For optimal shoulder stability 4 mechanism must occur:
Optimal compression and tracking of the ball into the socket creating a tight fit of the convex on concave joint surface
A coordinated and synergistic guiding of the ball throughout shoulder range of motion by activation of the rotator cuff
Ability to progress and stabilize the shoulder blade onto and around the ribs
Maintain passive shoulder ligament integrity, to tension the ball into the socket
Stability for the shoulder is an odd ball of a topic when we look at how mobile the joint is. The topic can be made simple if we just pause and consider that the upper extremity developed through an early exposure to creeping,crawling, climbing, and pushing off or from the ground. These developmental gross closed kinetric chain movement patterns are what ultimately shaped our shoulder girdle. We start life and end life with the same stress of gravity on the body, but what doesn’t carry on with us through aging is crawling.
The stability that is created through muscle activation can be trained and in doing so we can protect the shoulder from injury. Namely, the glenoid labrum a soft cartilage doughnut shaped tissue that deepens the shoulder socket and acts like the head of a plunger sucking the head of your humerus into it. In other words, the synergy between the rotator cuff, the labrum, and the ligaments of the shoulder all work to maintain the ball in the socket under various positions. Loosing the position of the ball in the socket known as a subluxation or complete dislocation can occur when weakness to the muscles due to poor training, or loss of integrity to the ligaments due to poor mobility.
Injury prevention and rehabilitation for overhead shoulder instability should be progressive and cover both scapular stabilizers, and the rotator cuff, not to mention the T-spine as well.
Thoracic spine mobility prep can ensure an easier transition into this progressive drill.
Click this link to learn more about it: Thoracic spine mobility for improved overhead training
Scapular stability progression drill (Enforce joint compression while stabilizing the ball within the socket):
- Prone scapular press up progression to overhead:
- This will stabilize the head of the ball into the socket at a 90 degree angle of shoulder flexion. Perform with breathing. Breath in and push the elbows into the ground raising the thoracic and spreading the shoulder blades. Start with two arms, and progress to 1 as seen in the video. Progression will include a roller that can by easily knocked over to ensure joint stability and stop cheating. The alternate arm as seen here can press into a wall at various angles forcing for the working arm to adjust and stabilize.
- This will begin to provide a reactive stability progression as the body assumes a single hand pose. Using a foam roller for self cueing will improve the learning time and force for additional stability and time under tension to occur.
- Foam roller wall slide progression:
- This progression to upright posture can aid in improving thoracic and cervical stability while grading the exposure to vertical load and compression.
- Hand stand wall walk
- Starting somewhere with the wall walk or handstand progression is essential to provide stability now beyond 90 degrees.
Rotator cuff strength and stability drill for overhead pressing:
- Supraspinatus and Teres minor progression:
- Isolating both of these muscle can be partnered for better time management. Adjusting the bench at various anglesWhile laying face down or prone perform shoulder extension with external rotation.
- Perform external rotation in standing or side-lying. As seen in the video, progression from simple to more complex will ensure exposure to various torque angles which can be seen at various points along the overhead racking to pressing motion.
- Internal rotation performed in standing or side-lying
Progression overhead shoulder stability drills:
- Posterior chain Banded scapular stability:
- Use a tension band of choice which provides enough of a challenge to perform the movement with as little loss of form as possible. This movement is performed first with a facepull and progresses into the various of other postures that will continue to strengthen the rotator cuff.
- Overhead isometric joint centration:
- This will activate the rotator cuff and along with the lat muscle to tension the head into the socket. Start by depressing the head of the shoulder into the ground, now begin to use the lower legs to rotate towards the opposite side. Progress to overhead elevation as you go.
- Turkish get up
- Progress into this position over time through phases leading to a full overhead and standing position. Note the kettle bell grip position. This allows for an active grip and not a passive grip; equally a bottoms up approach would be a preferable grip.
- Overhead weighted carry
- Advance to a weighted overhead carry and reap the benefits of reactive overhead stability.
Take each one of these progressions phases at a time incorporating them onto your recovery days or single session training days to substitute the overhead lift until able or given the clear from your coach.
Doc Novo out.