Thread: Shoulder Issues

Some information I have found.

#1
Eric Cressey's Blog: Fixing the Flaws: Weak Rotator Cuff / Scapular Stabilizers

#2
How to Improve Your Thoracic Mobility | StrongLifts.com

#3
Posterior Capsular Contracture of the Shoulder -- Bach and Goldberg 14 (5): 265 Figure A0008404FIG9 -- Journal of the American Academy of Orthopaedic Surgeons

#7
7 Dynamic Stretches to Improve Your Hip Mobility | StrongLifts.com

#8
Mike Robertson's Blog: Ankle Mobility with Bill Hartman

#10
Eric Cressey's Blog: Got Shoulder Problems? How's your breathing?

Thoughts?

ill see if i can find the program that my dr gave me after i had my shoulder fixed

1. Scapular stability

strengthening of scapular stabilizers like lower/mid trap and rhomboids and serratus will help to maintain good stability and improve shoulder function and rotator cuff strength. importantly is the timing that these muscles fire as they should fire to allow proper stability before the stronger, prime movers, kick in and work.


2. Thoracic Spine Range of Motion

How is your t-spine extension? How is your t-spine rotation?


3. Glenohumeral (ball-and-socket joint) range of motion

how does your shoulder move when you go through movements....flexion, abduction, etc....does the head of the humerus slide downwards within the joint (optimal when the rotator cuff muscles are firing properly to keep it centered and the subscap and infraspinatus can pull the humerus downwards and posterior as the shoulder goes through those movements)? would be tough to assess yourself. also, is their tightness? is it lats or pecs? is it a myofascial tightness. how does the scapula move during abduction? is it 'stuck' on one side, not allowing enough upward rotation.....all things that you can't really assess on yourself.

4. Overall soft tissue quality (especially posterior capsule)

if posterior capsule is tight, it will push the head of the humerus forward (anterior)....like squeezing one side of a water balloon....you squeeze and the water moves to the other side. same thing when the posterior capsule gets tight. it squeezes and the head of the humerus moves forward. what is the quality of that tissue back there....infraspinatus, teres minor, terese major, lats, long head of triceps....are those fascial structures adhered too and not allowing good movement and slide of the tissue?

5. Rotator cuff strength

rotator cuff timing! do they fire at the right time to provide stability? if scapular stabilizers get stronger, these muscles can function more optimally.
6. Cervical spine function

any restrictions with flexion (chin to chest), extension (chin looking up), or rotation movements.

7. Mobility of the opposite Hip

poor mobility on the opposite side will affect thoracic spine movement, creating poor scapular momvent. look for asymetries between the two sides.

8. Mobility of the opposite ankle.

same as the hip...poor movement here affects hip function....is the foot over pronating? Do you have a rigid foot and over supinate? How good is the overal ankle function?

Also great toe (big toe) extension. We look at pitchers big toes on their opposite leg of the throwing arm (the plant leg). If they have poor great toe extension, they get poor deceleration and compensate with greater torque through the shoulder and elbow to get the needed velocity.

Ankle dorsiflexion too!

9. Core Stability/Force Transfer.

poor core stability, leads to poor firing/timing, creating greater compensation
with the shoulder (see above example regarding pitching/throwing and the great toe).


10. Breathing patterns

chest breather? if so, that places greater strain on the shoulder as the pecs are held tight. also, the scales get tight and affect cervical range of motion, which is going to affect the thoracic spine and how the shoulder opperates.



I'll try and email you some stuff after class tonight. If not tonight definetly this weeked.

The articles you have are good. I'll try and email you some stuff that can help you hopefully figure out (or get a better idea) where your movement asymetries are and hopefully you can take some of the info from those articles and make it more specific to you.

p

P-funk I wanna have your babies.

DAMN that's good shit.

My small contribution to this thread: A scapular mobility vid from my friend Boris Bachman.

Did you friend create the video in order to show these movements to be used as a warm-up, re-hab., or just to demonstrate ROM? Or all of the above?

Kinda all of the above. He wrote an article called "Shouldering through the pain" and the vid kinda ties in.
Shouldering Through The Pain

Excellent, thanks.

