Bulletproof Your Shoulders
When it comes to the shoulder, most athletes (and even some rehab specialist) think any deficits in the overhead position is strictly a shoulder problem. The reality is, there is much more involved in getting our arm overhead than the glenohumeral joint. Yes, oftentimes the glenohumeral joint is restricted in athletes and exercisers, forcing us to compensate to achieve overhead positions. That being said, there is also contribution from the cervical spine, thoracic spine, rib cage, and even our diaphragm that need to move or stabilize appropriately to allow the glenohumeral joint and scapula to get into positions to allow shoulder flexion.
It's important to appreciate this concept to make sure we are working on everything that is contributing to our problem. If we cannot achieve the overhead position in a shoulder press or snatch and we recognize that we are compensating with excessive low back extension, bending the elbows, and more… than we cannot just keep stretching and forcing our shoulders into this position and expect change. Let’s take a look at the vital components to shoulder flexion, common causes of shoulder injury, and how to address everything to bulletproof the shoulders.
First, what is needed to get the hands straight overhead? Well, we need shoulder flexion (the arm going forward and up until overhead). What happens in the shoulder joint is gliding and rolling of the humorous bone on the scapula. Further, the scapula rotates upward and glides on the rib cage to achieve positions to allow the humerus to continue to achieve this motion. Now, the stabilizing capsule of ligaments around the head of the humerus and the muscles of the rotator cuff surrounding the joint need to allow for this motion to happen. That is, this capsule and the muscles cannot be too tight. Further, the larger muscles of the back and chest need to allow for these motions (like the lats and pecs). So, we do need to assess and address these structures in the shoulder to help us ensure shoulder flexion.
As I mentioned, the ribcage plays a role in getting us to achieve shoulder flexion. Let’s discuss the rib cage and the thoracic spine together. The thoracic spine is the middle portion of the back where the rib cage extends from. We need to make sure this part of the spine is mobile enough to allow for the scapula to move on it and create the upright spinal position. For this, we need this part of the spine to extend slightly from each segment. This motion is most often limited in people. If we cannot get full access to extension in the thoracic spine and full excursion of the rib cage to maintain its rounded shape in the back, then even with full range of motion in the shoulder joint, we may not be able to achieve a stable and compensation free overhead position.
Therefore, when thinking about snatching, pressing, catching a football overhead, and serving a tennis ball, we need to appreciate the role of the rib cage, spine, AND shoulder working together to achieve this position without increasing our risk for injury.
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Focus 1: Overhead mobility and the rib cage (Monday Post)
The rib cage plays a vital role in shoulder flexion. The scapula needs to rotate, elevate, and protract as we reach our arms overhead. Since the scapula articulates on the rib cage, we need to address the rib cage to make sure it is not restricting the scapula and is allowing for thoracic extension. Check out the video below for an example of how we address the rib cage and thoracic spine for mobility beyond stretching or fighting tension with more tension. Check out the video below to see an example of how we address the rib cage!
Focus 2: Common shoulder injuries (Wednesday Post)
It is often our compensation to create or mimic full shoulder flexion that creates our injuries in the shoulder. When we cannot achieve proper gliding and rolling of the humerus in the shoulder socket, then we begin pinching tissues or jamming the bone into the scapula as we move. The same occurs even if the shoulder joint does have full range of motion but the other components are not moving well (rib cage, spine, and scapula), forcing us to push the shoulder joint range of motion beyond what it is designed for.
Focus 3: Bulletproofing the shoulders (Friday Post)
To bulletproof the shoulder, we must address the entire complex (rib cage, spine, and scapula). We want the ribs to be able to expand and compress, internally rotate and externally rotate, and rise and fall. We need the thoracic spine to be able to extend and rotate. And last, we need the scapula to move with the humerus to help achieve the overhead position and allow the muscles to maintain their optimal length to keep the humerus centrated. Check out the video below for an example video working on centrating the shoulder joint.
Closing
Shoulder pain can be a complex issue. It is important to understand that having appropriate mobility is a vital pre-requisite for getting out of pain and enhancing performance. We must address the rib cage, spine, and scapula along with the humerus and shoulder capsule to truly address overhead mobility. Check out the Instagram posts to see more examples of how we work on overhead mobility for exercise and performance at IRPC.
Phone: (585)478-4379
Website: www.integratedrpc.com
