Exercises for Shoulder Injuries
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Causes - Common Injuries - Exercises & Stretches
Shoulder injuries are amongst the most common in sports and particularly prevalent in sports and activities such as baseball, basketball, CrossFit and weightlifting.
The shoulder is a 360° ball and socket joint protected by the shoulder blade and sitting on top of the ribs and thoracic spine. The joint allows for movement in all directions. However, this inherent freedom of movement makes it susceptible to injury.
Within the joint is a complex area of muscles, ligaments, and joints, which work in unison to perform shoulder actions. Neighbouring areas such as the thoracic spine, acromioclavicular (AC) joint, sternoclavicular (SC) joint and the rib cage also influence how the shoulder moves. All these areas must be properly aligned and functioning for the shoulder to function effectively, otherwise pain and stiffness start to occur.
SHOULDER IMPINGEMENT SYNDROME
Impingement syndrome is a general classification of injury that typically indicates that a tendon is inflamed. In some cases, the tendon is squeezed within its surrounding structures, giving the feeling of the nerve being ‘pinched’ or ‘impinged’. There are a few common structures that can cause this pinching feeling in the shoulder. In the front of the shoulder, the supraspinatus tendon and the longhead of the biceps tendon are commonly problematic. Meanwhile, the back of the shoulder capsule itself can also get pinched on the inside - a condition known as ‘internal impingement’. Typically, it’s possible to recreate these symptoms by bringing your arm across your body or rotating your shoulder inwards.
ROTATOR CUFF TEAR
The rotator cuff is a group of four muscles (supraspinatus, infraspinatus, subscapularis and teres minor) whose job is to compress and keep the arm bone inside the socket. These muscles are prone to tear due to:
the small cross-sectional area of the tendons
a lack of loading to the tendons, which means they are not robust to forces placed on them.
There are three different grades of muscle tear:
Grade 1 - a strain, where the muscle fibers are overstretched
Grade 2 - a partial rip in the muscle fibers
Grade 3 - a rip through the entire muscle.
SHOULDER DISLOCATION
High velocity impacts to the shoulder can force the ball to pop out of its socket - either in a forward or backward direction - and result in a dislocation of the shoulder. After such a dislocation, athletes may experience symptoms such as moderate to extreme pain, a lack of stability or an overly loose feeling in the arm.
The most common dislocation is the anterior dislocation, which can occur during tackles in sport (involving direct impact to the shoulder) and when falling onto an outstretched hand. When the ball comes out of the socket, the structures holding the arm inside the socket become overstretched and lax.
ROTATIONS
When a lot of different movements cause you to feel shoulder pain, one of the best exercises is the farmer’s carry because the shoulder does not need to move - instead, it actively hangs by your side.
This exercise requires the use of a dumbbell or kettlebell.
Exercise instructions:
Choose dumbbells or kettlebells that require a decent amount of effort to carry.
Hold a weight in each hand by your sides.
Walk with the weights while maintaining good posture.
Tips on technique:
Grip the bell as hard as possible. The harder you grip, the more force goes up through the arm into the shoulder in a process called ‘irradiation’.
Suggested workout:
3 sets of 10 steps.
Exercise instructions:
Choose a kettlebell that requires a decent amount of effort to carry.
Hold the kettlebell in a comfortable, upright position with your upper arm out in front.
Walk forward while trying to maintain posture and keeping the kettlebell steady and upright.
Tips on technique:
Try to keep your core braced and chest out throughout.
Try to engage the armpit muscles rather than the biceps.
Suggested workout:
4 sets of 15-20 steps.
Exercise instructions:
Choose a dumbbell or kettlebell that require a decent amount of effort to carry.
Hold the weight in one hand by your side.
Walk and carry the weight for steps while maintaining good posture.
Tips on technique:
Grip the bell as hard as possible. The harder you grip, the more force goes up through the arm into the shoulder in a process called ‘irradiation’.
Suggested workout:
3 sets of 10 steps on each side.
Exercise instructions:
Holding a cable pulley, take two to three side-steps away from the apparatus
Keeping your elbow tucked in, rotate your shoulder inwards towards your body.
Tips on technique:
Perform the exercise while holding a towel between your elbow and rib cage in order to prevent the whole scapula rolling forwards
Try to rotate at the shoulder joint only, rather than through the scapula or thoracic spine.
Suggested workout:
3 sets of 10 repetitions
3 seconds in and resisting the outwards pull for 3 seconds.
Exercise instructions:
Tie one end of a band to a rack at about waist height.
Stand at arms-length and at 90 degrees from the rack.
Hold the band with your near hand, keeping your elbow at a 90-degree angle and the other arm by your side.
Side-step away from the rack, holding for 5 seconds with each step.
Side-step back towards the rack, holding for 5 seconds with each step.
Suggested workout:
3 sets of 6 reps, where each rep consists of 5 second holds at 3 distances.
Exercise instructions:
Kneel with one leg out in front and hold the cable with the opposite arm.
(Row) Pull the cable straight back, keeping your elbow out horizontally to the side.
(External rotation) Rotate your elbow 90 degrees until your arm points upwards.
(Press) Extend your arm fully overhead.
Perform the same actions in reverse and repeat.
Tips on technique:
Try to keep your core braced and chin retracted throughout.
This exercise targets the external rotator (infraspinatus) of the shoulder, which is one of the four muscles of the rotator cuff.
Exercise instructions:
Lay on your side with the top arm bent at the elbow
Keeping your elbow by your side, rotate your arm upwards (opening like a door)
Slowly return the dumbbell back down to the starting position
Tips on technique:
Try to control the downward motion by resisting the pull of gravity.
Suggested workout:
3 sets of 10 repetitions
3 seconds up and 3 seconds down.
The shoulder sits directly on the rib cage and thoracic spine. If the spine cannot move well, this will in turn affect the function of the shoulder.
Exercise instructions:
Kneel down, sitting back onto your heels.
Rotate your body so that you are opening up your body towards the side.
Tips on technique:
Remember to breathe as this will help open up the rib cage even more.
Suggested workout:
2 sets of 12 repetitions on each side
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