Got shoulder pain? Don’t worry – you aren’t the only one! Shoulder injuries are common amongst athletes and older individuals. I am a competitive dragon boater and experience shoulder pain regularly. It is often associated with poor technique and over training. An effective shoulder conditioning program is crucial towards prevention and recovery.

The goal of shoulder rehabilitation is to restore function of the shoulder. Shoulder function can be defined as working in a proper way without causing any pain or discomfort. Through a series of strength exercises and mobilization techniques, recovery can be achieved at an accelerated pace.

Shoulder Function

There are two components when it comes to shoulder functionality; shoulder stability and shoulder mobility. A balance between the two is what contributes to normal shoulder function. Shoulder mobility is what allows the shoulder to move up, down, left and right in a free range of motion. Kinesiologists and physiotherapists may describe these movements as external rotation, internal rotation, flexion, extension, abduction and adduction at the shoulder joint. The glenohumeral joint (shoulder socket) is a ball and socket joint and enables the arm to perform multi-directional movements and rotation. Stability on the other hand, is the resistance musculoskeletal tissues provide to the joint from various movements. In other words, shoulder stability refers to the ability to keep the arm stable while performing various movements.

Pain Reduction

Pain is a major indication of a shoulder injury. At the onset of discomfort, exercise should be put to a halt to prevent further aggravation. The degree of impingement (pain) can vary depending on the seriousness of the injury. Rest is crucial during the first couple of days to allow the injured area to heal. Once pain levels begin to decrease, we can begin our rotator cuff exercises.

Our main focus is rehabilitating the rotator cuff muscles and restoring range of motion and increasing shoulder stability  The rotator cuff is responsible for stabilizing the shoulder joint and is made of 4 different muscles. These muscles originate at the edge of the shoulder blade and insert around the head of the arm bone, or humerus, forming a “cuff” like network.

Rotator Cuff Exercises

Scapular Protraction and Retraction

Scapular Elevation and Depression

Internal and External Rotation

Clock Exercises

 
Wall Angels

Dynamic/Plyometric Training

Once a full range of motion is achieved we can begin dynamic/plyometric training. Plyometric training focuses on increasing power and exerting maximal force during exercise. These exercises can be used to return the shoulder to optimal functioning. Make sure to start out with lighter weights and gradually increase the weights as the shoulder gets stronger.

Serrano Press

Wall Push-Ups

Overhead Forward Throw with Medicine Ball

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Medicine Ball Slams

Have you ever done any of these exercises? Leave a comment below!

Kevin Kwok – Client Care Manager

Kevin enrolled in numerous sports program as a child, which exposed him to an active lifestyle early in life. He played ultimate frisbee competitively in at the junior level while in high school. Kevin now focuses his training exclusively on dragon boating. He has been paddling for the past 2 years and hopes to make the Canadian National Team in 2019. He hopes he can motivate others to accomplish their short and long term fitness goals.

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Pushups are a great body weight exercise that help strengthen the chest, shoulders, triceps and increase trunk stability. An essential and functional movement, understanding proper pushup technique and then incorporating them into your routine can have amazing effects on your overall performance, due to the complexity of the movement, use of the entire body and full body awareness it can create. Great pushup technique is even helpful in sport and activities like yoga and pilates. For example, newbie surfers will appreciate the application in popping up (getting up off your surfboard into an upright position).

Top 3 tips for proper pushups

1. Place your hands under your shoulders or slightly wider

Common mistake: hands are placed in front of the shoulders, so if you were to lay down with your hands in place, they would be at the level of your chin or ears, which is too far forward. Too far forward positioning can increase the stress to your shoulder joints, as your elbows tend to wing outward and forward, causing internal rotation and possible impingement of structures supporting your shoulder. In other words, potential shoulder and neck pain.

2. Maintain a straight plane through the hip and upper trunk

Common mistake: leading the movements with the head and shoulders on the pushup. This significantly compromises the intensity of the exercise, along with any improvements in trunk stability that you would experience.

3. Start to increase range of motion over time, as you become stronger

Common mistake: doing quarter range of motion pushups and always increasing the number of reps, versus increasing depth of movement to half, then full range of motion. Common mistake: Headbanger pushups. This is a combination of mistakes seen in tip 2a and 4a where you may notice someone doing many, many, many, pushups, but it really is a combination of many, many, many little elbow bends and head bobbing. This can lead to neck pain (you saw that coming, didn’t you?).

Rehabilitation Tips for Pushups

If your shoulders hurt

* Angle your elbows toward your feet, and imagine folding your arms in closer to your body, as though you are doing pushups in a skinny alleyway.

* Place your hands on a bench, table or stable surface like a fixed bar to reduce the angle, in order to decrease pressure in the shoulders, and focus on shoulder stabilization throughout the movement.

* In the top (plank) position, ensure your shoulder blades are in a neutral position before you begin the movement, and focus on keeping them there. Often people will shrug their shoulders up towards their ears during the movement potentially causing impingement.

If your neck hurts

* Have someone check to see if you are stabilizing your head in the proper position: neutral cervical spine and chin gently tucked.

If your wrists hurt

* Use push-up handles.

* Forms fists to push off of.

* Use the edge of an elevated, sturdy surface.

If your back hurts

* Lift, or keep your hips “high” to ensure they are not dropping below the level of your head (stay parallel to the floor, so they are on the same plane throughout the movement)

* Perform push-ups from your knees, so you can focus the effort on maintaining a strong core, before challenging your upper body

* Remember to engage your core before you start the movement

* Use the edge of an elevated, sturdy surface

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