Healthy Shoulders
Welcome back to the Total Performance Newsletter! If you are a new subscriber and did not receive previous editions, let me know and I will send them over right away! This month, we will continue to take a look at some specific movement and injury-related issues that commonly arise and how to deal with them.
Before we dive into today's topic, I wanted to give a quick social media plug-follow us on Instagram (@total_performance_pt) and Facebook (@Total Peformance Physical Therapy). I am going to be more active in those places and will be making regular posts on ways to further help you move better, feel better, and perform better!
Getting back to today's newsletter, we will focus on the common approach we take at Total Performance keep your shoulders healthy, strong, and mobile.
First, a brief background on the methodology behind our approach. The shoulder is a ball and socket joint, where the ball sits in the socket. The arm bone (humerus) is the ball, and the shoulder blade (scapula) is the socket. Though not directly part of the shoulder, it is important to note that the shoulder blade rests on the ribcage, and the ribcage acts as a "track" for the shoulder blade to move on. Anytime you move your shoulder, the shoulder blade has to "travel" on the ribcage in order for the shoulder joint to move properly and keep the ball in the socket. The part of the ribcage in which the shoulder blade sits has a natural curvature to it, which provides an optimal track for all this motion to occur.
So, our approach to maintaining healthy shoulders is to optimize this shoulder blade/ribcage position, and then train the shoulder to move properly within this positioning. If you'd prefer a visual, here is a video link: https://youtu.be/BrJucdBzC6Q
Here is a sequence of exercises we frequently use to accomplish this. Click on the name of the exercise for video demonstrations.
Quadruped Breathing; 3-4 sets of 5-6 breaths per set
set up with hands under shoulders, knees under hips, eyes looking just in front of finger tips; gently push upper back away from your hands without rounding over too much; take slow, silent inhales through your nose, with slow, relaxed exhales through your mouth without losing the upper back position; should feel a gentle stretch in upper back/between shoulder blades with each inhale; the goal here is to use our air and position to stretch the upper/back part of the ribcage to restore the proper relationship of the ribcage and shoulder blade
Circuit; 2-3 rounds
Hands Supported Downward Dog; 8-10 reps
use a support surface as high or as low as needed-if able, you can do this from the floor as well; start with upper back gently pushed away from hands without rounding over, keep hips relaxed/in straight line with the body; from here, push hips up into air and let heels fall naturally towards the ground; only go as far as you comfortably can without pain; pause briefly, then return to starting position; reset upper back position if needed before each rep; goal is to utilize the ribcage/shoulder blade position from the previous exercise and train the shoulders in an unweighted overhead motion (they shoulders unweight as your hips go up in the air); an extra bonus is the nice hamstring/calf stretch you will feel
Hooklying DB Shoulder Rotation; 8-10 reps per direction, per arm
gently reach towards ceiling and rotate the shoulder as far as you comfortably can in each direction without pain; make sure you are rotating from the shoulder and not just the wrist/elbow; goal is to train the rotational motions of the shoulder while taking advantage of positioning we gained from the first exercise
Circuit; 2-3 rounds
1/2 Kneeling Single Arm Cable Row; 10-12 reps
as you perform the rows, let the arms do the work (do not actively twist the trunk); when each arm is long, be sure to let it reach long-should feel a gentle stretch in the upper back when you do this; the goal here is to train the shoulder blade to move around the ribcage in a more active manner; if this is easy and you need more overhead mobility, progress to a High to Low Row (https://youtube.com/shorts/0UweFD-j7L4?feature=share)
Bear ISO Hold; 15-30 seconds
set up with hands under shoulders, knees under hips, eyes looking just in front of finger tips; gently push upper back away from your hands without rounding over too much; lift knees 2-3 inches off the ground and hold this position for 15-30 seconds (break into multiple sets if needed); should feel abs/shoulders working-if you feel your legs working, gently shift weight forward just a bit while maintaining upper back position; goal is to build strength/stability with proper ribcage/shoulder blade positioning
Single Arm Bottoms Up KB Waiter's Carry; 2-3 sets of 20-30 yards per arm
if you do not have a kettlebell, use a dumbbell as shown in this video; arm should be at about 45 degree angle from the body (can adjust for comfort) with elbow at 90 degree angle in relation to the shoulder; gently reach the arm forward and feel a gentle stretch in the upper/mid back; maintain this position as you walk the given distance; goal here is to challenge the strength/stability of the shoulder to maintain proper positioning under load
You can use this sequence as a shoulder-mobility focused workout, or you can take pieces of it and incorporate it into your regular training routine.
As always, there are several progressions and variations for each of these exercises based on each person's individual capabilities, limitations, and needs, but this general outline is a good place to start. Give this a shot and if you have any questions, need some different variations, or are ready to progress beyond this starting point, feel free to reach out!
Stay tuned for next month’s newsletter, where will we continue to look into some common issues that arise and practical solutions to deal with them! Also, if you have any topics that you want to see covered in a future newsletter, please let me know!
Brett