1. Scapular stability

strengthening of scapular stabilizers like lower/mid trap and rhomboids and serratus will help to maintain good stability and improve shoulder function and rotator cuff strength. importantly is the timing that these muscles fire as they should fire to allow proper stability before the stronger, prime movers, kick in and work.

So things like:

DB retractions
DB protractions
Pull-up retractions
Push-up Plus
YTWA


2. Thoracic Spine Range of Motion
How is your t-spine extension? How is your t-spine rotation?

Not sure how to check spine extension, but the rotation I can check from your email.

Some Decent things to do:






3. Glenohumeral (ball-and-socket joint) range of motion

how does your shoulder move when you go through movements....flexion, abduction, etc....does the head of the humerus slide downwards within the joint (optimal when the rotator cuff muscles are firing properly to keep it centered and the subscap and infraspinatus can pull the humerus downwards and posterior as the shoulder goes through those movements)? would be tough to assess yourself. also, is their tightness? is it lats or pecs? is it a myofascial tightness. how does the scapula move during abduction? is it 'stuck' on one side, not allowing enough upward rotation.....all things that you can't really assess on yourself.

Need to talk to the PT about this. I know we have spoke about the sleeper stretch before. But it seems pretty common in overhead athletes
http://www.nsca-lift.org/perform/figures/05060606.jpg
I could also incorporate some more posterior capsule stretching. I am pretty sure there is tightness in the pecs, and I need to work on improving that.

4. Overall soft tissue quality (especially posterior capsule)

if posterior capsule is tight, it will push the head of the humerus forward (anterior)....like squeezing one side of a water balloon....you squeeze and the water moves to the other side. same thing when the posterior capsule gets tight. it squeezes and the head of the humerus moves forward. what is the quality of that tissue back there....infraspinatus, teres minor, terese major, lats, long head of triceps....are those fascial structures adhered too and not allowing good movement and slide of the tissue?

Don't have an answer. As far as I know there is nothing major wrong with the tissue, from the MRI some things: Small partial thickness bursal surface tear in anterior portion of supraspinatous tendon, Tiny articular surface tear in superior portion of subscapularis tendon. Mild lateral inferior tilt of acromion


5. Rotator cuff strength

rotator cuff timing! do they fire at the right time to provide stability? if scapular stabilizers get stronger, these muscles can function more optimally.

So basically the above should help with the function here.

6. Cervical spine function

any restrictions with flexion (chin to chest), extension (chin looking up), or rotation movements.

No

7. Mobility of the opposite Hip

poor mobility on the opposite side will affect thoracic spine movement, creating poor scapular momvent. look for asymetries between the two sides.

This I wouldn't be suprised if my mobility wasn't that good, obviously from years of playing hockey. Will again take a look at the emails.



8. Mobility of the opposite ankle.
same as the hip...poor movement here affects hip function....is the foot over pronating? Do you have a rigid foot and over supinate? How good is the overal ankle function?

Also great toe (big toe) extension. We look at pitchers big toes on their opposite leg of the throwing arm (the plant leg). If they have poor great toe extension, they get poor deceleration and compensate with greater torque through the shoulder and elbow to get the needed velocity.

Ankle dorsiflexion too!

Will have to go back to the PT and Podiatrist.

Have any examples of the big toe extension, or literature?

Ankle Dorsiflexion seems to be the big one that is addressed.


9. Core Stability/Force Transfer.

poor core stability, leads to poor firing/timing, creating greater compensation
with the shoulder (see above example regarding pitching/throwing and the great toe).


10. Breathing patterns

chest breather? if so, that places greater strain on the shoulder as the pecs are held tight. also, the scales get tight and affect cervical range of motion, which is going to affect the thoracic spine and how the shoulder opperates.

The only time I become a chest breather is during very intense exercise, other then that breath all occurs at the diaphragm

I'll try and email you some stuff after class tonight. If not tonight definetly this weeked.

The articles you have are good. I'll try and email you some stuff that can help you hopefully figure out (or get a better idea) where your movement asymetries are and hopefully you can take some of the info from those articles and make it more specific to you.

