By Ned Simerlein, Integrated Athletic Performance

September 29, 2007

Tell me if you have ever experienced this before: Your son or daughter comes home after a game and says, “My shoulder hurts.” What is your answer? Put ice on it. It’s funny that society thinks that the universal answer to fixing pain is ice and aspirin. Do ice and aspirin work? Yes they does but only as a TEMPORARY fix. It is just like putting a can of “fix a flat” into a tire that has 80,000 miles on it and is completely bald. It will temporarily fix the problem, but if you don’t resolve the root of the problem and replace the tire, you will have the same problem recur and it may be even worse (a blowout and/or accident).

In this article I will cover the anatomy of the shoulder, why shoulder stability is important and some simple exercises that can help prevent shoulder related injuries.

Before we can fix the problem we have to know what the problem is. In my experience athletes who have “Upper Crossed Syndrome” have the most anterior shoulder/rotator cuff pain. “Upper Crossed Syndrome is characterized by rounded shoulders and a forward head posture,” ( Clark , p65). More basically, Upper Crossed Syndrome appears clinically as bad posture. Below is a diagram of someone with Upper Crossed Syndrome.

Upper Crossed Syndrome is caused when large primary muscles (such as the chest) are tight and smaller stabilizing muscles (such as the rotator cuff and medial/lower traps) are weak. The large primary muscles are overtrained for two main reasons. 1. They are on the front of your body and people tend to train the muscles on the front of their body because that is what they can see when they look in the mirror. 2. Old school training methodologies focus on benching and pushups; both front side based exercises. The smaller stabilizing muscles are weak for two reasons 1. They are on the backside of the body and, if you read my last article you know that people don’t usually work the backside of the body because they can’t see the backside. 2. Old school training methodologies focus on benching and pushups; both front side based exercises, and neglect to address the back side muscles. This combination of factors is what has contributed to your son or daughters upper crossed syndrome.

Let’s look at those small stabilizing muscles that are being ignored.

The rotator cuff is composed of four tiny muscles on the back of the shoulder, the infraspinatus, supraspinatus, teres minor, and subscapularis. These little guys are what decelerate your arm after you release the ball when throwing. If you didn’t have these muscles your arm would rip out of it’s socket! Other small muscles are the rhomboids and medial/lower traps located between your shoulder blades. These guys play a big role in scapular retraction, which allows you to sit up straight with good posture. When you tell your child to sit up tall and pull his/her shoulders back, the rhomboids and lower traps are activated. The reason why your child can only hold proper position for a couple short time is because these smaller muscles are too weak and his/her chest is too tight so it fights against the movement trying to snap back into a relaxes position.

Now that we know what the problems are, how do we fix them? The first step is to implement flexibility into our strength training program on a daily basis. Stretching the tight muscles such as the chest, Trap 2 and lats is going to help. Here are some examples of good stretches:

(PB CHEST STRETCH PICS)

On your hands and knees you should have a stability ball to your side with your arm at a 90 degree angle on the ball. You will then push the ball out and drop your chest down at the same time. Hold the stretch for 5 seconds and repeat four times.

PB Lat Stretch (pictures 1-2)

On your hands and knees, put the ball in front of your body with your arm straight on the ball. You will allow your arm to roll forwrd and simultaneously drop your chest and head down. Hold the stretch for 5 seconds and repeat four times.

The two exercises above will help improve the flexibility in your chest and lats.

In addition to stretching the tight primary muscles, we must also strengthen the smaller stabilizing muscles that have been ignored and weak. Here are two exercises that will help strengthen the small stabilizers on the backside of the body.

Prone T’s (pictures 1-2)

Lie on your chest on the floor with two 2 pounds weights to your sides. While holding this position, slowly raise your arms off the ground pinching your shoulder blades together. Keep your chest on the ground. At the top of the movement, hold for one second, then lower their weights slowly. perform 8-12 repetitions for 2-3 sets. Make sure that only light weights are used – never more than 4 pounds.

Side Lying External Rotation

(pictures 1-2)

Lie on your side holding a light dumbbell (4-8 pounds). Keeping your arm at a 90 degree angle and your elbow tucked into your side, raise your arms through it’s normal range of motion. Be sure not to externally rotate your arm further than you safely can and do not rotate it further than you can while keeping your elbow tucked into your side. Perform 8-15 repetitions for 2-3 sets.

By correcting the problem of Upper Crossed Syndrome we can help prevent shoulder pain in throwing athletes. Above are four examples of exercises that will help achieve this goal. However, if the problem worsens, I recommend seeking the care of a credible physical therapist in your area.

Remember, ice is the easy answer, not the correct one!