Master Class: The Shoulder

The Shoulder 

• Glenohumeral joint is the main Shoulder joint. Ball and socket, very mobile joint. Movements: flexion, extension, abduction, adduction, internal and external rotation, circumduction.

• Acromioclavicular joint very common joint to separate when falling on your arm, snowboarding, biking etc.

• Sternoclavicular joint

• Scapulothoracic joint, the ”floating joint"

• Shoulder Girdle is the clavicle and scapula

The scapula can perform six actions

• Elevation: upper trapezius and levator scapulae.

• Depression: lower trapezius.

• Retraction (adduction): rhomboids and middle trapezius.

• Protraction (abduction): serratus anterior.

• Upward rotation: upper and middle trapezius.

• Downward rotation: rhomboids.

Rotator cuff muscles SITS

Rotator Cuff is the core of the shoulder. Rotator Cuff muscles as a group hold the head of the humerus in the socket.

• Suprapintaus- abduction

• Infrapinatus- external rotation

• Teres Minor- external rotation

• Subscapularis- internal rotation, adduction
  
  

Rules for a Healthy Shoulder

1. Scapula needs to be mobile along ribcage to maintain scapulohumeral rhythm.

2. Scapula should be stable on ribcage when doing planks/push-ups/weight bearing on arms. (serratus anterior must be strong).

3. Humerus needs to be stable in the socket; the rotator cuff must be strong.

4. The shoulder needs to be in correct placement, “neutral shoulder”; Pectorals need to be correct length - not tight.

General Strategies

• Release trigger points in the shoulder area with a pinky ball

• Stretch/release pectorals If shoulders are rolled forward.

• Stretch/release mid-traps and rhomboids if shoulder blades “wing”.

• Work on scapular and ribcage mobilization using breath.

• Strengthen rotator cuff and serratus anterior.

Stretch and Release Exercises

• Release Shoulder muscles with pinky ball 

• Lying supine: Lie on pinky ball and release all posterior shoulder muscles, rotate arm while on pinky ball

• Against the wall for pectoral release (making out with the wall)

Lying on a Roller 

• Basic Shoulder Set

  • Shoulder Slaps (scapular mobilization, rhomboid release)

  • Arm Reaches- lat/tricep stretch, separation of church and state

  • Chicken Wings- pectoral stretch

  • Arm Circles- more pectoral stretching and mobilization 

Lying Sideways on an Arc or on a mat with pillows under waist and head.

• Scapular mobilization

  • Breathe into ribcage, add arm reaches above ear using breath.

  • Telescoping Arms

  • Windmill Arms

Strengthening Exercises

• Theraband

  • External Rotation: Teres minor, infraspinatus: is especially critical in stabilizing the shoulder during medial rotation to prevent anterior dislocation of the humerus.

  • Internal Rotation: Subscapularis is a powerful defense to the front of the shoulder joint, preventing displacement of the head of the humerus.

  • Abduction: Supraspinatus, only 10 degrees necessary.  prevents the head of the humerus to slip inferiorly

  • Scapular Adduction: Rhomboids, middle traps - need to attach to a bar

• Reformer

  • Seated on Long Box facing back or Kneeling

    • Chest Expansion

    • Rhomboids

    • Middle Traps

    • Rotator

  • Seated Sideways on Long Box or Moon Box or Kneeling

    • External Rotation

    • Internal Rotation

    • Abduction (Supraspinatus)

Winging

If Shoulder blade “wings” during planks, stabilize scapula by strengthening Serratus Anterior. Release rhomboids, middle traps if tight.

• Exercises

  • Mat: Forearm planks are the best way to strengthen serrates anterior.

  • Reformer: Serratus series (control front on forearms).