Shoulder Mobilization Strategies Part I

In my previous post I covered some information about the shoulder, and by how mobilizing the thoracic spine we can help to eliminate many issues with pain and injury at the shoulder.  I would highly suggest you read that post before getting into what is going to be discussed next if you have shoulder issues.  While mobilizing the thoracic spine is important, it does not mean that the shoulder (glenohumeral) joint itself should be ignored.  Rotator cuff tendinopathies and impingement are just some of the chronic shoulder issues that plague active individuals.  By making sure that appropriate posture and mobility is in place, one may avoid these issues.  But before I get into some specific exercises to address this problem, one needs to examine what causes many individuals to develop shoulder pain.

Many of the postural issues that people have are just caused by how we sit; we sit with our upper backs rounded and our shoulders in a forward position, causing individuals to have reduced internal rotation at the shoulder for functional activities.  Over time, this causes shortening of soft tissue around the shoulder.  However, even though we have this shortening of tissue, the body is capable of adapting to this through dysfunctional movement, which eventually causes irritation and damage to the tissue (one of the reason why with many athletes I work with I NEVER do overhead pressing- the risk to me just outweighs the reward of what is a good strength movement).

Most people will exhibit forward shoulder posture either because of natural postures in everyday life (i.e. work, driving) or different sport activities.  One of the changes that occurs with this type of posture is tightening of the pectoralis major and minor.  In particular the pec minor will shorten due to the posture of your scapula (shoulder blades).  This tightening will cause inhibition and weakening of other muscles surrounding the shoulder girdle (see some of my previous posts on shoulder injury prevention). In order to correct this, one will typically need to mobilize both anterior and posterior regions of the shoulder, and then complement this by adding in strengthening exercises to address inhibited muscles in order to help in supporting good postural alignment.

Kelly Starrett in his book Becoming a Supple Leopard describes many different types of mobilizations that can be used to address the shoulder (and for any other body part for that matter).  These exercises can be included in a warm-up prior to activity, or they may be added in as an extra workout in helping to improve mobility.  It is highly suggested to spend at least 10-15 minutes daily working on problem areas to avoid injury.

Part II of this post will include videos of some of the suggested exercises to use to correct these issues.  The following exercises that can be performed to address dysfunction at the shoulder are:

1.  Banded Overhead distraction

2.  Supine (lying on back) internal rotation mobilization

3.  Banded Bully

Future posts on this subject will also include application of exercises to strengthen the region in supporting good postural alignment.

Shoulder Injury Prevention

The shoulder girdle represents a very complex structure in the body that requires muscle balance and stability for proper function.  Certain athletic activities place a great deal of stress on the shoulder region.  Athletes who are classified as “overhead” athletes need to be sure that the structures of the shoulder are able to withstand the forces that are applied to them.  This will not only ensure optimal performance, but will also prevent injuries to the region that are more common in activities that involve increased stress at the shoulder.

A good place to start would be to look at the static posture of an individual.  Although it is not the only upper body postural distortion that could occur, a common one to come across is a forward head/rounded shoulder posture or what is called upper crossed syndrome (as described by Janda).  This postural distortion typically involves the following muscle imbalances.

Tight/Overactive Muscles

*Pectoralis Major/Minor, Upper Trapezius, Levetor Scapulae (in the upper back/neck region)

Weak/Underactive Muscles

*Rhomboids, Middle Trapezius, Lower Trapezius, Deep Flexors of the neck, Serratus Anterior

Other issues commonly seen with individuals with this type of posture is a tight latissimus dorsi and weak rotator cuff mucles.  A way to help address these imbalances to place exercises in one’s strength training program for this body region.  Exercises to work on these weak or tight areas can easily be implemented in a pre-lift warm-up or can be included in the main part of the training session.

Here are some movements you can use to include in your program.  In a future post, I will add some additional exercises and include a program that can be used as a warm-up prior to training.

Blackburn holds

YTWL Series

Band Joint Traction (Thanks to Dick Hartzell at Jumpstretch), Scapular Wall Slides, Band Pull-Aparts

Dynamic Blackburns

Standing Static Pec Stretch

Push-Up Plus

These are just some of the exercises that may be used to promote mobility and/or strength around the shoulder girdle.  In upcoming posts I will include more exercises, along with some routines that may be used in a training program to help prevent injuries to the shoulder.

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