Upper body rehab
Shoulder injuries are becoming very common within the fitness and all rehabilitation exercises for the upper limbs needs to have an emphasis on making sure the shoulder blade, shoulder joint and arm are moving correctly and in the right movement sequence. If you do not rehabilitate the correct way, you will find without the ‘scapula humeral rhythm’ you will struggle to improve with any shoulder injury and therefore never reach 100 per cent.
Most people will feel pain and tightness in their shoulders when they have an injury due to the messages from the brain, from tissue damage and then the inflammation activates a ‘threat messaging system’.
This is then interpreted as pain, and quickly inhibits the stabilising muscles for the shoulder blade and shoulder joint. The brain then starts to compensate with other muscles to get the arm moving. This then starts a reaction of tightening other muscles, and in turn creates more irregular movement patterns.
If the postural and stabilising muscles are not rehabilitated early, you can get stuck in an incorrect movement pattern.
The exercises you need to focus on are stabilising the muscles of the shoulder blades, slowly building strength and stability for the shoulder. Then progress onto the rotator cuff stability with strength and control. As the exercises get harder and more advanced, you need to maintain scapula stability throughout, and this principal needs to be applied throughout the training regime. You must complete correctly in order to activate and stabilize the shoulder blade.
PRONE SCAPULA PRESS
On your hand and knees place knees hip distance apart and hands shoulder distance apart. Push through your hands and push your ribs into your shoulder blades to flatten you scapula. Do not hunch your shoulders or arch your thoracic spine (lower back).
SINGLE ARM SKYDIVE
Lie on floor on your stomach with your head resting on the hand of your good shoulder arm. The shoulder that is tight, have it straight out beside you, keep it straight – then lift it off the floor. Do this by focusing on slowly pulling up the shoulder, moving down and back to the opposite hip. Hold this position and rotate your arm outwards and upwards.
This is great for isometric lower trapezius (neck) activation, building strength in the scapula. Don’t lift too much as then you’ll use other muscle groups.
SINGLE ARM ROW
Use a resistance band tired around a pole and either sit or stand facing the pole. Slowly pull your shoulder down and back first with a straight arm, then pull through with arm bending at the elbow. One the return of the arm, hold the shoulder blade back. Think shoulder blade/arm/arm/shoulder blade.
This exercise helps correct the scapula humeral rhythm, strengthening the lower trapezius and posterior rotator cuff, and teaches you eccentric retraction control of the shoulder blade.
Be mindful not to raise your shoulder up when completing this exercise.
ROTATIONS
Again with the resistance band – stand side on to the pole with tight shoulder away from the pole.
Keep your arm slightly away from the body, but don’t let your elbow move during the rotation. Your scapula needs to remain stabilized (still) through the movement.
This is helpful for the rotator cuff as it teaches isometric scapula stability during the dynamic ration movement of the shoulder joint.
Be mindful not to pull your shoulder blade back too far, hitch it or let it roll forward.
To advance the last two exercises you may use heavier bands and then onto light weights, but always work through the exercise with control and stability before increasing the weights all the time. Heavier is not always best – control and use of the right muscles are for increasing the scapula and rotator cuff.
Always refer to a physiotherapist for advice on further progression exercises and have you trainer work with them so they can work with you.
