activity level and sedentary time at baseline [19]. Detailed protocol for assessment of body weight (kg), body height (cm) and body mass index (BMI; kg/m2) is described elsewhere [19]. Testing of peak oxygen uptake (VO2peak; mL/kg/min) was performed either as walking on a treadmill or cycling on a stationary bike. The test started with 10 min at a chosen warm-up speed. Approximately every two minutes, either the incline of the treadmill was increased by 2%, or the speed was increased by 1 km/h. The test protocol ended when participants were no longer able to carry a workload due to exhaustion or until all the criteria for a maximal oxygen uptake were reached [22].
Exercise doesn't have to be done at the gym. You can work out in the comfort of your own home. And with calesthenic-type exercises such as squats, lunges, pushups, and sit-ups, you can use the resistance of your own weight to condition your body. To boost your strength and aerobic capacity, you may also want to invest in some home exercise equipment.
LSR, SBS, HV, NPA, JEI, UW and DS contributed to the conception and design of the study. LSR, SBS, HV and DS were responsible for the collection of the Generation 100 data in cooperation with colleagues at the Cardiac Exercise Research Group at the Norwegian University of Science and Technology, Norway. LSR, SBS and XT provided the data for analysis. LSR undertook the data analysis and drafted the manuscript. All authors provided critical insight and revisions to the manuscript. All authors read and approved the final version of the manuscript submitted for publication.
Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
So what's so special about tendon problems and eccentric exercise? It seems that eccentric exercise seems to be helpful to injured tendons. Why? Researchers still do not know why this type of exercise is special. Still, if you have a tendon injury, like Achilees tendonitis, your physical therapist may have you perform eccentric exercises to help treat your condition.
In 1904, Danish prize-winning athlete and gymnastics educator JP Müller followed Checkley’s exercise philosophy with the publication of ‘My System’. This book described how the relatively healthy, average person could keep fit, fortify health and stamina, and increase physical and mental efficiency with 15 min of daily exercise. He claimed: ‘If people only knew how much more, how much better and how much longer they can enjoy life, instead of being controlled by a weakly body, they have a strong and healthy one at their command!’15 Müller JP. My system. London: Link House; 1904. [Google Scholar] Müller was born a weak child and developed an exercise routine to re-build his own body, inspired by the harmony of ancient Greek statues. His routine included exercising natural functional movements, self-massage of skin in fascial lines, exposure to the sun, and bathing in cold water in addition to running on the balls of the feet as an aerobic activity.15,16 Müller JP. My system. London: Link House; 1904.
If you really want to get in shape, why not turn some everyday tasks into exercise opportunities? We know you're lazy, so between your DVD-guided workout sessions, finding ways to incorporate exercise into daily tasks may help to make exercise less of an intimidating, dark, scary monster that looms ahead. Finding room for exercise in your daily life could even make exercise—dare I say it—fun.
The squat is performed by squatting down with a weight held across the upper back under neck and standing up straight again. This is a compound exercise that also involves the glutes (buttocks) and, to a lesser extent, the hamstrings, calves, and the lower back. Lifting belts are sometimes used to help support the lower back. The freeweight squat is one of 'The Big Three' powerlifting exercises, along with the deadlift and the bench press.[2]
Video Abstract for the ESSR 46.4 article “Modulation of Energy Expenditure by Estrogens and Exercise in Women” from authors Kathleen M. Gavin, Wendy M. Kohrt, Dwight J. Klemm, and Edward L. Melanson. Reducing estrogen in women results in decreases in energy expenditure, but the mechanism(s) remain largely unknown. We postulate that the loss of estrogens in women is associated with increased accumulation of bone marrow–derived adipocytes in white adipose tissue, decreased activity of brown adipose tissue, and reduced levels of physical activity. Regular exercise may counteract the effects of estrogen deficiency.
I must confess: the title of this section is misleading, because while most of us associate the first home workouts with fitness icons Jane Fonda and Richard Simmons, they were not the first ones to bring workouts inside our homes. In fact, before there were VHS tapes, before there were even televised workouts, there were the audio-only vinyl record workouts, nicknamed vinylcise.
