A common problem with contact sports athletes is shoulder injuries. Impingements, tears, dislocations and subluxations are a frequent occurrence that need rehabilitation. Obviously, some issues may need surgery but often what the joint is lacking is proper movement / mobility and strength.
If you’re struggling with shoulder injuries at the moment or deal with constant niggles, then you’ll take something away from this. This is general advice only; each situation is different and may require working with a physio or other health professional but here’s a few key ideas to think about…
First rule is – do no harm…
Shoulder rehab can be a slow and tricky process to navigate as anyone with a shoulder injury will tell you. While the rehab takes time, a good starting place is to do no harm. Avoid movements or activities where the pain is made worse. We find pressing movements such as an overhead press or full range bench press as well as overhead pulling such as chin-ups tend to aggravate it. So the first thing we do is avoid pain. It’s important to note that there is a difference between pain and discomfort. You’ll probably be able to recognise the difference but if you’re confused, stick to a 2-3 / 10 on the pain scale as a guide.
Strengthen the rotator cuff:
These are the tiny muscles inside the shoulder joint that keep the shoulder head stable inside the socket. Rotator cuff dysfunction or tears can result in pain and impaired function. You can do direct rotator cuff work here such as external rotations with a band or small weight plate. But you should also incorporate some shoulder stability work where the rotator cuffs are contracting to lock the shoulder joint down. This can be seen in the ‘chaos push-ups’ and ‘bottoms-up kettlebell press’ videos. While the arms are unstable and shaking, the RC muscles are working to stabilise the shoulder joint. Perform 3-4 sets of 8-12 reps with theses exercises.
Strengthen the large muscle groups:
Your shoulders aren’t sore because they’re too strong. They’re most likely lacking strength and stability. You’d be surprised at how many issues can be taken care of purely by strengthening the muscles surrounding the joint. For shoulder health we like to focus on our pulling muscles. In saying that, we like to do a lot more horizontal pulling like inverted rows and incline dumbbell rows as oppose to vertical pulling such as chin-ups. It’s important that you don’t let your shoulder roll forward while doing these exercises. To prevent this, think about puffing your chest out by pulling your shoulder blade back and down. A few common cues we’ll use are ‘show me how big your chest is’ or ‘put your shoulder blades in your back pocket.’ 3-4 sets of 8-20 reps will be fine here.
Gain full mobility / movement around the shoulder girdle:
Depending on the severity of your injury, movement may be limited. In order to get full function of your shoulder it’s important to work on the mobility of the shoulder, scap (shoulder blade) and t-spine (upper back). Our aim is to reach overhead completing pain free. As long as you can reach overhead with pain or impingement, I often find the best way to increase mobility is under load. So start out by performing exercises such as the stretch seen in the video followed by supine press on the foam roller (again 3-4 sets, 10-20 reps). Opening up the shoulder / upper back area with a lacrosse ball, foam rolling, and soft tissue work will also help here.
Again, the first rule is ‘do no harm’. Each scenario is different and may require slightly different advice. If in doubt, message us or see a physio. This is general advice for those with nagging shoulder pain. If you have any questions, feel free to contact us. #one22