Shoulder Rehabilitation Part III

Following on from part II, we now need to do what every other "personal Trainer" doesn't do - or rather, we're going to do the opposite! Let's leave the external rotators alone, or even subdue them and focus on firing up the lone internal rotator: subscapularis. 

If you - or a client has a specific problem with the external rotator cuffs then this may not apply so much - so test them to find out  - or ask a physio or appropriately qualified person to do so. In my experience many common sports injuries follow the above pattern - external rotators dominating over the lone internal rotator - especially when you consider the deltoid muscle sitting over the top of the 'cuffs' is also an additional external rotator.    

So, my top exercises for helping to fire up and strengthen the subscapularis, serratus anterior and fibres of lower traps (without getting too clinical and complicated with tubing or bands everywhere) are:

• Medicine ball push ups
• Bent over row
• Push up plus variations
• Dynamic hug
• Horizontal bar hang
• Prone cobra (Internal and external rotation of arm variations)
• Scapula retractions ala McGill
• Straight arm lat pulldowns

So go give them a try - not all of them right now and not all together which will just fatigue them. Try focusing on firing the internal rotators up with some of these. Focus on quality to ensure they're well executed, and then go and work on some bigger, more complex movements to integrate rather than isolate.

Shoulder rehabilitation part II: Anatomy of the Shoulder

To help you understand what's going on when your shoulder (s) complain I thought I'd repeat a nice simple analogy of the anatomy of the shoulder that I came across the other day. Basically and very simply think of your shoulder as a house - so far so simple yes?! The FLOOR of your house is the the top of your arm   - the ball of the humerus. The ROOF of your house is the bony bit you can feel across the top and outside edge of your shoulderblade and the clavicle - what is clinically known as the combined anatomy of the acromion process, coraco-acromial ligament and coracoid process. In between these two is where most of the trouble arises - THE LIVING ROOM! This is essentially the space in which your various tendons, ligaments and bursae live in what is known as the subacromial space. When this space is compressed - you feel pain as the tendons get squashed during certain movements! Sounds familiar? Next week I'll continue with how to address this most common irritation.

Shoulder Rehabilitation Part 1

The shoulder is the most muscular of all the body parts, and therefore very prone to imbalances. Over time the brain sets preferential neural patterns meaning certain muscles being inadvertently used for “functional” movements. Over time neuro-muscular adaptations become physiological: poor position, increased muscle activation, muscle ischemia, metabolite accumulation, reflex muscle contraction and so on. Prolonged isometric contraction causes anaerobic metabolism resulting in increased irritation etc, you’re now in the pain spasm cycle.

What do you do, well actually the first thing you need to do BEFORE you go diving into corrective exercise prescription is reduce dominance patterns of the following muscles with techniques such as trigger point therapy, myofascial release, METs and stretching:

–        Pectoralis major and minor

–        latissimus dorsi

–        Upper trapezius

–        Levator scapulae

–        Sternocleidomastoid

This will immediately enhance the function of serratus anterior and lower trapezius, which will become more biomechanically efficient. The other muscle we want to get fired up is the oft ignored subscapularis primarily because it is THE local joint stabiliser.

Part II next week.

Get ‘X’ Factor like the Pros

‘X’ factor is the separation between the shoulders and the hips. Why is it important? Well, you ideally want more separation between these two axes as that gives more potential to load up using the big muscles of the groups of the pelvis - principally the glutes, and torso or ‘core’. What is more important however is that the separation is balanced. In golfers over practice symmetry causes all sorts of problems – this will be covered in another article.

To explain it imagine your torso as a big coil, the harder and faster you wind it up the faster the power is unleashed. Now picture that at tee off and you will get the idea why the ‘X’ factor is so important when it comes to producing power in a golf swing.

Sports science research such as Burden et al (1997), Lephart et al (2007) Thompson et al (2007) and Myers et al. (2007) have all carried out research focusing on the torso-pelvic separation. They all suggest that greater torso-pelvic separation and velocity during the downswing results in greater ball velocity as maximal club head speed is directionally influenced by the body’s ability to apply more force.

What is vital to understand is that the scientific research in this field – including my own – demonstrates the characteristics related to the x-factor are be modifiable through golf-specific conditioning programs.

• Must train in multi-plane, dynamic and functional manner.

• Possible to achieve measurable results in 8 weeks.

• An increase of 5% in clubhead speed results in an additional 10 – 15 meters carry distance off the tee.*

Now go get some ‘X’ factor!!