Overhead Shoulder Problems?

– Courtesy: crossfitwilmette.com

This is for those of you who are having shoulder pain with overhead motions or after overhead motions.  If you are having pain (not normal post exercise soreness), I advise you get started with Physical Therapy as soon as possible to address the problems, but if you want to try some things on your own first, here are my basic recommendations.

To begin, we need to regain mobility of the shoulders, scapulae, and thoracic spine.  I like to begin with 1 basic overhead shoulder flexibility test:

Stand with your back against a wall and you feet a few inches away from the wall.  Tilt your pelvis back to flatten your lower back against the wall.  Raise one arm straight up (keep your elbow straight) and try to touch the wall overhead.  There are a couple of different options for results of this test.

  1. You could have pain (this is a red flag for injury, you should definitely see your doctor of physical therapist).
  2. You could be unable to touch the wall, but you don’t have pain, indicating you need to work on mobility.
  3. You can barely touch the wall with your thumb (this is the absolute minimum mobility you should have to perform overhead activity).  You definitely need to continue working on mobility.
  4. You can easily touch the wall with the back of your hand.  This is  a passing score, you should probably be safe for overhead exercise.

If you fall into category 2, you should eliminate all overhead activity (pullups, pressing, push pressing, jerking, hand stand push ups) from your workouts until you improve the mobility.  Wall balls are probably questionable, but you might be able to do them.  Kettlebell swings should not go overhead.  Sub in pushups, ring rows, eye level kettlebell swings.  Maybe chest passes into a wall with a slamball instead of wall balls.

If you fall into category 3, then do a bunch of mobility and see if you can get yourself into category 4 before you workout.  Many of you will be able to get there.

Mobility work for categories 2 and 3:

Thoracic spine:

Scapula:

Shoulders: We actually don’t want to stretch the ball and socket out all that much, if you improve the scapula and thoracic spine, you should be better and able to pass your test.  The few exceptions might be to use a lacrosse ball on your deltoids a little and to work gently on internal rotation.  There should be no pain with this though.  The other exception is the overhead stretching with the band, I’m all for this one, keep doing it, but this will also stretch your scapula as much as the shoulder joint.
Kstar on some good shoulder stuff: http://www.mobilitywod.com/2010/09/free-your-scap-free-your-mind.html

After you do 1 mobility drill, go back to the wall and retest.  You should find that some of the mobility drills will help more than others, when you find one that helps, repeat it over and over.

The biggest takeaway here should be rest the painful shoulder.  You should never exercise the painful shoulder, but it will do a lot better with mobility work and stretching (and icing).

If you are having a problem, I’d be happy to take a look on a Saturday sometime or at a separate time that we can arrange.  Email me at jason.sweas@gmail.com

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