Thanks bud, as always appreciate it.

Originally Posted by Built

P-funk I wanna have your babies.

DAMN that's good shit.

My small contribution to this thread: A scapular mobility vid from my friend Boris Bachman.

Already had that bookmarked

Sorry if these seems long and drawn out, but for other people with shoulder issues, I feel it can be helpful, so I am trying to incorporate some of the resources I have crossed through my readings.

Also some food for thought with other weight trainers and balancing movements for shoulder health.

This is from Eric Cressey.

Shoulder Saver #5: Structural Balance in Training
There's been a lot of talk of balancing horizontal pushing (e.g. bench pressing) with horizontal pulling (e.g. rowing), and vertical pushing (e.g. overhead pressing) with vertical pulling (e.g. chinning). For the most part, this system works pretty well.
Unfortunately, there are a lot of exceptions to these rules, and often times, people walk away more confused after hearing this than they were before the issue came up. With that in mind, I've come to the conclusion that about the only thing you can do is make a list of all the exercises that come to mind, and show how they "balance each other out."
I look for balance in three main pairs of antagonist movement patterns: scapular retraction vs. protraction, scapular depression vs. elevation, and humeral external rotation vs. internal rotation. In the balancing equation, absolute loading isn't nearly as important as total reps.

Scapular Retraction ----------------Scapular Protraction

All Rowing* ---------------------------All Bench Pressing

Rear Delt Fly** --------------------------All Flyes

Prone Trap Raise Variations*** ---------------Dips

Face Pulls -------------

*Excluding Upright Rows
**Also involves horizontal abduction and external rotation
***Counts as scapular depression, too

Scapular Depression---------------------- Scapular Elevation

Scapular Wall Slides ---------------------------Shrugs

Prone Trap Raise Variations -----------------------Upright Rows*

Behind-the-Neck Band Pulldowns -------------------Cleans and Snatches

Prone Cobras to 10&2 (held for time)------------------ Seated DB Cleans

Straight-Arm Lat Pulldowns (strict!) ----------------------Cuban Presses

*You'll find out how I really feel about upright rows in Part II.

Humeral External Rotation ----------------Humeral Internal Rotation

All External Rotation Variations -----------------Bench Pressing, Pushups

Seated DB Cleans -------------------Pullups/Pulldowns

Cuban Presses -----------------Front Raises

Rear Delt Flyes -------------------Dips

Prone Trap Raises ----------------------Overhead Pressing

Prone Cobras (held for time) --------------------All Internal Rotation Variations

Now, I've deliberately set these charts up so that you'll realize that the exercises in all left-hand columns are the ones most lifters tend to overlook altogether. If your posture isn't looking so hot, and your shoulders are bugging you, chances are that you need to shift to the left for a while until you've balanced out.

Originally Posted by IainDaniel

1. Scapular stability

strengthening of scapular stabilizers like lower/mid trap and rhomboids and serratus will help to maintain good stability and improve shoulder function and rotator cuff strength. importantly is the timing that these muscles fire as they should fire to allow proper stability before the stronger, prime movers, kick in and work.

So things like:

DB retractions
DB protractions
Pull-up retractions
Push-up Plus
YTWA


2. Thoracic Spine Range of Motion
How is your t-spine extension? How is your t-spine rotation?

Not sure how to check spine extension, but the rotation I can check from your email.

Some Decent things to do:






3. Glenohumeral (ball-and-socket joint) range of motion

how does your shoulder move when you go through movements....flexion, abduction, etc....does the head of the humerus slide downwards within the joint (optimal when the rotator cuff muscles are firing properly to keep it centered and the subscap and infraspinatus can pull the humerus downwards and posterior as the shoulder goes through those movements)? would be tough to assess yourself. also, is their tightness? is it lats or pecs? is it a myofascial tightness. how does the scapula move during abduction? is it 'stuck' on one side, not allowing enough upward rotation.....all things that you can't really assess on yourself.

Need to talk to the PT about this. I know we have spoke about the sleeper stretch before. But it seems pretty common in overhead athletes
http://www.nsca-lift.org/perform/figures/05060606.jpg
I could also incorporate some more posterior capsule stretching. I am pretty sure there is tightness in the pecs, and I need to work on improving that.

