Shoulder Injuries - Prevention and Treatment Shoulder problems can certainly be stubborn. Prevention is so much better than cure.

We have found that many shoulder problems are due not only to bad habits of technique, but to the unbalanced upper-body workouts many athletes /people undertake in the mistaken belief they are doing themselves good.

Injury and pain lie just around the corner. Read on to find if you are among them and whether we can help you!

We teach you in detail the 7 sections listed below:

1. Shoulder overview: the five main ingredients for keeping shoulders injury-free
2. Rotator-cuff protection: a specialist in treating sports injuries explains how overhead athletes can prevent chronic shoulder pain
3. Preventing injuries: we show you further exercises to help you avoid shoulder pain
4. A surgical view: an orthopaedic surgeon explains why shoulders go wrong and what can be done to repair them
5. Case study: how a keen club golfer was cured of a nagging shoulder pain
6. Technical review: two surgeons discuss the diagnosis and treatment of acromioclavicular injuries in athletes
7. Prehab guide: an assessment of the latest research into shoulder problems and with practical advice on achieving balanced upper-body development

The Amazing Shoulder Joint

Consider what the shoulder does, and how many athletes - swimmers, tennis players, bowlers, baseball pitchers, javelin throwers - take it for granted. 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.

The shoulder joint actually comprises four joints - see if you can feel them on yourself:

• Sternoclavicular (SC) joint (between the sternum and the collar bone) - this is actually the only bony connection that the shoulder has with the main skeleton
• Acromioclavicular (AC) joint between the collar bone and the point of the shoulder called the acromion, which is part of the scapula or shoulder blade
• Glenohumeral (GH) joint between the glenoid part of the scapula - the socket - and the head of the humerus (HOH) - the ball
• Scapulothoracic (ST) joint (the ‘false joint’ between the scapula and the rib cage that it rides over).

Treatment, prevention and performance enhancement

We outline the prevention and treatment of overuse injuries of the shoulder are guaranteed to improve your performance. They will genuinely improve the way your shoulder works, and thus it will be stronger, more co-ordinated, reach further and last longer before fatigue sets in. Remember injury prevention equals performance enhancement.

Balance Through Control: The Five ingredients

Exercises and guidelines are given for the five most essential ingredients for an everyone whose main weapon is the shoulder:

• Sports-specific technique
• Flexibility
• Core stability
• Rotator-cuff control
• General strength
• Avoiding the common mistake of imbalance

Most people believe that a gym routine needs to include strengthening work for the deltoids (three heads), latissimus dorsi, pec major, upper trapezius, and the rectus abdominis because they are the prime movers of the shoulder.

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 trapezius, rhomboids, posterior deltoids, and posterior rotator cuff.

In these situations, flexibility must often be improved, scapular setting must be taught, and the focus of gym exercises changed towards the back. We explain how it’s done.

How to prevent the damaging cycle of chronic shoulder pain

Any overhead activity that involves the arm being taken often enough from below the shoulder level to above shoulder level has the capacity to damage the rotator cuff. With repeated impingement, a poorly conditioned cuff can become damaged, and a cycle of cuff damage, impaired function, further impingement and worsening cuff damage is initiated.

We look at how such repetitive damage is caused, how the athlete may be able to prevent it occurring in the first place and why a co-ordinated action of this group of muscles is needed to provide a stable base for pain-free overhead activity. Here are the symptoms:

• The shoulder aches after overhead activity
• It gets worse and restricts the activity
• Periods of rest apparently resolve the problem only for the pain to recur when you returned to sport
• Chronic shoulder pain is an all-too-common consequence of repetitive ‘overhead activity’, such as serving and smashing in tennis, freestyle or butterfly swimming, bowling in cricket, javelin, or baseball throwing and above-shoulder weight-training exercises.

Injury prevention strategies

Most cuff injuries can be prevented relatively simply, and we provide shoulder-injury prevention strategies to focus on improving shoulder stability.

Isolated rotator-cuff strengthening exercises can be very effective as part of a pre-participation conditioning programme. These can be done with our three simple exercises of single sets comprising a minute of either external or internal rotation exercises. The exercises strengthen these areas:

• Internal rotator (subscapularis)
• External rotators (infraspinatus and teres minor)
• Abductor (supraspinatus) muscles of the shoulder
• Three to-five minute sets over the course of a day will produce a conditioning effect.

Balance your upper-body workouts: a good way to avoid shoulder injuries is to make sure your upper-body strength sessions are balanced. Limit your range of movement and take it easy: rehabilitation from a shoulder impingement injury should focus on rotator-cuff strengthening. We explain why it’s important to remember that when it comes to re-introducing your weight-training exercises, you must progress slowly.

It’s also important to avoid certain ranges of motion where the shoulder joint sub-acromial space is compressed the most.

Details are given for the impingement zones to avoid, which muscles to start the training with, and once the pain is completely gone, which exercises to introduce.

Correct scapula positioning when performing exercises: the correct position for the scapula (shoulder blade) is back and rotated down. Essentially, this means maintaining a good ‘military posture’, with shoulders back and chest out. A round shouldered or hunched posture is to be avoided at all times.

To achieve the correct position, you need to use your rhomboids, mid and lower trapezius muscles to retract the shoulder and pull the scapula down. You’ll learn the correct position and exercises to keep your scapula back and down while you move your arms.

Sports-specific exercises - plyometrics for the shoulder: just as rehabilitation training for leg injuries requires a functional progression from simply strength exercises to sports-specific exercises, so does rehab for the shoulder.

So call us today so we can help you with your shoulder challenges.

NOTE: Here at Vibes Fitness we liase with your doctor, physio, chiropractor or osteopath, helping you achieve the best possible results that you deserve. So call us today to rehabilitate you and get you back on track and pain free.