Most of us “crossfitters” know how debilitating shoulder pain can be. From sub acromial pain to labral tears – both of which can take a long time to fix either through physiotherapy, exercise rehabilitation or surgical intervention.
The best strategy for injury rehab? Prevention of injuries through PREhabilitation.
- Strengthen the weaknesses
- Increase movement at the stiff segments
- Gain control where you lack it
Prior to training, especially with load overhead we need to get the shoulder warm and switched on neurally. We should aim to increase all of the aforementioned aspects but not to fatigue. Fatigue prior to training will put us at a greater risk of injury.
What are we aiming to do in the bigger picture?
- Centralisation of the humeral head (HH) – most of us suffer from an anteriorly positioned HH.
- Static control
- Dynamic control – force couples. Need to be strong and correctly balanced.
Whilst we may not be able to influence number 2, we can certainly play a large role at increasing number 1, 3 & 4.
How do we do this?
Shoulder prehab exercises
Thoracic spine mobility – I previously blogged regarding some quick tips on mobility. This link focuses largely on increasing movement at the thoracic spine. As a society, we spend too much time in a constantly flexed position. Lets open up our thoracic which plays a pivotal role in allowing full shoulder flexion into elevation.
External rotation strength. See video below. Whilst we cannot ignore subscap (internal rotation) deficiencies, I generally find more of a problem with external rotation strength. We shoulder aim for a 1 (external rotation) to 1.5 (internal rotation) strength ratio. In my own opinion this is usually due to inhibition as a result of being held for long periods in a stretched position (rounded shoulders). Depending on what you are aiming for, perform approx 3 sets and vary your resistance/repetitions. A fellow professional colleague enlightened me on performing external rotation whilst in abduction (as seen below) allowing the scapula to upwardly rotate and stabilise isometrically. This will be mimicked when performing lifts overhead.
- Upper, mid, lower traps strength work – see video below. 2 min 10 to 2 min 37. It’s important we have good control and strength along this large muscle. It plays a highly important role in moving the scapula to allow full function at the shoulder.
- Isometric control of your external rotators whilst strengthening upper traps. 2 min 37 to 2 min 44.
- Serratus anterior strength work – beginner to advanced. High plank holds to varied bear crawls – keep the shoulders active. Good efficiency allows the scapula to maintain its tight position against the thoracic wall and therefore setting up for good scap-thoracic rhythm. 3 min 36 to 5 min.
If you have shoulder pain it is ok to train, however stay away from THE PAIN ZONE – do not train through it. Find alternatives. If pressing is your strength focus on the day, change to pendlay rows or work lower extremity strength for the day. It’s important that you seek help. Go and see your local sports therapist / physio to help find out where your problems exist. Just because you present the same shoulder pain as someone else, it does not mean you rehab this in the same way. Different abnormalities for different individuals.
Prior to training, aim to work for approx 5 mins on one of the above exercises. The next time you train, work on the next exercise on the list. Keep at it. Strength and control takes time and patience.
Thanks for reading!