Ken Hutchins' analysis is not just book theory; it is based on real experience training many, many thousands of subjects over a span of decades. He trained everyone from amateur and professional level athletes and bodybuilders to little old ladies with osteoporosis and also a great many genetically normal/average folks. He assisted Arthur Jones and Ellington Darden at Nautilus Sports Medical Industries where he first refined the Superslow method during a 5 years long clinical trial, the Nautilus Osteoporosis Study at The University of Florida Medical School in Gainesville (the study is mentioned in chapter 8 of the 1990 edition of "The Nautilus Book" by Ellington Darden, a book I highly recommend for beginning HIT practitioners). Hutchins' writing is as dry and clinical as one would expect to find in any textbook about medicine or engineering. It is also filled with rich insight into the intellectual processes and long history of carefully controlled experiments at Nautilus (and later Hutchins' own facilities) that brought Ken Hutchins to his current level of knowledge. His understanding of anatomy, biology, physics, engineering, psychology, history and sociology are all put to good use in this book and should enthrall any reader that possesses solid critical-thinking skills. Understanding the arguments for a distinction of "Exercise vs. Recreation", "The First Definition of Exercise" and "Requirements for Functional Ability" are crucial for everyone that cares even the slightest about the subject of human health, fitness, longevity or quality of life. These are not trivial matters.
Both groups performed 2.2 ± 1.3 exercise sessions per week during the year. Walking was the most common exercise type in both groups, but MCT had a higher proportion of walking sessions than HIIT (54.2% vs. 41.1%, p < 0.01). Compared to MCT, HIIT had a higher proportion of sessions with cycling (14.2% vs. 9.8%, p < 0.01), combined endurance and resistance training (10.3% vs. 7.5%, p < 0.01), jogging (6.5% vs. 3.2%, p < 0.01) and swimming (2.6% vs. 1.7%, p < 0.01). Outdoors was the most common exercise location in both training groups (67.8 and 59.1% of all sessions in MCT and HIIT, respectively). Compared to MCT, HIIT had a higher proportion of sessions at a gym (21.4% vs. 17.5%, p < 0.01) and sports facility (9.8% vs. 7.6%, p < 0.01). Both groups performed an equal amount of sessions alone and together with others, but women had a higher proportion of sessions together with others compared to men (56% vs. 44%, p < 0.01).

So, for me, squatting while commuting or planking (one of the 7 Best Ab Exercises for Women!) before bed has become quick and foolproof ways to make sure I get some part of my workout in without having to stress about making time for the gym. Instead, I bring the working out with me even on the go. Everyone has at least 30 spare seconds (trust me, even the days you’re sure you don’t—you do). That’s why I went to the experts and compiled a master list of exercises that work every body part. Best of all? Each one brings results if you do them for 30 seconds every day (some ask for 60 seconds, but that’s so you can work both arms and both legs). Just remember to keep your diet on track, too; just because you squeeze in mini workouts doesn’t mean you can feast on foods like these 20 Shocking Foods With More Fat Than a Big Mac!
Circuit training is a fun way to focus on strength and aerobic exercise and is great especially if you love some variety and a faster pace of working out. It’s worth noting that circuit training doesn’t offer the same level of conditioning as strength and aerobic exercise does on their own. Specifically, if your fitness goal is to be strong, circuit training is not the best way to reach that goal. You can do circuit training in groups or classes as well as alone. This article offers an easy way of creating your own circuit routines.
A 2015 review of clinical evidence which included a medical guideline for the treatment of depression with exercise noted that the available evidence on the effectiveness of exercise therapy for depression suffers from some limitations;[53] nonetheless, it stated that there is clear evidence of efficacy for reducing symptoms of depression.[53] The review also noted that patient characteristics, the type of depressive disorder, and the nature of the exercise program all affect the antidepressant properties of exercise therapy.[53] A meta-analysis from July 2016 concluded that physical exercise improves overall quality of life in individuals with depression relative to controls.[43]
There are tons of exercise videos for sale on the market today. That makes finding one that you will enjoy and use both overwhelming but entirely possible since so many are out there. Following the information in these exercise videos buyer’s guide will help you narrow down your choices based on your needs and fitness goals and choose one that you will enjoy and benefit from as well. Knowing what to look for is the most important step in making the right choice for your needs. With so many styles and choices available you can even decide to buy several so you have a good variety to choose from. Boredom is one of the biggest reasons people stop their workouts, so giving yourself choices can alleviate this problem completely.
It’s like preparing for the birth marathon, or any marathon for that matter. The more you can prepare your body for what it’s about to experience, the better you feel and the better your body responds. Implementation of our foundational techniques is a perfect way to set up for a successful pregnancy and postpartum phase. We want to keep you doing what you love to do, so no need to rush and cancel your memberships at other studios. You can incorporate our “basics of Bloom” into any workout you desire. Through this, you’ll not only be setting up your body for a more comfortable pregnancy but you’ll also be able to amp up your current workout for more efficiency and better results.
