We’ll continue our shoulder series with Part II today. You can catch Part I here if you haven’t already.
So with the athlete in question that we talked about in Part I the overwhelming question is what do we do with him now.
The non glamorous answer is that he will crush soft tissue work, as well as be manually stretched. We have to restore that range of motion quickly as our fall ball season is starting in less than 10 days and pitchers are already starting to throw bullpens. I will manually stretch him every other day, and this is only due to our schedule this week. Starting next week I will be able to stretch him everyday. In the mean time he will still stretch himself at least two times a day, everyday, with a variety of different movements, as well as be stretched by our athletic trainer everyday. I would rather have increased frequency when it comes to stretching than a high intensity only once per day. Doing three sessions per day easily is in my opinion much more effective.
When he stretches himself he will do so with the side lying sleeper stretch as well as the side lying cross body stretch. We teach our athletes to be gentle with these two variations. Depending on the severity of the deficit in the affected arm, we will hold our reps 5-15 seconds with anywhere from 3-7 reps. The below photo is the athlete’s first time trying the sleeper stretch with our technique. When we’re in the weight room we have the availability to utilize the foam rollers as a head support, which I stole from Eric Cressey. It also gives athletes a cue as to being in the proper position as well. I’ve had a lot of good feedback from adding in the foam roller for support from our players.
The sleeper stretch is one that’s easily done wrong. We always want to cue our athletes to have their shoulders stacked on top of each other. More times than not athletes just lay down and start cranking on that arm. If you’re forearm can touch the floor, or even get close you’re not set up correctly and you’re definitely not getting motion from only your shoulder. Stacking your shoulders with the scaps pulled back and stabilized allows for the motion to come from the glenohumeral joint, which is what we want.
As far as the soft tissue goes, we will roll, smash, crush, etc. everything he can find from his spine to his armpit using a variety of tools. The LaX ball will go a long way in this area. Rolling out the teres minor, infraspinatus will begin to free up IR as well as foam rolling the t-spine and lats to help increase flexion overhead.
From here on out we will re-evaluate his motion every week until he has regained that motion.
He will continue with all his all important scapular stabilization work training the lower and middle trap, as well as the serratus anterior.
Alongside of that we have active stretches that will help generate more internal rotation as well. These are tied into our thoracic spine mobility program. Obviously the t-spine is super important when it comes to shoulder health and directly tied into the act of pitching. Here is one of our upper level t-spine progressions.
Screening our new, incoming athletes is always an eye opener. In the coming days I’m planning on going over impingement, the different forms of, and the treatment options to relieve the problems. The beauty of having 10 new incoming athletes to our program right now gives me loads of information and I get to see a whole new host of problems and then talk about it fixing them here.