4. Overall soft tissue quality (especially posterior capsule)

if posterior capsule is tight, it will push the head of the humerus forward (anterior)....like squeezing one side of a water balloon....you squeeze and the water moves to the other side. same thing when the posterior capsule gets tight. it squeezes and the head of the humerus moves forward. what is the quality of that tissue back there....infraspinatus, teres minor, terese major, lats, long head of triceps....are those fascial structures adhered too and not allowing good movement and slide of the tissue?

Don't have an answer. As far as I know there is nothing major wrong with the tissue, from the MRI some things: Small partial thickness bursal surface tear in anterior portion of supraspinatous tendon, Tiny articular surface tear in superior portion of subscapularis tendon. Mild lateral inferior tilt of acromion


5. Rotator cuff strength

rotator cuff timing! do they fire at the right time to provide stability? if scapular stabilizers get stronger, these muscles can function more optimally.

So basically the above should help with the function here.

6. Cervical spine function

any restrictions with flexion (chin to chest), extension (chin looking up), or rotation movements.

No

7. Mobility of the opposite Hip

poor mobility on the opposite side will affect thoracic spine movement, creating poor scapular momvent. look for asymetries between the two sides.

This I wouldn't be suprised if my mobility wasn't that good, obviously from years of playing hockey. Will again take a look at the emails.



8. Mobility of the opposite ankle.
same as the hip...poor movement here affects hip function....is the foot over pronating? Do you have a rigid foot and over supinate? How good is the overal ankle function?

Also great toe (big toe) extension. We look at pitchers big toes on their opposite leg of the throwing arm (the plant leg). If they have poor great toe extension, they get poor deceleration and compensate with greater torque through the shoulder and elbow to get the needed velocity.

Ankle dorsiflexion too!

Will have to go back to the PT and Podiatrist.

Have any examples of the big toe extension, or literature?

Ankle Dorsiflexion seems to be the big one that is addressed.


9. Core Stability/Force Transfer.

poor core stability, leads to poor firing/timing, creating greater compensation
with the shoulder (see above example regarding pitching/throwing and the great toe).


10. Breathing patterns

chest breather? if so, that places greater strain on the shoulder as the pecs are held tight. also, the scales get tight and affect cervical range of motion, which is going to affect the thoracic spine and how the shoulder opperates.

The only time I become a chest breather is during very intense exercise, other then that breath all occurs at the diaphragm

I'll try and email you some stuff after class tonight. If not tonight definetly this weeked.

The articles you have are good. I'll try and email you some stuff that can help you hopefully figure out (or get a better idea) where your movement asymetries are and hopefully you can take some of the info from those articles and make it more specific to you.

Thanks bud, as always appreciate it.

you are on the right track. some of the things you are going to need to have someone look at (maybe a trainer or strength coach), just to get an idea as things like asymetries in head rotation or scapular movement during abduction, or even soft tissue quality (like, is it dense and fibrotic? or ropey feeling? or soft with good slide, etc..) are tough to analyze on yourself.

The articles I sent you will help you assess your overal/gross movement patterns and where things are breaking down or asymetrical. that way you can be more specific in your training/rehab program instead of just going into the gym and doing "stuff".

What is the town in Ontario you are in? I know a guy that is a really good soft tissue therapist from Canada (lives here now) and he may know someone you can check out that is local.

Maybe I will just come visit you

Just southwest of Hamilton.

Considering your goal, externally rotating face-pulls are a great exercise. Set the cable at shoulder height and finish in the 'front double biceps' pose with your scapulae fully retracted.

Also, push-ups on a swiss ball are great for your shoulder stabilizers, especially the serratus anterior.

Obviously, cut back on the pressing movements. Exercises where your scapulae can move freely are a lot better than shoulder killers like the barbell bench press.

I think p-funk already adressed 90% of your concerns.

Alright man,

I asked my buddy. He said he lived in Western Canada only, but he said he knows peeps in Onatario and is going to contact them for you and ask if they know anyone really good close to your location.

I'll email you when I hear back from him!