Chronic shoulder pain is nothing new to weight lifters or overhead athletes. It can range from something you just live with and work around for debilitating and at retirement. It is not something you mess with. If you currently have shoulder pain, go have it looked at. If you have not known at this point so pay attention to the following.
shoulder pain that is chronic in nature is often the result of an "impingement syndrome". In a word, the soft tissue between the head of the humerus and the acromion and coracoid are literally stuck for throwing, hitting, pushing, and other high speed or weighted activities. These soft tissues include tendons of the rotator cuff, subacromial the purse, glenoid labrum, and even the biceps tendon. Ask an orthopedic surgeon and they will tell you the rotator cuff will look like someone took sandpaper to it and just wore a hole in it. These chronic type of symptoms can also lead to acute tears of the cuff, labrum and biceps tendon, which in many cases means surgery and a long process of painful rehabilitation.
So how can we get to this point? There may be a number of causes, the most common of which I will discuss here because they are avoidable
Poor posture -. Sitting is a necessary evil for many of us. Of sitting at a computer all day, driving for a living, and for students who have to sit in class all day. God forbid they receive a physical education course to run and undo what institutional learning has done for them physically. Over prolonged sitting time leads to muscular adaptations. Some muscles become short and tight while others become weak and lengthened. Anyone familiar with the upper cross syndrome Janda recognize this: tight pecs and levator with small diamonds, jagged and deep cervical flexors
What these muscle adaptations do is change the scapular mechanics and rhythm gléno- .. the humeral humeral head then gets into the acromion and / or transmit the ligament corocoacromial causing encroachment
pressure Volume exceeds shoot -. What this does is to reinforce the earlier dominance of pecs relative to the scapula stabilizers upper back. Again, posture and shoulder belt mechanical suffer
A lack of stability through the trunk and hips -. We have known for some time that poor trunk and hip stability is a major cause of shoulder and elbow injuries for pitchers. This is well documented. More and more research comes before looking at these factors with other athletic populations and find the same results. A study is underway now watching the swimmers with and without shoulder pain. To this point, the leading indicator of shoulder pain is single leg balance (the side opposite the painful shoulder). The shoulder will be as stable as the rest of the body
Exercise selection -. There's just some exercises that should be avoided by athletes generals, weightlifters and powerlifters. In particular bodybuilding-type exercises. heavy shrugs and straight lines, flyes and pec decrease for the chest, and front and side elevations deltoid really should be excluded. It is rare to see someone run them properly and they all increase the risk of impact through various mechanisms. Little reward for such a high risk. If you are a bodybuilder then I understand that you have to do, but please use a weight that allows you to maintain posture and perfect form
GIRD (Glenohumeral Internal Rotation Deficit) -. This involves the head over the athlete push but they also need to be tested (see photo). A difference of 25 degrees of the dominant shoulder to the non-dominant indicates a positive test. GIRD develops due throw or hit a pole position requires a lot of shoulder joint in external rotation. Over time, the athlete develops excessive external rotation at the expense of internal rotation. Physiologically what happens is the capsule of the posterior shoulder tightens and thickens resulting in superior / posterior translation during the loading phase and the upper / anterior translation during follow-up. In both cases, encroachment may occur and significant shear on the labrum.
extensible Sleeper
So now that we have discussed the causes, what should you do about it? The following list consists of seven strategies to maintain the health of the shoulder while maximizing performance. Note: The order of the solutions do not exactly match the order of the above causes. The first three solutions are designed to improve posture and glenohumeral rhythm
Increase the extension of the thoracic spine and rotation -. Poor posture so that we see is in part due to the rounding of the thoracic spine. The blades must be in place for the normal glenohumeral rhythm to occur, and this can not happen with a spinal kyphosis Does column.
Thoracic mobilization of extension of the spine can be performed lying on a foam roller. Start at the top of the shoulder blades and work down just below the lower corners about an inch at a time. Take 2-3 deep breaths and relax back on the roll at each level.