We’ve gone on the record with our love of MMA conditioning exercises, and that’s why we bookmarked this video. Even the warm-up is jam-packed with explosive movements that’ll get your heart pumping (think high knees and walking front kicks). And once you move into the actual workout, you’re in for even more high-energy exercises, like hopping front kicks, that are sure to condition your body from head to toe.
In 1890, English-born American physician Edwin Checkley published ‘A Natural Method of Physical Training’ in which he presented his MMB philosophy. Checkley’s exercise method was non-competitive, did not encourage physical or mental exhaustion, and did not require equipment. The aim was ‘to feel naturally light and strong and to have an effective body.’9 Checkley E. A natural method of physical training. New York (NY): William C. Bryant & Co.; 1890. [Google Scholar] Checkley expressed his dismay toward the vigorous and ‘unnatural’ athletic training methods utilized in the gymnasiums at the time, as well as toward the new mechanized ‘muscle-molding schemes’ he referred to as ‘straining’ more than ‘training.’ He criticized the ethics of aggressive performance-enhancing gymnastic and athletic training techniques claiming they were not natural, therefore harmful for the body and mind. In comparison, Checkley described animals in nature that sustain a lifetime of health, fitness, and beauty by performing seemingly effortless movements on a regular basis.9 Checkley E. A natural method of physical training. New York (NY): William C. Bryant & Co.; 1890. [Google Scholar] Perhaps ironically, Checkley’s philosophy and exercises famously ‘converted’ Alan Calvert, the weightlifting pioneer who founded the Milo Bar-bell Company in 1902 and started Strength Magazine in 1914 (Figures 1, 2).12 Beckwith KA. Building Strength. Alan Calvert, the Milo bar-bell company, and the modernization of American weight training; PhD thesis. Austin: The University of Texas; 2006. [Google Scholar]
An essential move to any workout. Keep in mind that if doing a push-up on your toes is too tough, you can always start on your knees. It’s still a very effective strengthening move. HOW TO DO IT: Begin the push-up in a plank position with your hands on the ground under your shoulders and with your feet together, toes driving into the ground. Your body should be in one straight line with your core locked. Slowly lower yourself down to the ground so that your chest touches the ground, then push yourself back up to the starting position without collapsing your lower back. MUSCLES USED: Shoulders, triceps, biceps and core.

If you don't have access to weights, then you can perform resistance exercises utilizing just the weight of your own body. These types of exercises include pull ups, push ups, crunches, squats, and lunges. If you'd like to find a well designed workout using body weight resistance, try the Slow Burn Fitness Revolution, which relies on slow movements to really increase intensity as you perform isotonic exercises.
Jump up ^ Pratali L, Mastorci F, Vitiello N, Sironi A, Gastaldelli A, Gemignani A (November 2014). "Motor Activity in Aging: An Integrated Approach for Better Quality of Life". Int. Sch. Res. Notices. 2014: 257248. doi:10.1155/2014/257248. PMC 4897547. PMID 27351018. Research investigating the effects of exercise on older adults has primarily focused on brain structural and functional changes with relation to cognitive improvement. In particular, several cross-sectional and intervention studies have shown a positive association between physical activity and cognition in older persons [86] and an inverse correlation with cognitive decline and dementia [87]. Older adults enrolled in a 6-month aerobic fitness intervention increased brain volume in both gray matter (anterior cingulate cortex, supplementary motor area, posterior middle frontal gyrus, and left superior temporal lobe) and white matter (anterior third of corpus callosum) [88]. In addition, Colcombe and colleagues showed that older adults with higher cardiovascular fitness levels are better at activating attentional resources, including decreased activation of the anterior cingulated cortex. One of the possible mechanisms by which physical activity may benefit cognition is that physical activity maintains brain plasticity, increases brain volume, stimulates neurogenesis and synaptogenesis, and increases neurotrophic factors in different areas of the brain, possibly providing reserve against later cognitive decline and dementia [89, 90].
It's hard to pinpoint the first time exercise appeared visually on-screen—meaning on film or video, something that you could see, as opposed to hear—but one of the earliest is the 1928 film Exercise: A Film Lesson in Health and Hygiene. It isn't exactly instructional, but features a bunch of boy scouts showing off some rather bizarre group exercise routines. Check out the bit that starts around 1:22, where they ride each other like human chariots. Anyhow, this film is significant in that its primary purpose is to display and broadcast forms of exercise to an audience, and it seems to be the first to have done so.
