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Priming the shoulders, and the injury risk with overhead movements!

10/7/2015

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Written by Megan Gaudry. 
The views and information provided by Aspire Health & Rehabilitation, and Megan Gaudry, in the form of blogs, videos, photos and reviews are not in any way to be substituted as a Medical consultation, and are for education purposes only.

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This post is in the response to a follower's request to provide some idea of corrective- or activation-based exercises to injury proofing or prepping shoulders prior to a training session, given the higher risk of injuries in sports requiring overhead movement, such as throwing sports, olympic lifting movements, Crossfit and the like.

Shoulder injuries are very common, in fact shoulder injuries are the third most common injury to lower back and neck pain. Up to 36% can suffer shoulder pain in the general population, and 8-13% of shoulder injuries are suffered within the athletic population. Of these injured individuals, studies show that only 44% of acute shoulder pain will resolve within 3 months and 50% within 6 months. 

Shoulder injuries are usually associated with heavy, overuse, repetitive type movements, often in the overhead position. The shoulder is at its most weakest in the overhead position, a great example is wide up phase of a baseball pitcher, with the arm externally rotated and above 90 degrees flexion causing repetitive capsular overload.

In this position, research has shown that ligaments in the shoulder play a bigger role then muscle force in that overhead position, meaning, that all your stability is relying on three particular ligaments holding the shoulder (ball) to the glenoid (socket). Therefore many individuals tend to dislocate in these positions, especially given the amount of force and load that we put on ourselves.

Repetitive and overuse injuries such as bursitis, or rotator cuff injuries are also common, whether it be in sports, or work related injuries.

However before I go on and talk about ways to address your shoulder, I want to place some emphasis on the thoracic spine. If you are locked up and restricted in the thoracic spine, you will also have restrictions in shoulder range of movement. I like to give many to whom have seen who have developed a kyphotic posture with inwardly rotated shoulders the car driving example to try and explain, and provide a visual and tactile demonstration on how much their posture can impact them.

Firstly, start by slouching over while sitting, bring the shoulders forward/inward, now in this position I want you to lift your arm up out in front as high as you can go. Now I want you to repeat the arm movement, however with a good sitting posture, sitting tall with your shoulders back. You would of significantly increased your shoulder movement, simply by correcting your spinal alignment, and being positioned in what's called a neutral position.

I have previously written a blog on thoracic mobility, and it is well worth the read to ensure that you can get more out of your performance especially in overhead movements like the snatch or jerk if your not locked up in your thoracic spine. Check it out here.

Here are 5 exercises that I incorporate into my program:
Yoga-Tune Up (YTU) ball pec release
After placing the ball on the pec region, you can roll around and find the nitty gritty areas. After a minute or so, you can than add arm movements by raising your arm out in front, to the side or in an arc movement while applying pressure to the tender area, thick creates a tacking motion where you are compressing the tissue and stretching it by moving the arm.
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Reach, roll and lift
The exercise helps to improve shoulder girdle mobility and stability.
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Band Internal and External rotation exercise
Great for rotator cuff strengthening. By placing a rolled up towel in between your elbow and body, it turns on the external rotators better, providing better activation of the post cuff and supraspinatus with minimal deltoid activation. The aim is to start in neutral, with arm by side, and progress to more functional ranges of motion. The photo below provides a demonstration of external rotation.
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Low row from high, and/or band pull apart
These exercises are aiming to target the lower trapezius muscle, which tends to be overridden by the upper trapezius muscles in many movements. 
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Kettlebell Get Up exercise
This is a more advanced stability based exercise for the shoulder. Each stage can be performed individually, and progressed to be performed all 3 at once, and even into the full Turkish get-up movement. This exercise requires the ability to be able to control the weight in an unstable shoulder position, and requiring the activation of the entire shoulder complex.
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Enjoy the article, and if you have any questions head to our 'Contact us' page.

Yours in health,

Megan

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All photos (unless otherwise stated) used in this blog are a product of Aspire Health & Rehabilitation (2014), and cannot be reproduced without permission.
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    Megan Gaudry

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