How to Prevent a Shoulder Injury
During my time in physical therapy, I saw the same two or three injuries over and over and over again. Two of them were shoulder injuries and one was hip. I can tell you that injuring your shoulder is by far the most painful, cumbersome, and difficult injury to have and to heal from.
The shoulder is a very complex joint. Most of us have heard that is is a ball and socket joint which means it is capable of a range of motion of 360 degrees. Most of us don’t have that, most of us still have a large amount of motion in our shoulders.
The shoulder joint is surrounded by muscles called the rotator cuff, which are the 4 primary muscles that keep your arm in the shoulder socket. But those four are not the only muscle at work in the shoulder. There are a number of muscle that attach to the upper arm - including the second largest muscle we have: the latissimus dorsi (the lats).
What I have come to find is that MOST people have shoulder pain. It is usually in the anterior side pf the shoulder. This comes from the shoulder round and stooping forward. It is a product of the hours we spend in an anterior crunch position (sitting). The muscles on the front of our body get short and tight while the muscles in the back of the body get stretched and weak. Considering that the rotator cuff - the primary muscles stabilizing our shoulder - are attached from our back, this constant sitting is a big problem.
In shoulder injury prevention, we are focusing on three things: opening up the anterior chain, good thoracic mobility, and creating space in the joint. Any physical therapist reading this is thinking “WTF” because I am not talking about stabilization, strengthening, OR range of motion. Yes, those things are absolutely important. But today we are not talking about rehabilitating an injury, we are talking about preventing injury, preventing worsening a small injury/pain in, and/or keep our shoulder healthy in a population that participates regularly in exercise and strength training.
By focusing on opening up the anterior chain, good thoracic mobility, and creating space in the joint we are also preserving our range of motion and activating the muscles used for stabilization and strength of the shoulder.
Opening the anterior chain
These days, there seem to be far more necessary daily activities that keep us sitting rather than standing. Most of our body ailment are from exactly this: tight hip flexors, tight hamstrings and a tight chest, in conjunction with stretched and weak back and glutes. Even people who exercise are not immune to this because most of us spend one hour exercising and then sit the other hours of the day.
If you exercise, make sure that you do not cool down in the seated position. Get up and walk around or do some stretching. One of the most counter productive things we can do is get warm, sweaty and loose, then allow our bodies to cool in a cramped and best position - think: going to the gym before work then getting on your car and sitting for 20 minutes.
Be sure to stretch your hip flexors, your chest, stomach and ribs. Never try to PR a stretch, gentle and long is the best way to stretch, holding each stretch for at least 2 minutes in total (4 sets of 30 seconds or 2 sets of one minute). Include your neck in the stretching, lifting your chin during chest stretches.
Good Thoracic Spine Mobility
This is a secret to reducing shoulder pain that I learned only when I started dating a chiropractor. Stiffness through the thoracic spine causes shoulder problems. The stiffness pinches nerves, causes impingement in the AC joint, and limits our ability to freely move our shoulders. Three months of regular chiro adjustment got rid of shoulder pain that 7 years of PT and strength work could not.
We can work on these with rotational stretches. Think: sitting in the bottom of a squat and reaching upward, lying with you upper spine on a med ball, swiss ball or Bosu ball. Another great exercise is going into a deep lunge and rotating your chest to meet your forward leg by reaching up in the sky. Bowspring Yoga in another great way to reach those hard places.
Creating Space in the Joint
Creating pace in the point can be done in a number of ways: dead hang from a bar, exercising with indian clubs and using large exercise bands attached to a pull up bar to gently pull the arm from the shoulder. All of these exercises do the same thing to different degrees.
I have had many clients with shoulder injuries and surgeries. Let me tell you: clubs, a PVC pipe, and bar hangs do more for them than yanking on rubber bands. And it goes faster.
Bar hangs are a great place to start. Work by accumulating 2 or 3 minutes on the bar. Do in small sets. You want to beagle to be relaxed enough to allow your shoulder to relax and elongate. This will cause discomfort for many when you first start. Work on breathing through your bell and allowing you shoulder to relax. Do not start with your full body weight. Have a small step you can rest your feet on and then work on getting to a full body weight hang.
For those of you with limited range of motion, a PVC pipe and bands will work just fine. Work on Pass Throughs and Around the Worlds with a pipe. And stretch your shoulder with the bands in the way I described above.
Indian clubs are my favorite way to strengthen the shoulder and increase mobility and space within the joint. A discussion about clubs is beyond this particular article, but there is plenty on info out there.
Shoulder health is very important, especially as we age. Being able to safely carry, push and pull is essential to independence and maintaining our fitness. Incorporate some of these thing into your routine 2-3 times a week and you will feel different withing 3 weeks.