The shoulder is one of the most amazing joints in the body. In fact it is not a 'joint', but rather a 'complex' of 5 joints, over 30 muscles and 6 major ligaments. The shoulder can assume no less than 1,600 different positions! There is more movement at the shoulder joint than at any other joint in the body. As such, it is easily prone to overuse and injury.
Athletes, such as swimmers, tennis players, golfers, baseball pitchers, javelin throwers, cricketers, rugby players and martial artists use their shoulders a huge amount and often take it for granted.
Because shoulder injury can happen, seemingly without cause, prevention is so much better than cure.
BALANCE – THE KEY TO AVOIDING INJURY
Balance is key to injury prevention of the shoulders. And balance is achieved through five ingredients of control:
• Sports-specific technique
• Flexibility
• Core stability
• Rotator-cuff control
• General strength
•Limit your range of movement, and take it easy
Sports-specific technique – poor performance and shoulder pain commonly originate in bad habits and faulty technique. Often these faulty methods are only revealed when muscle fatigue sets in, and injury occurs.
Flexibility
The purpose of flexibility varies for the different muscles around the shoulder. For the major power muscles, flexibility facilitates freedom of movement for the pelvis, trunk, scapula, and humerus. For the rotator cuff, the critical issue is balancing forces that center the head of the humerus, and whatever provides overall more freedom of movement. This is why stretching is so important.
Core stability
core stability is critical it is for the inner core of the body and providing a stable strong support for the shoulder to work off. A good shoulder needs a good foundation. The core also provides the kinetic chain for overhead activities, allowing the trunk muscles to transfer energy and momentum to the shoulder for overhead sports. For the shoulder, the critical areas are the lumbar and cervical spine and the scapulothoracic joint. If these areas are not stable, significant extra loading and strain is passed on to the shoulder joint.
Rotator-Cuff Strength And Control
The rotator cuff is dependent on the good positioning of the scapula for effective control. If your scapula is angled too far forward or downward, for instance, rotator-cuff muscles are biomechanically disadvantaged and prime mover muscles may fail to generate enough power to be effective or avert injury.
General muscle strength
once the essential issues of technique, flexibility, core stability, and rotator-cuff control are being implemented, we then should also look at the 'outer core'. What is the rest of your body like - does it help or hinder the performance of the shoulder?
Athletes often overwork and build up their 'mirror muscles' at the front of the shoulder, such as pec major, front deltoids, trapezius and rectus abdominis ("six pack"). What is often critically overlooked, however, is the imbalance that can develop between the front of the shoulder and the back. In those athletes that are carrying an overuse injury in the shoulder, nine times out of ten they have overdeveloped pecs and lats relative to their lower trapezius, rhomboids, posterior deltoids, and posterior rotator cuff.
Limit your range of movement, and take it easy
Rehabilitation from a shoulder impingement injury should focus on rotator-cuff strengthening, as explained in Dr Kemp's article last time. However, it's important to remember that when it comes to re-introducing your weight training exercises, you must progress slowly. Often this means avoiding certain ranges of motion where the shoulder joint sub-acromial space is compressed the most. The impingement zone to avoid is between 70 and 120 degrees of shoulder abduction (when you move the arm laterally away from the side of the body)