Corrective Exercise Strategy For Shoulder Impairments

Because the shoulder is one of the most unstable or mobile joints in the human body it relies upon precise muscle activity for support. Any injury throughout the human body can alter the support mechanisms of the shoulder and lead to dysfunction and, eventually, injury.
Some common local injuries associated with shoulder impairment include biceps tendonitis, supraspinatus tendonitis, impingement syndrome, and anterior and posterior shoulder pain. Injuries above the shoulder include cervical injuries and headaches. Injuries below the shoulder at the Lumbo-Pelvic-Hip-Complex include low back pain, sacroiliac joint dysfunction, and hamstring, quadriceps, and groin strains. Injuries at the knee include patellar tendonitis (jumper’s knee), IT-band tendonitis (runner’s knee), and medial, lateral and anterior knee pain. Injuries at the foot include plantar fasciitis, Achilles tendonitis, and posterior tibialis tendonitis (shin splints).
Corrective exercise strategies should focus on overactive and underactive muscles previously identified through specific movement screens such as the impingement or shoulder crossover test and the overhead squat assessment, just to name a few.
When it comes to shoulder impingement typically you’ll find the overactive muscles include Teres Major, Latissimus Dorsi, Posterior Capsule, Pectoralis Major/Minor, Anterior Deltoid, Levator Scapulae and Scalenes. Conversely, the underactive muscles would include the Rhomboids, Middle/Lower Trapezius, Rotator Cuff and Serratus Anterior.
When using the Corrective Exercise Continum to correct shoulder impingement it should look something like this:
You will want to start with inhibiting the overactive muscles using Self-Myofascial Release techniques. Typically one would use a foam roller, a tennis ball, a lacrosse ball, a golf ball, or a frozen bottle of water. Look for tender spots and hold for 30-90 seconds.
Next you want to lengthen the overactive muscles using Static Stretching and Neuromuscular Stretching with a 30 second hold or a 7–10 second isometric contraction followed by a 30 second hold.
After inhibiting and lengthening the overactive muscles you will want to activate and integrate the underactive muscles with some positional isometrics and or isolated strengthening. Start with 4 reps of increasing intensity: 25, 50, 75, 100% or 10–15 reps with 2 second isometric hold and 4 second eccentric deceleration.
Start by using a foam roller on the Lats and Thoracic Spine – Stretch the Lats, Pecs and Rotator Cuff – Activate the underactive muscles using a Stability Ball Combo and Cable External Rotation – Integrate with a dynamic movement such as the Cable Squat to Row.

Amanda

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