Playing overhead throwing sports like baseball, softball, tennis, and football (if you’re a quarterback) puts a tremendous amount of stress on your shoulder for multiple reasons. Overhead motions stress the extremes of shoulder range of motion, and do so at exceptionally high velocities. For example, Seroyer et al. (2010) demonstrated that the shoulder can reach internal rotation velocities of up to 7,000-9,000 degrees per second during the pitching motion. Going through these motions repeatedly puts stress on all the structures of your shoulder including the muscles, ligaments, tendons, and the bones. If you play such sports for multiple years, the stress keeps building up, and for a lot of athletes it can lead to injury.
Taking care of your shoulder is extremely important if you want to stay healthy and be able to keep playing your sport for as long as possible. Here are some important factors to take care of to keep a healthy shoulder in the long run:
Thoracic Spine Mobility
When going through a throwing motion (or when you serve the ball in tennis) your arm reaches overhead before releasing the ball in front of the body. When reaching overhead you want to make sure you have the right amount of thoracic spine (t-spine; upper back) extension.
A lack of t-spine extension range of motion will prevent your shoulder blade from rotating into a position that allows your arm to explore overhead positions. This will put the athlete at risk of compensating some other way, typcially overextending at the lower back or overstretching the front of their shoulder.
Notice how the example on the right has a limited overhead range of motion because of his lack of t-spine extension.
Here is a great drill to improve t-spine mobility as it relates to the overhead throwing athlete:
Along the same lines, in order to have proper overhead range of motion, you need to have proper rib positioning/alignment. Remember that the ribs attach to your spine, so poor positioning of the spine or the ribs will influence one another.
Also, the ribs provide the foundation for your scapula (shoulder blades) to sit on, so poorly positioned ribs will influence the positioning and control of the scapula. This is especially important because the scapula holds the socket that your arm moves in.
If you connect all the dots, you’ll quickly see that spine/rib positioning and range of motion can have a profound influence on shoulder range of motion. Ensuring proper rib positioning will help the shoulder blade maintain it’s ability to upwardly rotate, which is a requirement to control overhead motions without impingement.
Notice how the shoulder blade rotating upward moves the arm up, even without any actual movement at the shoulder joint. This is a great illustration of the importance of scapular rotation.
Ribs postioned improperly can negatively affect the “normal” function of the scapula on the thoracic cage. One of the most common issues we see is ribs positioned with a “flare” in the front, which is related to an excessive arch through the lower back.
Breathing exercises are a great way to help restore full rib range of motion and abdominal control, which ultimately leads to a better rib positioning with movement. PRI (Postural Restoration Institute) teaches a lot of effective exercises to address this. The 90-90 hemibridge done with a balloon helps provide feedback and resistance to your exhalation, a commonly deficient part of the breathing sequence, which effectively engages the abs to pull the ribs back and down in the front.
Another factor to consider in overhead throwing athletes is the importance of hip dissociation, the ability to rotate the hips forward while allowing the shoulders to “lag” behind. It may not be obvious at first how hip dissociation can affect the shoulder, but if you think about the rotational movement that happens when you throw a baseball or a football, for example, you’ll realize that the hips normally initiate the movement.
Notice how the hips are engaged and the arm is still back.
This simply means that the lower body and the hips are responsible for a good amount of the force production that is then transferred to the arm during the throwing action.
If you lack proper hip dissociation, you won’t generate as much “ground up” force through your legs and hips, which will require you to generate more force from the shoulder as a compensation. This added stress can lead to an increased risk of breakdown over time, similar to how erosion can slowly eat away at rock.
Medicine ball work can help teach hip dissociation and force transfer from the lower body and the hips:
Shoulder complex stability
Last but not least, strengthening the muscles around the shoulder in a way that mimics their true function is of the utmost importance. This includes the muscles that control position and movement of the scapula (rhomboids, trapezius, serratus anterior, etc), as well as thoe rotator cuff, which functions to stabilize the shoulder in the socket. Proper functioning of these muscles helps take stress of the labrum, ligaments, and tendons within and around the shoulder.
Those muscles should always be trained in the way we want them to act during the throwing motion. Here are 2 good examples of shoulder stability exercises that will help keep the shoulder strong.
Challenging the rotator cuff to control the shoulder in the socket with perturbations
Improving the muscles around the shoulder blade's ability to control full scapular retraction and upward rotation
Maximizing durability at the shoulder requires a much more comprehensive approach than just strengthening the muscles around the shoulder. Factors such as hip mobility, lower body strength/power, thoracic rotation and extension, and rib position/control will all influence the stresses placed across the shoulder. It’s important that overhead athletes have a strategy to both assess and train these factors.
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David Lasnier is a Performance Specialist at Endeavor Sports Performance. For more information about how Endeavor can help you achieve your performance and health goals, click the "Services" tab above.
Seroyer, S., Nho, S., Bach, B., Bush-Joseph, C., Nicholson, G., & Romeo, A. (2010). The Kinetic Chain in Overhand Pitching: Its Potential Role for Performance Enhancement and Injury Prevention, Sports Health, 2(2), 135-146.