May 5th, 2014
Category: Injury Prevention
Shoulder Tightness leads to Pain, Injury and Decreased Athletic Performance
By, Mark Wine CSCS; USAW; NASM PT, PES, CES
If you have ever been fortunate to work with professional athletes, fitness enthusiasts, older populations and/or youth, chances are you’ve trained individuals with shoulder tightness and/or pain. Studies have estimated that 67% of the population will suffer from shoulder tightness and/or pain in the shoulder within their lifetime; many of that 67% were already suffering (2). The pain and tightness can be a result from excessive pressing or pushing, throwing, contact, overuse and many more. The ailments that often result are chronic pain, arthritis, rotator cuff pathology, altered kinematics, impingement syndromes, tears, etc… Regardless of where the shoulder pain lies this common ailment can be a major limiting factor in everyday life and/or athletics.
The Shoulder Complex:
The shoulder complex comprises of the glenohumeral joint, acromioclavicular joint, and the sternoclavicular joint. If any one of these joints is compromised than flexibility/mobility is affected and kinematics are altered. Joint mobility, synchrony of the complex and flexibility of the soft tissue are all causes for shoulder injury/pain. Luckily, these issues can be avoided with a proper training program that utilizes proper exercise selection, progressive planning and flexibility.
One exercise, which can be an alternative to a traditional lift, is Dumbbell Military Press. This exercise allows for less restriction than a barbell while allowing for greater ranges of motion. To further increase flexibility, while working the entire shoulder complex, combine compound lifts with dynamic flexibility exercises like Rainbows or Wingspans (1). Joints and ligaments are a part of the endocrine response system and can therefore be strengthened with increased range of motion resistance training (2).
Athletes / Persons who most commonly suffer:
Research has shown that weightlifters, contact athletes, less active individuals and various other overhead athletes often suffer from shoulder tightness syndrome. The majority of doctors will simply prescribe no overhead movements to limit the shoulder pain; however, research on this subject is very limiting in nature because it never takes into account all variables. Most persons that I have encountered with shoulder pain do very little mobility work and have too much pushing and not enough pulling within their training programs.
These are examples of questions that should be asked in regards to shoulder pain / tightness:
- Does the athlete perform pre-habilitation movements along with Overhead movements?
- Does the athlete perform functional movements or stick to only traditional bodybuilding exercises?
- Does the athlete focus on overall flexibility along with Olympic lifting?
These questions, along with many others, are pertinent pieces of information that must be gathered to capture the whole picture.
All strength programs should place emphasis on functional movements that involve multi-planar full range of motion (ROM) movements; this includes overhead pressing and pushing. Functional movements should encompass stabilization, ROM, strength and power lifting and total body flexibility. All athletic trainers and strength and conditioning coaches who prescribe programs must have a basic understanding of the shoulder complex. This includes various techniques that eliminate shoulder tightness and/or shoulder pain.
Post workout should involve the following: static stretching in both forms, isometric & passive; dynamic stretching, which is active; soft tissue therapy, such as self-myofascial release or ART; and dynamic resisted range of motion movements, like wingspans with a small band (1). Upon completion of any resistance training session, it is imperative that the trainer has the client / athlete perform stretches for the posterior deltoids (rear), anterior deltoids (front) and the lateral deltoids (middle, outer or side).
One stretch that should be used on individuals whom currently suffer or are at risk for Posterior Shoulder Tightness (PST) is shoulder protractors (1). This exercise requires internal and external rotation while the arms are abducted to near 90˚. Bring your elbows up to your sides, lining them up with your shoulders, and rotate your palms / forearms downwards towards your waistline (far as possible). Leave your elbows lined up with your shoulders for the entirety of the stretch / exercise. This position places your shoulder complex in a vulnerable position so be sure to apply additional pressure gently. Perform this movement pattern as a rehabilitation exercise with 3-5 pound weights in each hand. To do so, constantly bring your hands from your waistline, past the starting position, and all the way up until your hands are fully rotated above the sides of your head. Continue this movement pattern in a slow controlled fashion, while keeping your elbows lined up with your shoulders for the entirety of the movement.
There are numerous other movement assessments and rehabilitation / pre-habilitation exercises that can help the shoulder complex. It is important for all persons suffering from PST to seek out and find a strength coach or athletic trainer that has an understanding of the shoulder complex. All resistance training programs must emphasize range of motion and functional movements. Persons considered “high risk” are power lifters, Olympic weightlifters, throwers (i.e. baseball pitchers), golfers and all contact athletes. However, PST is a persistent problem that can alter anyone’s life. So regardless of age or experience level shoulder health must be emphasized in all training programs.
1. Exercise Videos on Functional Muscle Fitness’s YouTube page
2. NASM Essentials of Personal Fitness Training (3rd edition)
By, National Academy of Sports Medicine
Editors: Michael A. Clark, Scott C. Lucett and Rodney J. Corn
3. Prevalence and incidence of shoulder pain in the general population; a systematic review.
By, Luime JJ, Koes BW, Henderiksen IJ, Burdorf A, Verhagen AP, Miedema HS, and Verhaar JA.
Scand J Rheumatol 33: 73-81, 2004