Wildman S. Kafka's Calisthenics. Slate [Internet]. 2011 Jan 21 [cited 2015 Aug 30]. Available from: http://www.slate.com/articles/life/fitness/2011/01/kafkas_calisthenics.html.  He was conferred a knighthood by the King of Denmark in 1919 and his work was granted patronage by the Prince of Wales in 1925.15,16 Müller JP. My system. London: Link House; 1904.
There’s a simple way to get your body back in fat-blasting mode: Temporarily ditch your go-to moves. "When you change up your workout, your body works harder because it’s in unfamiliar territory," explains Amy Dixon, a Santa Monica, California–based trainer and exercise physiologist. "That’s what causes it to burn more calories and build more muscle."

The only measures that accurately distinguished NFO from OTS were increases in ACTH and PRL concentrations after a second maximal exercise bout. The OTS athletes showed a very small or no increase in ACTH and PRL concentrations after the second exercise bout; the NFO athletes showed very large increases. This is a confirmation of our previous studies with this protocol.10 22 The use of two bouts of maximal exercise to study neuroendocrine variations showed an adapted exercise-induced increase of ACTH, PRL and GH to a twoexercise bout.10
For some, it’s the ultimate quest for physical preparedness; for others, the very thought of CrossFit makes them want to puke. Either way, CrossFit is making an undeniable impact in the fitness world, with followers tackling muscle-ups, Fran, and the infamous Filthy Fifty. So whether you're off to the nearest “box” or tuning in to the CrossFit Games on ESPN, here’s the need-to-know lingo for any and every WOD.

Multiple new, yet generally typical MMB methods originated after 1950, including the Feldenkrais Method;51 Reese M [Internet]. A biography of Moshe Feldenkrais. 2015 Aug 30 [cited 2015 Aug 30]. Available from: http://www.feldenkrais.com/moshe-feldenkrais. [Google Scholar] the modern form of Calisthenics;52 Ozer Kaya D, Duzgun I, Baltaci G, Karacan S, Colakoglu F. Effects of calisthenics and Pilates exercises on coordination and proprioception in adult women: a randomized controlled trial. J Sport Rehabil. 2012;21(3):235–43. [Google Scholar] Gyrokinesis and Gyrotonic by Horvath;53 Gyrotonic and Gyrokinesis [Internet]. 2015 Aug 30 [cited 2015 Aug 30]. Available from: https://www.gyrotonic.com. [Google Scholar] Gaga by Naharin54 Gaga [Internet]. 2015 Aug 28 [cited 2015 Aug 30]. Available from: http://gagapeople.com/english/about-gaga/. [Google Scholar] and CoreAlign55 The CoreAlign [Internet]. 2015 Aug 30 [cited 2015 Aug 30]. Available from: http://www.pilates.com/BBAPP/V/education/corealign/index.html. [Google Scholar] and Human Harmony by Hoffman.56 Human Harmony Training [Internet]. 2015 Aug 30 [cited 2015 Aug 30]. Available from: http://www.fffforlife.com/#!human-harmony-training/c66t. [Google Scholar] In recent decades, many allied health professionals and therapists have embraced the MMB concepts as an integral part of their practice and detailed in mainstream scientific literature their research findings on its effectiveness.57–59 Wells C, Kolt GS, Marshall P, Hill B, Bialocerkowski A. Effectiveness of Pilates exercise in treating people with chronic low back pain: a systematic review of systematic reviews. BMC Med Res Methodol. 2013;13:7. Available from: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3563510/10.1186/1471-2288-13-7
Conclusions: Rediscovering the Western mind–body exercise movement is hoped to facilitate official healthcare establishment recognition of this kind of training as an integral entity. This may widen research opportunities and consolidate approaches toward: optimal musculoskeletal rehabilitation and injury prevention, promotion of a healthy active lifestyle environment in the modern world, and enhancement of the natural pain-free human athletic look, feel, and performance.
Do you even lift, bro? While putting away groceries, do bicep curls with cans, bottles, or other objects. You can also try holding these objects above your head for ten seconds before putting them away. Alternately, when grocery shopping, opt for a basket instead of a cart when you can. You'll be working out your upper body without even thinking about it.
Alicia Marie, celebrity trainer, says you can change your core with plank twist corkscrews. “Hold in low plank position, keeping your core muscles tight and your forearms flat,” she says. “Slowly rotate your hips to one side, being sure not to drop them to the floor, then rotate your hips back to center. With your core muscles still engaged, rotate to the opposite side. Alternate back and forth slowly, completing five reps on each side for a total of four sets.”

