Tuesday, April 12, 2016

Shoulder Mobility and Beyond

Shoulder mobility is necessary for a large number of tasks.  It is crucial for performance of overhead activities such as the overhead squat, snatch, and jerk.  Many people find it difficult to perform these activities and may even experience pain or discomfort.  It usually feels tight or restricted and the many people's initial thought is there is a mobility restriction.  This generally leads people to foam roll, smash tight areas with a lacrosse ball, and hang from a pull up to get the shoulder moving.  There may be varying degrees of short term success but the problem may not go away completely (unless you are perhaps one of the lucky ones).  As we often ask ourselves...is a treatment really working if the problem keeps coming  back?  What else could be causing the shoulder to feel tight if it is not simply a mobility restriction?  The short answer, motor control.  This is where the idea of stability comes into play.  For our purposes, we will use motor control to describe the intricate dance and coordination of the muscles in our bodies.  When we demonstrate that we have control in our movements, we naturally move with less restriction, tightness, and stiffness.

So how does motor control work exactly?  You can consider our muscles the tools, our nerves the messengers, and our brain the orchestrator.  To create controlled movement, our body coordinates both our stabilizing muscles and our primary mover muscles.  The stabilizing muscles tend to be smaller and located deeper within the body, closer to our joints.  They help us "centrate" our joints and keep things moving smoothly and without unnatural restrictions.  Our primary mover muscles are larger, more superficial, and are responsible for creating the big movements we can observe with our eyes.  Understandably, there is a lot going on to perform any simple task (such as raising one's arm overhead).

A key deficit for many people is that their stabilizers do not contract quickly or adequately enough prior to the larger muscles initiating movement.

When this happens, we lose some of our natural joint stability and the end result may appear to be a stiff or tight area.  But often what is occurring is really a disorganized movement pattern, not a true mobility problem.  Most of us work our primary mover muscles frequently but do not necessarily provide adequate training for our stabilizers.

So how can you test whether or not you have a mobility problem or a motor control problem when it comes to tight shoulders?  It's actually quite simple.  Start by holding a band between both hands directly in front of you, elbows locked straight, and get some tension on it.  Next raise your arms over head and pay attention to how your shoulders feel.  If you can move overhead with the taut band and you feel less tightness than you usually do, you my friend have a motor control issue (Overhead Testing Video).  But how exactly does this voodoo magic work?  By loading the band prior to your big movement, you help to activate your stabilizer muscles first.  If activating your stabilizers first improves your movement, than you've proven that part of your shoulder tightness lies in your muscle coordination.


But what about the people whom the band does not have a big effect?  Now I want you do pay attention to where you feel your tightness.  If you feel mostly tight in the upper back, you might start looking at your thoracic spine or latissimus dorsi mobility.  If your posterior shoulder is screaming at you, you may have a posterior shoulder tightness, chest, or latissimus dorsi tightness.  If it is in the anterior shoulder, you may have chest or upper trap tightness.

The tightness in these areas could still be originating from an over reliance on stronger superficial muscles to stabilize the shoulder.

When this happens, you still end up with a similar problem of properly coordinating your stabilizers and your prime movers.  But in this case, you may require a more in depth movement analysis to find out exactly why you're cheating the movement.

We have a few examples of exercises for the shoulder that have been shown to improve motor control.  The key in their execution is quality repetitions and demonstration of control during the actual movements.  It makes sense right?  To improve shoulder control you want to practice controlling the shoulder.  Here are some exercises to help you.  Click on the exercise to see the video.

Scapular T

Scapular Y

Scapular I

Shoulder Flys Alternate

Seated Cross Legged Alternate Arm Raise

Upper Body Rolling

 

After you gain the motion with the exercises, it is time to work exercises into that motion.  Work exercises that you are able to move the full range of motion without degrading form. 

If your form degrades, go back to the exercises and back off whatever made you degrade.  It is a good idea to perform these exercises at the end of a session as well to "recover" and fight off any stiffness.  

While proper shoulder motor control practice can often improve the problem, if you're not noticing a difference or still have persistent tightness, you may need a little extra help.  If you are in the Colorado Springs area you can get personalized attention with one of our movement assessments.  Our movement assessments are designed to look at your whole body movement and tackle the areas that may be causing or perpetuating compensations (and leading you to not succeed in your program).  You'll get personalized homework from these sessions to help you achieve actual, lasting results.  It's like going to the dentist...but for your whole body.  See our services page to learn more.

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