18 Feb Bulletproof Your Shoulders
The Shoulder is a complicated body part. With its complexity, proximal body parts are often overlooked when creating shoulder [P]rehab programs. The glenohumeral joint (shoulder) sits on the scapula (shoulder blade) which moves in accord with the thoracic spine (mid-Back). A Shoulder [P]Rehab program is not comprehensive unless all components of the shoulder are addressed. This article will guide you in how to Bulletproof Your Shoulders! The free program this article includes can be utilized by anyone seeking how to improve shoulder health!
Bulletproof Your Shoulders
Of the optimal 180 degrees required for shoulder elevation, did you know only about 2/3 comes from the Shoulder Joint, meaning the Gleno-humeral joint? While a Whopping 60 degrees of shoulder elevation comes from the Scapulothoracic joint! This is why you can’t have full shoulder mobility unless the Scapula and Thoracic Spine are adressed!
Lets take two examples:
1. A persons walking across the room on top of bosu balls step after step.
2. The same individual walking across the room on a sturdy floor.
Would you want to walk across the room on a sturdy floor? Wouldn’t it be easier to perform higher level exercises such as jumping, cutting, landing, and running on the sturdy surface? The shoulder moves off of the shoulder blade in a similar manner. This is why it is imperative to address scapula muscle function when the goal is to prevent overuse injuries and enhance performance of the shoulder. If you are unfamiliar with the anatomical structures of the shoulder Watch this video.
This Article breaks down the Shoulder into 5 Parts:
- Lumbar Spine Control with Overhead Motion
- Thoracic Spine Mobility
- Scapula Control
- Shoulder Mobility
- Shoulder Strength
Lumbar control with Overhead Motion
Poor Control at this region will result in excessive extension of the Lumbar Spine which is noticeable with a rib flare. This will give you a false sense of achieving shoulder elevation when in reality this is a compensatory pattern. Your Lumbar Spine should remain relatively neutral as you perform overhead exercises, here are 2 exercises that will help with Lumbar Spine control as you reach into an overhead position.
Quadruped Shoulder Overhead Reach
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How: Begin on your hands and knees; hands under shoulders and knees under hips. Spread your shoulder blades by pushing your body away from the floor. Find a neutral pelvis, you may need to arch and tuck your low back to find neutrality. While keep a neutral low back elevate one arm out to your side into a 90/90 position, then slowly reach over head. Attempt to keep the arm as close as you can towards the ceiling. As you reach overhead rotate your thumb towards the ceiling. Return to starting position and repeat!
Compensation: Avoid allowing your shoulder blade to sag during this exercise. Make sure to keep your torso directly towards the floor, avoid trunk rotation especially to the side your are reaching overhead with.
Supine 90/90 Wall slide
How: Begin on your back with your hips and knees bent to a 90 degree position. Make sure to keep your core engaged while you perform this. I have a foam roller between my knees to keep my legs aligned. Tighten your core by pushing the small of your back towards the floor, this may be easier if you squeeze the roller with your knees. Now bring your arms out about 90 degrees then slide your arms overhead as high as you can overhead. Return to starting position and repeat. If you can’t place your wrists flat against the floor, it’s ok- work within what you have.
Feel: You will feel the muscles of the shoulder blade and shoulder working, you may also notice a stretch in the middle of your back as you push into the overhead position.
Thoracic Spine Mobility
Thoracic mobility is key for shoulder motion. This mid back region is where you want spinal extension to occur at. The Thoracic spine is responsible for roughly 20 degrees of shoulder elevation. Without appropriate mobility here the scapula will not move optimally thus limiting your shoulder motion.
This image will give you some insight. I am not saying avoid looking like the image on the right nor am I advocating that you need to remain in a position similar to the image on the left. As you reach your arm overhead you should have the appropriate Thoracic Spine extension (as shown on the left) for optimal scapula function and shoulder mobility. The key is to vary your movement which will avoid allowing your body stiffening in one position. The following three exercises will show you how to improve extension and rotation in this region!
