As we get closer and closer to the warmer spring and summer months it always seems as though the number of shoulder complaints in the office slowly rises. I am not sure if there is a direct correlation, or if it’s just a coincidence. Sports-related shoulder injuries can occur at any point throughout the year, so maybe this is just a coincidence. These injuries can be anything from repetitive use or traumatic.
The Anatomy of the Shoulder
The shoulder is a complex joint that is comprised of three bones (humerus, clavicle, and scapula), four joints (glenohumeral, acromioclavicular, sternoclavicular, and scapulothoracic), as well as numerous muscles and ligaments, which too many to list to keep the interest of the reader.
The shoulder is considered the most mobile joint in the human body, and some might argue it’s one of the most complex joints. Knowing that it’s the most mobile joint in the human body I am often puzzled as to why many athletes focus on mobilizing the shoulder, rather than stabilizing the shoulder.
Common Shoulder Injuries
Let’s talk about the common types of injuries that we typically see in the office.
- Rotator Cuff Injuries are the most common type of shoulder injuries that we see in our sports medicine office near St James. This “cuff” is comprised of four muscles which include the supraspinatus, subscapularis, infraspinatus, and teres minor which are responsible for abduction (bringing the arm to the side), internal rotation and external rotation (the last two) respectively. Repetitive overhead use can lead to strains and minor tears of these muscles, while falling on an outstretched arm (aka “FOOSH) can lead to a traumatic injury to these muscles.
- Labral Tear. Another common shoulder injury that presents to our office is a labral tear, also referred to as a “SLAP” tear (which stands for superior labrum anterior to posterior). What is the labrum you ask? Well to keep it somewhat simple it is cartilage that acts as a cushion for the ball and socket-type shoulder joint, as well as is an attachment spot for structures such as the proximal biceps tendon.
How To Prevent Shoulder Injuries
Okay, enough of the boring medical talk. Let’s talk about what you, the reader, really want to know. How do I prevent shoulder injuries? While there is no one magical exercise to avoid an injury to the shoulder, strengthening the shoulder might just be your best bet.
Isometric Strengthening Exercises
Isometric exercises are one of the easiest to prescribe and perform. “Iso” meaning “same”, and “metric” meaning “length”, these exercises engage and strengthen the rotator cuff in a safe and effective manner so as to not lengthen or contract the muscles.
Eccentric Strengthening Exercises
Another easy and effective exercise is an eccentric strengthening exercise. This type of exercise is where the muscle is lengthening under load, producing time under tension to help build strength safe and effectively.
Shoulder Stability Exercises
When dealing with shoulder injuries in the office, I typically like to have patients train for stability rather than mobility. Training the shoulder for stability, in my world, means loading the shoulder joint in a compressive manner.
As mentioned earlier, the shoulder is a very mobile joint, so loading the shoulder in this compressive manner not only helps to strengthen the musculature, but it puts the shoulder joint in a positive of joint centration, which means the shoulder is placed in the ideal location so that the muscles pulling at the joints are creating equal pressures thus creating stability.
So, what do these exercises look like you might be thinking? A couple of my go-to’s in this department are any type of overhead carry, shoulder taps, and an exercise that I may have “stolen” from Dr. Marc that we refer to as “The Donnelly” (it’s a long story).
Shoulder Taps Exercise
If you have made it through to the end, I much appreciate your attention. If you have any further questions regarding the shoulder, injury prevention, rehabilitation exercises, or anything else, feel free to contact our chiropractic and sports medicine office!