Steve Wowzynski, MPT, CMTPT/DN
Whether you play baseball, softball, volleyball, tennis, or are a competitive swimmer, the overhead athlete is always looking for ways to improve performance, not just feel better. The good news is, physical therapy can help you with both!
Physical therapists are really scientists of the human body. Muscle and bone function and structure, mechanical engineers of the body so to speak. We are trained in post graduate school to identify muscle movements and dysfunctions that can occur when these muscles are activated. Injuries that typically occur in overhead athletic events is one area where physical therapists can address to help athletes avoid poor positional habits that can lead to pain from overuse.
The shoulder is a framework of bones, connective tissues, and muscles that come together to work over the rib cage to allow for overhead activities. The three primary bones of the shoulder include the clavicle (collar bone), scapula (shoulder blade) and the humerus (upper arm). Most young athletes, as they begin to train for their sports, are instructed in basic exercises to train the rotator cuff. While the rotator cuff is an important group of 4 muscles (supraspinatus, infraspinatus, subscapularis, and teres minor) that make up the shoulder joint proper, there are an additional 20 muscles that need to interact with at least one of the 3 bones forming the shoulder that need to work together to keep an overhead athlete upright or rotate the body by either directly or indirectly acting at the shoulder. Those muscles do not even include the muscles on the opposite side of the body, required to form a counterbalance to accelerate and safely slow the body down.
Here are three exercises that can help setup these critical muscle interactions:
Prone Horizontal Abduction with External rotation
Position: On your stomach with your other arm or small pillow supporting your head, a pillow under your stomach for back support if needed.
- Bend your elbow and raise your upper arm at shoulder height level with your trunk.
- Twist your arm up so your wrist moves toward the ceiling (hand open or closed).
- Relax and Repeat 10-15 times, 2-3 sets or until fatigue.
Prone Lower Trap “Y” Lift – single arm
Position: On your stomach with your other arm or small pillow supporting your head, a pillow under your stomach for back support if needed.
- Let your arm hang down off the table.
- Raise it up forward leading with thumb up aiming for a 25-degree angle away from your ear.
- Relax and Repeat 10-15 times, 2-3 sets or until fatigue.
Advanced: repeat with both arms lifting at the same time to complete the “Y”.
Neutral Plank
Position: On your stomach with weight on your elbows aligned under the shoulders, hands supporting the chin
- Lift your pelvis and hips off the ground, keeping your knees in contact with the surface; maintain a level or straight back (no stomach sagging or butt lifting).
- Hold for 30 to 60 seconds.
- Relax and repeat 3-5 times.
Advanced: When strong enough to hold 5 reps for 60 seconds you can transition to the harder position of lifting the knees as well.
While the rotator cuff plays an important part of any training program for overhead athletes, however, the upper back, lower back, core, and stability counterbalance systems within the body deserve some serious attention as well. Over-working one specific set of muscles can lead to faster breakdown and longer recovery times after high endurance, repetitive overhead endurance performance. Using a holistic approach to training and rehabilitation can be fun, interactive, and challenging at the same time to build strength and muscle activation patterns that help avoid the overuse of one specific muscle group.
The next article in this series will begin to address further pieces of the overhead athletic training program, including flexibility, movement, and resistive strengthening. If you have any questions about a training or injury prevention program or have an injury or soreness that just won’t go away, feel free to contact our overhead athlete experts at MotionWorks Physical Therapy at info@motionworkspt.com.