“There is no perfect posture, the worst posture is the posture you spend too much time in”
Thoracic Spine Foam Roll Overhead Reach
How: Place the foam roller perpendicular to your spine onto a segment which you want to work on (personally I like to work from bottom to top). Now elevate your arms as far back as you can-in an attempt to touch the floor. This movement is very similar to a wall angel. Spend a few repetitions on each segment-then move up toward the next.
Feel: You will feel this in the middle of your back, specifically the area that is hinging over the foam roller.
Compensation: Don’t allow your but to come off the floor or your ribs from flaring out, this is typically due to excessively hinging at the lumbar spine. This exercise is designed to target the Thoracic Spine.
Advanced Open Book
This Exercise will help improve Thoracic Spine Rotation
How: Begin on your side, then bring the leg that is elevated over and across your body. Hold this leg onto the floor with the opposite arm. Make sure to keep the knee close to your chest to avoid motion coming from the low back. With the arm closer to the ceiling alternate between reaching in front of you and reaching back towards the floor. Perform slowly and attempt to reach as far back as you can towards the floor. Exhale as you are rotate. While laying on my left side shown here, I am working on my right rotation.
Feel: You will feel a stretch in the middle of your back, specifically the thoracic spine. You may additionally feel a stretch in the front of the shoulder while reaching back towards the floor.
Thoracic Spine Active Rotation
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Start in a 1/2 kneeling position with a ball between your inner leg and the wall. This will ensure you DON’T cheat with any hip motion! Try to rotate with your hand all the way around and back
In half kneeling – Keep both hands behind your head. Perform a Thoracic spine around the world against wall. Rotate all the way around and come back, try to challenge yourself from keeping the elbow away from the wall. Avoid side-bending the opposite direction, this is a compensation.
What is the difference between this and the open book exercise? This requires more active range of motion!
Looking for more on how to improve your thoracic spine mobility? Read Here!
Your scapula aka your shoulder blade is often very difficult to find. If you don’t engage periscapular muscles (muscles around the scapula) with exercises such as rows, pull-ups, push-ups = you will likely “arm” the movement. Meaning you will rely heavily on shoulder and arm muscles. Your scapula is able to handle more load than your arm muscles. With any movement you want to move proximally then distally, the scapula should initiate the motion when performing a movement like the Row, Lat Pull-Down, or when performing pull-ups. Shown here are a couple movements that will help improve scapula control.
Realize that at First implementing this strategy may decrease your performance, however the potential to improve your long term performance will increase!
To perform this exercise:
Anchor the resistance band around your back- here I use a CLX Thera-Band. Then I place the band over my elbow and trace it down my forearm to my hand. Begin by pushing your elbow up towards the ceiling- focus on protraction of the scapula.
Option 1: Elevate the shoulder to 120 degrees of shoulder flexion and 30 degrees of horizontal abduction to maximize activation of the serratus anterior.
Option 2: Externally rotate the shoulder while protraction the scapula- this will help reduce activity of the pec musculature to better isolation of the Serratus.
For More on the Serratus Anterior Click Here
Looking for a 16 week step by step program on how to optimize your shoulder health? Check out our Shoulder [P]Rehab Program for more!
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Start in open chain with your arms moving in space. Add a resistance band which will help give a resistance cue to target the scapula retractors (muscles that pull your shoulder blade back). Keep minimal elbow flexion here. Perform scapula pull-ups also with minimal elbow flexion.
Passive shoulder stretching
- Modified Child’s Pose Against Wall- In addition to improving Shoulder Flexion, this stretch will improve thoracic spine extension while minimizing lumbar spine (Low Back) extension.
