In Part I of this topic, I went over why practicing safe spotting techniques may reduce your possibility of a progressive or traumatic shoulder injury. Instead of going into more background information, I decided it would be more beneficial discuss the shoulder pre-hab information. I think that this content is much more important and also benefits both coaches and athletes. By investing some time in the exercises, stretches, and myofascial release techniques you can increase your shoulder joint health and possibly reduce your risk of injury.  By keeping your shoulder both flexible and stable, your shoulder will be more prepared for the workload of spotting.  When integrated to training programs, these techniques may aide the athletes in increasing shoulder strength, flexibility, and overall joint protection during training.

I have included pictures of our athletes performing some of the exercises we use, but there are a lot of other pre-hab exercises for the shoulder. The exercises are described as if you were to instruct an athlete, but the information is synonymous if you want to use them for your own benefit as a coach. I recommend picking which ones work with your space and program, and I encourage you to do some research for others.

As a quick side note, I realized a few days ago that I left something important out of last weeks post. Regarding how to reduce the distance between you and an athlete when spotting, a lot of people ask how to get closer to gymnast on bars without risking a face plant. A great solution for this is to use a seatbelt for assistance. Click in a seatbelt around your hips, then anchor it to the pole of the uprights.  Based on how far or close you want to be,  you can pull in or let out more slack. This allows you to lean your weight out while spotting to reach the center of the bars, without overextended your arms. This may help to reduce the stress a lot of stress on your body, most importantly the shoulders and lower back. This is also safer for the gymnast because you are closer to react faster, and can grab close to their center of mass should something go wrong.  I don’t know the price off the top of my head, but I personally feel that the cost is well worth the safety and reduction of stress on the body.

Photo Sep 09, 7 15 50 PM

Spotting High Bar Using Seat Belt for Reach

On to the fun stuff for this week. I included tons of descriptions and pictures of the techniques that I hope they make everything easier to understand. We add all of the exercises to our “Pre-Hab” Circuit 1-2 times a week following a dynamic warm up . We try to place them on days of heavy bar workouts, or sometimes the pre-hab is split up to be within event workouts. This allows us to get the most bang for our buck when time is limited. In the front are rotator cuff stretches, foam rollers, and over splits. In the back left are all our myofasical exercises, and shoulder pre-hab. Many versions of these circuits can be performed with different stations based on your athletes/coaches needs. These types of circuits range in many possible benefits such as aiding in the increase blood flow to muscles, reduction in muscular restrictions, reduction of soreness, and helping to prime the neuromuscular components of the body prior to workouts.

Photo Sep 10, 5 00 20 PM

Pre-Hab Circuit

Shoulder Strengthening Exercises Using Bands/Tubing

Using some sort of elastic tubing or band, have the athlete anchor it around a beam base or bar spreader base (with the exception of deltoid raises). We usually aim for 20 reps on each arm for the following exercises.  After you/the athlete know the routine it doesn’t take long to do. I personally believe the 4 – 5 minutes a few days a week are well worth the time.  Here are some general tips

  1. Take the time to explain these exercises and demonstrate them. This way the athletes understand the reason for it and what it should look like.
  2. As always, quality is the most important to make sure they athletes are getting something out of the exercises. No one wants their athletes simply throwing their arms around doing dance moves. Good form helps with better function.
  3. Make sure the gymnast is close enough or far enough away to feel some tension on the bands/tubes throughout the entire movement. It has to be a balance between no tension/too easy, and too much tension not allowing the exercise to be performed properly/too hard.
  4. All the exercises should be performed with a tight core and proper movement arcs, going through the motion slow and controlled.

Front Deltoid Raises – Standing next to the beam/bar. Starting position is with hands down by the sides, with the athlete standing on the middle portion of the band. With straight arms and a tight core lift both arms straight ahead to the front. I would double check to make sure the athlete is standing on the band. Take it from personal experience it doesn’t feel too good if it sneaks out in the middle of the exercise.

