Brian Schiff’s Blog

Shoulder impingement is a common problem for many clients. Specifically, some clients will suffer from internal impingement as a result of a significant loss of internal rotation range of motion, also known as GIRD (glenohumeral internal rotation deficit). This has been widely researched in baseball players, and it is a common issue for overhead athletes. Of note, it can also impact those doing repetitive overhead lifts.

It is common to see asymmetry in internal range of motion for the dominant and non-dominant arms. For those clients who have a total shoulder motion asymmetry greater than 5 degrees, it becomes more important to resolve internal range of motion deficits based on the current literature. In my previous post, I revealed how to improve soft tissue mobility. In this post, I will review the sleeper stretch and cross body stretch to improve posterior shoulder mobility while increasing internal rotation.

The video below from my column ‘Functionally Fit’ for PFP Magazine will demonstrate how to do these stretches.

Tightness and trigger points in the infraspinatus are common and create lots of dysfunction in the shoulder. You may also see tightness in the teres minor. Problems may include a rounded shoulder, chest tightness, a rotated scapula causing fatigue in periscapular muscles, trap tightness and even anterior compression of the humerus.

It is essential that any trigger points be resolved prior to stretching to make a lasting impact on the soft tissue mobility. The video below reveals how to use a trigger point ball to reduce soft tissue restriction in the posterior shoulder that may impede proper mobility and mechanics. Tightness may predispose overhead athletes and those doing resistance training to increased risk for rotator cuff and/or labral injuries.

In the case of shoulder pain and dysfunction, the lower trapezius and serrates anterior are often implicated as part of the problem. Research has shown that these two muscles often fatigue and don’t contribute equally to the force couple between them and the upper trapezius that facilitates upward rotation of the scapula.

Building scapular stabilization and dynamic stability is a must for those doing repetitive overhead activities such as throwing, swimming, serving, or work-related tasks.  It is a given that asymmetries will exist, so optimizing the strength of the rotator cuff and scapular stabilizers is paramount to prevent injury and recover from overuse syndromes.

To strengthen the lower trapezius, one of my ‘go to’ exercises is the lower trap raise. It can be done with just the weight of your arms or using light dumbbells.  The link below includes the full description for the exercise, and I also embedded the video below.

http://fit-pro.com/article-4137-Lower-trap-raise.html

In the next column, I will include a serratus anterior exercise using a kettle bell as a follow-up to this post.

I work with a lot of baseball players in my clinic.  In many cases, I see similar issues and recurring problems in them, especially pitchers.  Some of these issues include:

• Scapular dyskinesia
• Limited thoracic spine mobility (extension and/or rotation)
• Soft tissue tightness (lats, post shoulder, pec major/minor)
• Poor muscular strength/endurance in the rotator cuff and scapular stabilizers
• Glenohumeral internal rotation deficit (GIRD)

I integrate routine mobility exercises for my throwers, as well as other overhead athletes (tennis, swimming, volleyball, etc) to better prepare them for training and their sport, as well as prevent poor mechanics and compensatory motion that may lead to aberrant stress on the rotator cuff and labrum.

The following video reveals five of my preferred exercises using a foam roller to improve thoracic spine mobility, decrease latissimus tightness, and stretch the pec major/minor while facilitating lower trapezius activation.

In order you will see:

1. Lat rolling
2. T-spine extension in supine
3. T-spine extension coupled with lat stretch
4. T-spine rotation
5. Retraction and downward rotation

I advise performing 5-10 repetitions of each prior to training and sport. These will help improve performance, optimize overhead mechanics and reduce injury risk associated with overhead sports.

Lately, I have been working with an elite swimmer hoping to make it to the 2012 Olympics in London.  It has been blast training her since she is so fit, driven and willing to embrace training with a smile each session.  I mean seriously, how many 16 year olds do you know that swim 5 hours per day, go to school, and train with someone like me 3x/week?

While I utilize many common exercises in her program, I definitely pepper in several ones aimed at maximizing core and shoulder strength/stability.  One of the exercises I use from time to time with her is a shoulder glide exercise.  I thought I would share this little gem today.

This is NOT an exercise I recommend for people with shoulder impingement, recurrent instability, poor shoulder mobility or those lacking a high level of fitness to begin with.  In other words, this is no sissy exercise and it can be dangerous if used improperly.

To start with, I had my swimmer do it with both hands.  Once she demonstrated the right form with ease, we progressed to this version in the video below:

So, if you are looking for a great way to challenge and improve shoulder and core strength, this is one to add to your arsenal.  Be wary of gliding out too fast as this is a sign your upper body and/or core is not strong enough to decelerate the motion effectively.  The pull back motion is a great way to strengthen the lats and swimming muscles as well, all the while exposing and resolving any single sided deficiencies.