Thursday, June 4, 2009

Heal The Shoulders

I'd estimate that 90% of my clients have some sort of shoulder tightness, if not impingement or other similar issue. The same goes for every other trainer I know, so needless to say it's an important topic to address.

Since today I'll be doing a staff training on shoulder dysfunction and fixes I'll throw the notes up here so everyone can take a look. It might be a more technical than you really need to know, but pay attention to the fixes.

Basically everybody needs to be doing foam rolling for thoracic spine mobility, shoulder mobility work, and scapular stability and strength work.

Roots of common shoulder issues with clients

When shoulder issues are present look at posture and thoracic mobility and the scapula. Scapular function is most often the key to preventing shoulder impingement. Kyphotic (rounded) posture prevents proper scapula posterior tilt as the arms are lifted, which narrows space in the AC joint (subacromial space) eventually resulting in rotator cuff issues and impingement. The scapula may become stuck in anterior tilt with someone that has kyphosis, which will shorten the pec minor and weaken the upward rotators.

Poor scapula function and limited T-spine mobility results in weak upward rotators (lower traps, serratus anterior, upper traps) and scapular retractors (rhomboids, middle traps).

Fixes: Improve thoracic mobility through foam rolling and wall slides
Stretch the anterior: Subscap wall stretch, pec major/minor stretch, anterior deltoid stretch.

Activation and strengthening movements
1. Scapular Retraction: Neutral grip face pulls, row variations, band pull aparts, prone trap raises, rev flys.

2. Scapular Depression: wall slides, band pulldowns, chinups, prone trap raises

3. Upward rotators: Overhead shrugs. Dumbbell scaption with a shrug. Normal shrugs will stress the levator scapulae and rhomboids, both downward rotators, which will worsen the problem.

4. Humeral External Rotation: External rotation variations, prone trap raises (Y,Ts), band pull aparts.

3. Pushup variations (narrow hand placement with shoulders tucked) produce a significant increase in recruitment of shoulder stabilizers such as the supraspinatus, infraspinatus, and posterior deltoid. Scapular pushups, one hand on med ball, ring/TRX pushups etc…

Exercises to limit or not do: shrugs and upright rows, barbell bench press, military press or any press with shoulders at 90 degrees.

People with shoulder issues may need a 2:1 pulling to pushing exercise ratio. Or possible no benching or overhead pressing at all.

My friend Steve Cotter demonstrates some good shoulder mobility movements in the video below. Alot of his movements are derived from Chinese martial arts, and are quite effective.

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