Movement

Shoulder Mobility for the Overhead Athlete, Part 2


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Every year more than 600,000 baseball players are treated for injuries caused by their sport. If we include softball, tennis, volleyball, quarterbacks, hand-ball, and track and field throwers that number easily surpasses 1 million injuries per year. Of the sports listed, only a single position (quarterbacks), in a single sport (football), are contact based.

The majority of injuries that occur in the overhead population are the product of repetitive use. Athletics will test the durability of even the most efficient movers, but the truth is most of these athletes suffer injuries due to the repetitive execution of a faulty joint mechanics.

The prevention of such injuries calls for a multi-pronged approach.

This article covers strategies to help overhead athletes move better, greatly reducing the risk of injury associated with their sport. In addition, coaches must make a point to monitor the volume and frequency in which they allow their athletes to undergo.

Many athletes will be able to correctly perform low-intensity drills in the gym or practice. Furthermore, they will also utilize proper mechanics and postures when fresh. Everything starts to fall apart when athletes begin to fatigue, both over the course of a season, and in a single outing or game.

The title of this article is “Shoulder Mobility For The Overhead Athlete.” As we discussed in part I, the improvement of mobility is not the only factor in keeping overhead athlete’s shoulders healthy. Adequate stability, and alignment (or position) is equally crucial. If you refer back to part I we know that it all starts with getting into better positions, and then gaining the ability to keep this positioning throughout the movements associated with the sport in question.

Every athlete is different. However, there are few “molds” you will see time and time again. Let’s categorize them first, and briefly outline their needs.

Congenitally Lax: These are your “loosey goosey” athletes.  They make up a large percentage of the throwing population. Their ability to reach freaky ranges of motion is both their greatest ally, and greatest foe. While the ability to bend, twist, and contort their structures helps them create a ton of torque (and in turn throw harder, swing faster, and create more whip), it also continually places them in dangerous end ranges of movement.

If you remember our brief discussion on osteo and arthro-kinematics, these are guys who can create a ton of wanted movement to the eye, but also create an equal, albeit more dangerous, amount of movement within the joint itself. Contrary to popular belief, their incredible joint laxity, “mobility”, and flexibility actually put them at a higher risk for injury than those who seem more restricted. This is the population that needs WAY more stability. In other words they need strength in the right places to resist unwanted movement; namely excess movement within the joint itself. Lastly, these folks need to be advised against stretching, and closely monitored during various mobility drills to stay out of end ranges.

Stiff as a board: This crowd makes it’s living using the elasticity of their stiffness to create power. While they are probably less likely to suffer injuries at the joint supposedly responsible for the movement, they are more likely to develop injuries above and below said joint. Their stiffness would be less of a hazard if they had an equal amount of it throughout. Generally, these athletes lack what we call “relative stiffness.” When they are stiff in one place, and more movable elsewhere, they will find a way to compensate by getting more movement wherever they can, making up for the lack of movement somewhere else. This crowd needs to both create stiffness or stability in the right places, and mobility where they are restricted.

Placing people into one of two categories is being way to general, but it’s a good place to start, and adequate enough to make our point within the context of this article.

Regardless of whether an athlete falls into the lax or stiff camp, the first place we need to improve is positioning. This alone can require the addition of mobility and stability. Once we have achieved some semblance of normal alignment we can begin to improve upon mobility and stability in the necessary places to aid performance within their sport.

In order to keep overhead athletes healthy, and improve their performance we need to attack three main areas: posture, scapular movement and control, and authentic shoulder mobility.

Posture:

Here is a list of common postural flaws found with overhead athletes. Some may fit into only one category, but many will have multiple issues. As we discussed in part I misalignment in one area often causes misalignment elsewhere.

1. Gross Extension

The overwhelming majority of the overhead athletes you will come across are stuck in an over extended posture. Take a look at their static posture and you will notice a heavy anterior tilt of the pelvis, lordosis in the lumbar spine, flared anterior ribs, and a host of other “compensations” they have made to remain balanced and able to stand without falling down. These can include a kyphotic thoracic spine, locked, and possibly hyper extended knees, as well as a forward head posture.

These folks need a few key things to improve their situation. For starters, they need to strengthen their anterior core musculature. For the most part these muscles have been placed on stand by. Improving their function will aid in bringing the rib cage down, and taking them out of excessive lumbar extension. This can be done with exercises such as reverse crunches, and various other “core stability” exercises as long as they are coached to be in the correct position. Not to mention simply performing all exercises and movements with an awareness of proper positioning. Furthermore, an intervention in how they breathe is paramount to their success. In case you missed it check out this video form Jim Laird and Molly Galbraith that was posted earlier this week.

2. Scapular Depression

Scapular depression is very common with almost any athlete these days. This postural flaw involves the shoulder blades being permanently drawn back, and more so down. It is another characteristic of someone with an extended posture. However, not all extended individuals will show excessive depression of their shoulder blades. The easiest way to assess for scapular depression is to look at the slope of someone’s shoulders. With these individuals you will notice a heavy down slope from their neck to their acromion process. Another telling factor is the slope of their clavicles. Those with heavy scapular depression will generally have very “flat” collarbones, instead of collarbones that have a slight downward slope from the acromion process to the middle chest. We will look more at the negative effects of this posture when we discuss scapular movement and control.

3. Negative Carrying Angle

The last postural flaw we are going to discuss is the “negative carrying angle,” a product of posteriorly titled scapulae.  This is when the top of the shoulder blades begin to push forward toward the front of the body, and the bottom of the shoulder blades begin to push out away from the rib cage.  The positioning of the scapula in this scenario causes the humeral head to be permanently pushed forward into the anterior capsule of the shoulder. This can also be described as being stuck in a state of humeral anterior glide (glide if you recall is an arthrokinematic movement, so it’s taking place within the joint). You can spot this by looking at an athletes side posture and noticing the elbow positioned behind the shoulder at rest. As with scapular depression we will talk more about it’s repercussions in part III.

Stay tuned, and in the last installment of this series we will cover how these adopted postures cause a host of issues for overhead athletes. Additionally, we will look at strategies to correct these issues and help you keep your athletes healthy, and performing at a high level.

Greg Robins is a Strength and Conditioning Specialist at Cressey Performance in Hudson, MA. Greg has worked with clientele ranging from general population to professional athletes. His unique experience in many different aspects of fitness, strength training, and athletic preparation have helped him become an unbiased authority on all things fitness and performance related. Outside of coaching Greg is a former collegiate baseball player, active member of the MA ARMY National Guard, and enjoys power lifting.

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