Thoracic spinal column begins sidelying rotation with the upper 0 degree hip knee pressure in a ball or the floor, according to the mobile way, you are. Roll the shoulders back to the floor, reach the arms down, and give traction on the coast with the upper arm to take the spinal column does as far as possible. The goal is to get the shoulders flat on the floor. You will probably see a different side to the other, especially if you're a pitcher. Work the limited side twice more games than the other.
These are great exercises to prevent use in the warm-up.
Thoracic Mobility
Decrease tone and lengthen the muscle groups hyperactive - A foam roller and / or massage stick are great for reducing muscle tone . The main targets in this case are the pecs, the upper and levator traps. Tracking flexibility work to lengthen the muscles. For the levator, retract and support the shoulder blades, tilt your head to your shoulder and turn in the same direction. You will feel the opposite stretch. Optimal length of the chin touch the collarbone. If you know a good manual therapist benefit. There are many techniques they can use you can really not much you
Enable under-active and elongated muscle groups -. The target in this case would be the lower traps, rhomboids, and serratus. T Y, L, and W are great for strengthening the stabilizers of the shoulder blade and the rotator cuff muscles simultaneously. Make sure to lock the shoulder blades back and depression before lifting, and go light. It is easy for the upper traps are beginning to take more particularly when tired.
W 
Y 
Push-ups with more are great for activating the serratus. Turkish Get-Ups with a kettlebell is just a great way to put it all together. This is a fairly technical lift and unfortunately, only one image will not do justice. Those of you who have tried this know how difficult they may be, but are the ultimate exercise of shoulder stability
Adjust the volume of training front to back - At a minimum, training volume should be 1: 1, meaning for each set of bench press, you perform a set of lines. Shoulder press - chins. Flies - Flies reverse (rear delt raises). Etc. SUPERSET exercises or do them on different days. It does not matter as long as it equates to the end
I know Mike Boyle and others are now advocating kicks in January 1 :. Report 2 as they have seen fewer shoulder injuries by using this strategy.
Improving core stability - Perform prone and side pillar bridges to engage the trunk and scapular muscles simultaneously. Do these crunches up for your basic work. Yes, I said replace crunches. The only things crunches are good for increased thoracic kyphosis, pulling the shoulder blades in a longer and higher position, and focusing Cancel the cervical spine. All the things we try to prevent
Improve the stability of the hip -. Squats and deadlifts one leg will force greater stabilization of the hip compared to traditional squat and deadlift. I do not mean to replace them, but use the single leg versions of the exercises instead of hitting the leg press, hamstring curl machine. Y can not go wrong with exercises that challenge everything from the ground
Use the cross section -. The test is the remedy in the case of GIRD. This can be done before or after formation. Just do every day.
So there you have it. The causes and solutions. While prevention takes time and effort, it is always easier and less painful than rehab. Do not let your shoulders get in the way of your gains in the gym or your performance on the field.
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Joe Heiler PT, CSCS
Joe Heiler MSPT is the owner and manager of content SportsRehabExpert.com, a site dedicated to the advancement of education rehabilitation and performance professionals. The site focuses on orthopedic and sports physical therapy subjects through webinars, audio interviews, articles, manual therapy and exercise videos, and more.
Joe is also the owner of Elite Performance Physiotherapy and Sports in Traverse City, MI specializes in orthopedics and sports medicine, as well as training of athletic performance. It is Graston Technique (GT) and a certified instructor GT SFMA FMS and trained, and is passionate about a number of soft tissue and manual techniques, including Trigger Point Dry Needling and manipulation.
Latest posts of Joe Heiler PT, CSCS (view all)
- The Bird Dog - basic Classic stability - April 4, 2016
- Points triggering and pain shoulder - Part 2 - February 29, 2016
- trigger Points and shoulder pain - Part I - January 19, 2016
- basic stability vs core strength - Part II - April 1, 09
- basic stability vs core Force - March 1, 09
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