Photo Sep 09, 5 28 12 PM

Front Deltoid Raise: Starting Position

Photo Sep 09, 5 28 16 PM

Front Deltoid Raise: Ending Position

Pec Flys – Facing away from the beam/bar, starting position is with arms slightly below shoulder height  behind the athlete in a “T” position. Pull both arms straight ahead, while not letting the arms drop below shoulder height. Finish with the hands close together in front

Photo Sep 09, 5 28 39 PM

Pec Flys: Starting Position

Photo Sep 09, 5 28 47 PM

Pec Flys: Ending Position

Extended Arm Circles – In the finishing position of the pec fly exercise with hands in front at shoulder height, perform 20 clockwise shoulder circles and 20 counter-clockwise circles.

Photo Sep 07, 2 23 18 PM

Position for Shoulder Circles

Lat Pull Downs – Facing the beam/bar, step back so the tension on the band makes the athletes arms be away from their body. Keeping straight arms the athlete pulls both hands to their hips 20 times.

Photo Sep 09, 5 27 41 PM

Lat Pull Downs: Starting Position

Photo Sep 09, 5 27 49 PM

Lat Pull Downs: Ending Position

Rhomboid/Mid Trap Flys – Standing at the same length as the above lat pull down exercise, raise the arms up to shoulder height. Pull both arms back finishing in a “T” position 20 times, while trying to pinch the shoulder blades together at all times

Photo Sep 09, 5 27 41 PM

Middle Trap/Rhomboid Flys: Starting Position

Photo Sep 07, 2 22 40 PM

Middle Trap/Rhomboid Flys: Ending Position

Standing IR/ER at neutral – Have the athlete start facing sideways next to the beam/bar. The elbow will stay bent at 90 degrees and it is very important that the elbow stays tucked in to the rib cage.

  • For Internal Rotation (IR) the hand closest to the beam/bar pulls starts with the knuckles facing out and ends with the palm flat against the stomach. Pictured as the athlete’s right hand in these pictures
Photo Sep 09, 5 29 05 PM

Standing Neutral Internal Rotation: Starting Position

Photo Sep 09, 5 29 10 PM

Standing Neutral Internal Rotation: Ending Position

  • For External Rotation (ER), the hand farthest away from the beam/bar starts from the stomach and pulls out until the knuckles are facing slightly outward. Perform 20 Internal Rotation reps on the closest hand (left arm in this picture), then 20 External Rotation reps on the hand farther away (right hand in this picture). Then, the athlete can simply turn 180 degrees and repeat on the other arms.
Photo Sep 07, 2 24 51 PM

Standing Neutral External Rotation: Starting Position

Photo Sep 07, 2 25 01 PM

Standing Neutral External Rotation: Ending Position

Kneeling IR at (shoulder height) – This is another exercise that it similar to the standing IR/ER. This however, is at a different angle and allows the athlete to perform a more functional exercise.

  • For Internal Rotation, the athlete kneels facing away from the beam. Both hands are raised to shoulder height, and the starting position is with the knuckles pointing to the ceiling. With one arm, rotate from the shoulder until the palm is facing the ground 20 times. Then repeat on the other arm. Make sure the athlete is trying to pull their shoulder blades “down and pinched together” to avoid compensation.
Photo Sep 09, 5 29 59 PM

Kneeling Internal Rotation: Starting Position

Photo Sep 09, 5 30 12 PM

Kneeling Internal Rotation: Ending Position

Kneeling ER at shoulder height

  • Begin kneeling facing the beam/bar. Start in with both arms at shoulder height, and palms facing down (ending position of IR).  Rotate from the shoulder until the knuckles are pointing towards ceiling, then moves back to the starting position. Perform 20 on each arm, again with the “down and pinched together” emphasis in the shoulder blades.
Photo Sep 07, 2 28 09 PM

