In my opinion the shoulder is one of the most amazing joints in the body. In fact it is not a ‘joint’, but rather 5 joints, over 30 muscles and 6 major ligaments. Shoulder function is highly dependent on the coordinated function of the muscles around the shoulder, those that control the scapula or shoulder blade, muscles in the upper and lower back, as well as abdominal and pelvic muscles.
The shoulders incredible function and mobility comes at the expense of stability. Unfortunately this leaves the shoulder vulnerable to many of the injuries we have discussed previously. Any sport which requires extreme ranges of motion, repeated forces or one off traumatic forces, all have the potential to damage the shoulder.
So can we do anything to prevent this fantastic piece of engineering from being injured? Yes we can………
Pre-activity screening
Shoulder injuries can often be prevented, particularly non contact injuries. Pre-season screening of athletes is common place amongst professional teams and has been proven to be effective in both professional and recreational athletes in identifying and allowing modification of risk factors and reducing injury rates. A good assessment of the shoulder should include examination of:
1. Sports technique
2. Flexibility
3. Scapula and core stability
4. Rotator-cuff control
Sports-specific technique: poor performance and shoulder pain commonly occur due to bad habits. Poor positioning of the arm or body during certain tasks such as throwing or swimming can place excess pressure on structures, cause rubbing or wearing of the joints or tendons, or stress ligaments. Poor tackling technique in rugby may leave the shoulder vulnerable to excess force.
Flexibility: It is important that general flexibility allows good range of movement for the pelvis, trunk, scapula, and humerus. It is also essential that the forces around the shoulder are balanced which encourages centering of the humeral head within the glenoid fossa. It is more important that the internal and external rotators are equally flexible, rather than how flexible each one is.
Scapula and core stability: core stability is critical in providing a stable strong support for the shoulder to work off. A good shoulder, like a good house, needs a good foundation. The core allows the trunk muscles to transfer energy and momentum generated from the lower body to the shoulder for overhead sports. Poor core control places significant extra loading and strain on the shoulder joint.
Rotator-cuff strength and control: the rotator-cuff muscles are dependent on the good positioning of the scapula. If the scapula is angled too far forward or downward, the rotator-cuff muscles are disadvantaged and may result in damage over time. The rotator cuff should be balanced so they can center the humeral head on the glenoid. This requires equal strength and flexibility of the force generated on one side versus the other.
High speed traumatic dislocations, or any contact injuries are tough to prevent. This is due mainly to multiple elements outside of our control and often forces that are just too high for the structures to withstand no matter how strong the muscles are. We will not ever prevent 100% of injuries from occurring. The best we can do to prevent these injuries is to follow the recommendations above, ensure good technique when tackling, wear protective equipment and maintain good movement and strength in your shoulder.
LAUREN’S BEST EXERCISES FOR THE BEST POSSIBLE SHOULDER
These exercises have been used specifically for improving shoulder function in athletes. These exercises address the three important areas:
1. the rotator cuff
2. the muscles that stabilize the shoulder blade, and
3. the muscles of the low back, abdominal, and pelvis.
Download Lauren’s top shoulder preventative exercises here.
It is important to note that these exercises should only be performed by the uninjured athlete. Injured athletes may need to modify the exercises in duration and/ or range of motion depending on the level of pain or impairment the athlete is experiencing.
Lauren is based at our Bridgepoint Practice and would highly recommend getting your shoulder assessed prior to undertaking a new activity that involves overhead use of your arm such as tennis, swimming or throwing sports. If you are experiencing shoulder pain on sporting or non-sporting activities then a more tailored rehabilitation plan will be required. Please contact Lauren on 9968 3424 to discuss further.
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