Association of exercise type with sex in the MCT (a) and HIIT (b) groups. Data are presented as proportions of the total number of exercise sessions. Other type of endurance; treadmill, cross trainer, aerobics etc., Domestic activities; housework, gardening etc., Other: golf, bowling, horseback riding etc. *Significantly different from men (p < 0.05)


Do you even lift, bro? While putting away groceries, do bicep curls with cans, bottles, or other objects. You can also try holding these objects above your head for ten seconds before putting them away. Alternately, when grocery shopping, opt for a basket instead of a cart when you can. You'll be working out your upper body without even thinking about it.
Lose yourself in the high-energy rhythm of the Pound Rockout Results System, a five-disc sweatfest in which you wield drumsticks (aka Ripstix) instead of weights. "The drumming takes your mind off your muscles hurting!" one tester marveled. You'll "constantly tap the sticks" in each routine—core, upper body, lower body, intervals, tune-up and jam session—for a "totally unique" cardio blast.
One new exercise is added to each bodypart routine to provide even more angles from which to train your target muscles to promote complete development. You’ll hit each muscle group with two exercises of 3­–4 sets each: four sets for large bodyparts (chest, back, shoulders, quads, hamstrings) and three sets for smaller bodyparts (biceps, triceps, abs, calves). The result is 16 total sets for the week for large bodyparts and 12 sets total for smaller ones—again, working in the 8–15-rep range—which is a substantial increase in volume from Week 1.
The exercises listed in Week 1 are a collection of basic moves that, while also used by advanced lifters, we feel are suitable for the beginner as well. Notice we’re not starting you off with only machine exercises; a handful of free-weight movements are present right off the bat. Reason being, these are the exercises you need to master for long-term gains in muscular size and strength, so you may as well start learning them now. Carefully read all exercise descriptions before attempting them yourself.

Athletic trainers and physical therapists play important roles in the management of individuals with RCIS. When caring for this patient population, an athletic trainer or physical therapist performs a comprehensive initial examination. Information obtained from the examination is used, in part, to (1) identify impairments believed to be contributing to the individual's pain and functional limitations and (2) develop an impairment-based rehabilitation program. We believe that the prescription of specific evidence-based interventions designed to address the relevant contributory factors might be more appropriate than administering the same exercise program to everyone with RCIS. Ideally, individuals with RCIS would be classified into impairment-based subgroups and prescribed interventions specific to that subgroup. Although no treatment classification for patients with RCIS exists, this approach has been used to treat individuals with low back pain and has resulted in superior outcomes when compared with a general treatment approach.2


After trying many different workout "schemes" with limited success, I bought this book and began doing Super Slow workouts. I'm now working out 6 times a month, spending less than 30 minutes in the gym for each workout, and I'm stronger than I've ever been. I've never experienced progress like this before. At 45 years old, my leg press has gone from 400 to 820 lbs. in a couple of months. The workouts aren't easy, but they're over quickly, and I'm able to spend more time with my family without feeling like I'm compromisng my health and fitness.
Rotator cuff impingement syndrome (RCIS) is a multifactored disease that can lead to functional limitations and an inability to participate in work, leisure, and sporting activities. This syndrome can be caused by many factors, such as weakness of the rotator cuff and periscapular muscles, decreased pectoral and rotator cuff muscle flexibility, abnormal motion patterns, extrinsic factors (eg, vibration exposure, use of hand tools, work-station height), and trauma. Kuhn provided a valuable synopsis of randomized controlled clinical trials in which the benefit of exercise for individuals with RCIS was examined. Substantial evidence1 exists to support the use of exercise for the management of this patient population. In addition, manual therapy has been shown1 to augment the effectiveness of exercise. However, we believe it is premature to label the proposed rehabilitation protocol as a criterion standard because of the lack of specific exercise descriptions, variability in the exercise programs, and inability to separate the effects of specific exercises on the measured outcomes that Kuhn noted. Furthermore, because RCIS is multifactored, use of the same exercise protocol to treat everyone with RCIS might not be the best standard of care.
13.  Stretching is useful only upon awakening from sleep... it is not necessary prior to working out. As muscles become stronger, their associated tendons and ligaments will be stretched appropriately during the actual exercise, and you will have "functional flexibility", which is all you need. Many people are over-stretching their ligaments, and this leads to joint instability, which increases the chances of injury. Unless you are engaged in martial arts, ballet, or are training for the Olympics, you do not need to consciously stretch anything prior to a workout performed as outlined here.
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