- Across Body Stretch- The first stretch is an example of a common fault during a posterior shoulder capsule stretch. This is due to allowing the entire shoulder girdle including the scapula to be pulled with the stretch. What this targets is the scapula retractors (rhomboid/mid-traps. Ideally, you will perform this WITHOUT the scapula protraction. Set your shoulder in a good stable position before pulling across your body will allow for a good stretch of the posterior capsule of the shoulder.
- Hand Behind Back- Reach your hand towards the opposite shoulder blade, or as close as you can get towards it. From this position, squeeze the scapula together. This will assure the motion is coming from the shoulder (Gleno-humeral joint) instead of the scapula-thoracic joint.
- Pec Stretch- bring your arm up to a 90/90 position and place your shoulder onto a stable surface. Rotate until you feel a good stretch in the chest/anterior shoulder and hold. Try pinching your shoulder blade back to avoid excessive stress on the anterior shoulder.
Passive stretching only gives temporary mobility gains, we recommend activating in these newly afforded ranges to maintain this improved range of motion!
Lat Mobility Drill
How: Begin with your arms elevated on something like a bench shown here while grabbing onto something like a dowel or pipe- The more spread your hands, the greater the stretch. Then hinge back into a child’s pose position, this will bring the arms overhead. Slowly work into and out of this position.
Feel: You will feel the muscles on the side of your torso being stretched, specifically in the Lat region.
Compensation: Avoid arching the low back as you go through this, if your elbow are being irritated with this stretch then bring your hands a bit more narrow.
Shoulder Around The World
Follow up the Passive Stretching with an end-range activation drill!
How: Begin half kneeling with the leg towards the wall elevated. A foam roller is used here to separate me from the wall, begin roughly upper arm distance from the wall for this exercise. Start with your palm by your side facing your body, then slowly elevate your arm. You will feel a sticky spot, which is where you can rotate your palm towards the wall and continue this motion. Once you have reached the end position you can rotate back around to the starting position. This motion should be very slow and controlled!
Compensation: Avoid rotating at the trunk when performing this exercise, allow a majority of this motion to be coming from the shoulder. Alter your distance from the wall, the closer you are to the wall the more challenging, the further away the easier this exercise becomes.
Feel: You will feel the muscles of your shoulder working with this exercise.
Bulletproof your Shoulders with Strength
Although the primary intent of this article was to bring awareness to addressing proximal limitation, there is no way you can bulletproof your shoulders without strengthening your Shoulders! Although this is the last component of the article, it is the MOST vital in maintaining shoulder health. Check out additional Evidence Based Shoulder Exercise.
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This Shoulder Flow includes 5 different exercises:
- Shoulder External Rotation with arms at side
- Shoulder T’s
- Shoulder External Rotation with arms elevated to 90 degrees of abduction
- Shoulder Internal Rotation- Don’t forget Subscapularis is the strongest rotator cuff muscle
- Resisted Wall AngelI particularly like this cross over symmetry unit because of the external demand into horizontal adduction, this also allows me to go through more range of motion with exercises such as the T or shoulder external rotation with arms at side compared to a normal pulley with the anchor directly in front of my shoulder.
Kettlebell Overhead Carry
How: Lift the kettlebell up to your shoulder. Wrap triceps in towards your armpit, this will help stay engaged at the scapula. Maintain this overhead position for the entirety of the walk.
Compensation: Excessive shrugging of the shoulder, keep a window between the arm that is elevated and the ear on that side. If you find yourself pushing your neck out with this exercise perform a slight chin tuck as you go walk.
Inverted Kettlebell Carry Shoulder Flexion 90/90
Have you had any shoulder discomfort? Have your shoulders limited you from being able to workout? Shoulder aches and pains often get neglected until it’s too late, turning a minor fixable ache into a potential chronic pain and debilitating issue. Using the latest evidence-based research and our clinical experience, we have pioneered a very safe and effective [P]Rehab program that can take you from rehabbing old aches and pains all the way to maximizing your athletic performance on the field or in the gym. Join us in redefining 21st century healthcare at your fingertips, check our Shoulder [P]Rehab Program for more!