I have a question regarding a female client who has a left arm amputation. She has half the arm and wants to build strength in the shoulder or part of the bicep and tricep.
Thank you for your question and your passion to assist your client to a higher level of function! I will share some strategies to assist you in your endeavor. First, we will clearly define function. Function is everything the body needs and wants to do in order to be optimally efficient and effective (i.e., it is all and only that which is needed at the right time, in the right amount, for the right result… nothing wasted and everything gained). In simple terms, it’s who you are and what you need. Therefore, your assessment and programming, needs to start with your client’s NEEDS, followed by her wants. In addition, you must respect your client’s structural anomalies. Even though she exhibits (we all do to some extent) deficits, she also exhibits functional-task specific threshold(s). This is the key to your success. You must select one or more functional tasks to understand how to improve strength. For example, a client may request increased strength for the shoulder. As professionals, we need to ask the following: What is strength? What does strength in the shoulder mean? The shoulder muscles? Now consider that NO muscle in the body functions in isolation. In fact, muscles (all soft tissues) function in synergies to perform specific functions. Yes, that word function again. So, to accomplish your goal of improving shoulder strength, select tasks that involve the shoulder complex, search for ways to improve shoulder girdle motion (specifically scapula-thoracic) to help assist the known structural deficit. Ask your client what CAN you do with your shoulder today? What CAN’T you do with your shoulder? Start the training process with the “CAN” movements and work towards improving the threshold of the “CAN’T” movements. The more you study integrated function, the more tools you will have in your toolbox to enhance the “CAN’Ts” and therefore improve the shoulder strength (your client’s goal). I would urge you to purchase Gary Gray's Functional Video Digest titled Scapula V2.06. This DVD will supply you not only with the functional science but also many different exercises to improve you client’s function. And while you’re waiting for the DVD, focus on the "CANs."