One of our readers, Viki Altomonte, an accomplished long-distance swimmer (Bay Swim 8 times, the Manhattan swim, the Potomac Swim, Key West and numerous Jersey shore swims) and a nurse completing her masters and nurse practitioner boards, objected. She wrote the following and her physical therapist also commented.

Viki said, "I really disagree with the article about lateral arm raises. As someone who has had bilateral shoulder surgery, I know I have a preexisting problem, and cannot do full arm extension. However, I also feel most swimmers who put in reasonable yardage have some degree of shoulder problems, or inflammation. I really believe that extending above the head will exacerbate any inflammation."

Viki's therapist, Rob Germeroth, P.T., M.B.A., stated, "First there are two major errors in this article. The pinching that occurs in the shoulder is not a nerve. The tissue that is pinched is the rotator cuff and/or the sub-deltoid bursae. The Muscle and Fitness author also states that the supraspinatus 'does the bulk of the work from 0-90 degrees' which is incorrect. The deltoid is still the primary muscle that moves the arm through this ROM. The supraspinatus acts to depress the humeral head into the glenoid which, in turn, assists the deltoid in producing the smooth elevation of the arm.

"In regards to performing full elevation of the arm I really cannot disagree. If the should is healthy I do encourage the individual to work through the full range of motion. When a problem (i.e. impingement, rotator cuff pathology, etc.) does exist then one should perform specific exercises in a pain free range only and use ice to combat the inflammation. "

Rob works at Helix Sports Medicine and Rehabilitation and can be reached at:
(401) 512-5820.