Friday, September 18, 2015

Sturdy Shoulders (How to Spare Your Shoulders from Injury)

I'd say nearly every person I've trained has, during an assessment, mentioned a previous shoulder injury. Even I have suffered from the plague that is shoulder pain in the past.

The shoulder (glenohumeral) joint is the most mobile joint in the body. The ball and socket architecture allows it to move through all different planes. The downside to this excessive range of motion, however, is that, if the musculature surrounding the joint is not strong enough, injury is surely impending.

As a coach, I see two ends of the spectrum: the hypermobile (like myself), who have an abundant range of motion but lack the appropriate control overhead, and the stiff, tin men who can barely extend their elbows all of the way. Generally, men tend to fall on the latter end, while women are usually guilty of the former. Of course, there are plenty of ladies with tight shoulders, and mobile men, but this is the typical trend that I have noticed.

The ideal situation would be the middle (wo)man: someone who can achieve the positions necessary for his or her sport, but has sufficient strength as well.

Keep in mind that not all shoulder injuries are created equal. Depending where on the list of mobility you fall, your exercise prescription may need to change to cater towards your individual weaknesses. Someone who has really tight lats is not definitely going to be doing the same "prehab" as someone with weak lats.

Below, I will explain each scenario a bit more in depth, and give you some corresponding exercises to remedy those imbalances. Beware, as there are 7,000,000 clickable links coming your way for the exercise demonstrations.

Case 1: Hypermobility

The hypermobile individuals need more stability. I often find that these people  These people need to strengthen the shoulder girdle and the back (latissimus dorsi, serratus anterior, etc.)

Although these guys can seamlessly execute an overhead squat, core strength tends to be minimal in this group. Usually, this will go hand-in-hand with poor rib position during overhead movements. Therefore, we need to address the lack of midline stability first, and strengthen the rotator cuff second.

Here are some exercises that will go a long way for this population:
  1. Arm bars (progress into the Turkish Get-up)
  2. Barbell overhead carries (or single arm with a dumbbell)
  3. Barbell roll-outs
  4. Supine barbell rows
  5. Scap push-ups (or banded protraction)
  6. Deadbugs
  7. Face pulls
  8. Dumbbell serratus pull-overs (or with a barbell)
  9. Upside-down kettlebell press (or use a PVC)
Case 2: Poor Mobility

If you fit into the "incredibly tight shoulders" group, then movements like an overhead squat are completely out of the question; the rack position on a clean or a front squat is nonexistent. Most likely, these people will have limited mobility in the thoracic spine (rib cage area). The pectoralis muscles and the latissimus dorsi are excessively tight, and then the lower/middle trapezius, rhomboids, infraspinatus, teres minor will be weak.

Click to enlarge.

First, you'll want to release tight muscles like the pecs and the lats. You can also try this stretch on the foam roller or this stretch on a bench to open up those overused muscles. The next step is going to be to strengthen those weak areas I listed previously. Some of the best ways to reach achieve that are the following exercises:
  1. Y's, T's, and W's (or fall-outs on the rings)
  2. Farmer carries
  3. Cable external rotation (or with a band)
  4. Kettlebell overhead press
  5. Band tears
  6. Cable reverse flys
  7. Wall slides
  8. Forearm wall-slides
  9. Hangs from the bar (or single arm)
As you can see, the type of corrective exercises I would issue for each group is pretty drastically different from one another. Case 1 is working to stabilize the shoulder joint, whereas case 2 has a bit too much stability and needs to improve flexibility. While each exercise may add value to any workout routine, it's important to prioritize the most valuable movements, rather than trying to add 75 different correctives. Honestly, I could've added a gazillion more exercise ideas in here, but I figured it was best not to overwhelm you with even more links than I've already included!

As always, breathing will also influence the strength and stability of the shoulders, so make sure to reinforce proper breathing when you're doing these exercises, and even when you're just going about your day-to-day activities. Make some of these exercises a part of your regular routine, and you'll be well on your way to having solid shoulders resilient for any sport.

Works Cited:

  1. Beasley, Lauren. "Getting Control of Overhead Movement: 5 Basic Drills to Prepare the Body." Breaking Muscle. N.p., n.d. Web. 18 Sept. 2015.
  2. Beasley, Lauren. "The Scapula: How It Can Make or Break You." Breaking Muscle. N.p., n.d. Web. 18 Sept. 2015.
  3. Cressey, Eric. "Shoulder Hurts? Start Here." Eric Cressey. N.p., 16 May 2011. Web. 18 Sept. 2015.
  4. Cressey, Eric. "Shoulder Impingement." Eric Cressey | High Performance Training, Personal Training. N.p., 18 Jan. 2014. Web. 18 Sept. 2015.

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