Kneeling External Rotation: Starting Position

Photo Sep 07, 2 28 13 PM

Kneeling Internal Rotation: Ending Position

Overhead Wall Ball Stabilization Exercises

  • This is a great overhead functional exercise that is awesome for gymnasts, and targets overhead motion. Due to athletes spending a lot of time with arms overhead, the entire shoulder joint is constantly stressed. Have the athlete stand close facing a wall, with a light ball or light medicine ball overhead with the elbow completely straight in one arm. Engage the core, then use only the shoulder (no bending of elbow) to quickly bounce the ball off the wall 25 times on each arm. They can be done with two hands if it is too difficulty, and can be done at moving angles out to the side.
Photo Sep 18, 5 17 31 PM

Overhead Single Arm Wall Ball Stabilization Exercise – Side View

Photo Sep 18, 5 17 52 PM

Overhead Double Arm Wall Ball Stabilization Exercise – Back View

Photo Sep 18, 5 17 38 PM (1)

Shoulder Stabilization Circles with Weights

This is another exercise series that uses the entire shoulder and rotator cuff joint, and is great for stability/endurance. Using light weights (usually 3-5 lbs is plenty), have the athlete stand and engage the core first then bring the arms out to shoulder height. Holding this position, have the athlete perform 20 clockwise circles and 20 counter clockwise circles, then rest. Perform two sets out to the side then two sets in front of the body. Make sure the athlete pinches the shoulder blades down and back so they do not compensate with their neck/upper trapezius muscles.

Photo Sep 18, 5 19 02 PM

Stabilization Circles Out To Side

Photo Sep 18, 5 19 12 PM

Stabilization Circles Out In Front

Along with these simpler “one plane” motion exercises, a lot of positive support has been coming out to how weight bearing exercises can help to fire the rotator cuff muscle to hold the shoulder joint stable. By using some compression/distraction forces (like weight through a plank), the nervous system reflexively fires the rotator cuff muscles to keep it stable. So, here are some hanging and plank variation exercises that help to challange the stability of the shoulder joint and tone the rotator cuff through distraction (hanging) or compression (planking/handstand type movements).

Hanging Shoulder Shrug Start

Hanging Shoulder Shrug Start

Hanging Shoulder Shrug End - Emphasis on rotating shoulders down and toward each others

Hanging Shoulder Shrug End – Emphasis on rotating shoulders down and toward each others

Plank Shrug Start (shoulder blades together)

Plank Shrug Start (shoulder blades together)

Plank Shrug End (shoulder blades together)

Plank Shrug End (shoulder blades together)

Using Light Weight Dumbell for Core Stability, Shoulder Strengthening, and Biomechanical Alignment

Using Light Weight Dumbell for Core Stability, Shoulder Strengthening, and Biomechanical Alignment

Shoulder/Back Myofascial Release Techniques

Foam Roller –

  • Latissimus Dorsi/Teres Major & Minor: For this the athlete will lay on their side, with their arm outstretched overhead. Using their legs and the free arm, roll up and down the outside of the upper back/lats 10 -15 times on each side after a warm up. Put enough pressure to feel discomfort but not put you through the roof, making sure to hang out on tender points.
Photo Sep 09, 5 22 15 PM

Latissimus Dorsi/Teres Major & Minor Foam Roller Position

  • Middle Back – The athlete will lay with the foam roller under their shoulder blades, and with the arms over head. Keeping the lower spine neutral, you can extend over the foam roller to work on the mobility of this area.
Thoracic Extension Drill - Start

Thoracic Extension Drill – Start

Thoracic Extension Drill - End

Thoracic Extension Drill – End

Golf/Lacrosse Ball –

  • Latissimus Dorsi/Teres Major and Minor  – Standing sideways against a wall, place the lacrosse ball or golf ball close to the armpit but more on the outside. Bring the arm overhead, then lean into the wall. Move around the lats and shoulder blade area for tender points, then try to hold and massage them out. This one is a doozy, and the athletes usually make some fun faces.
Photo Sep 09, 5 23 21 PM

Self Trigger Point Using Lacrosse Ball for Latissimus Dorsi/Teres Minor & Major

  • Middle Back/Rhomboids/Middle Trapezius – Place the lacrosse ball or golf ball between the shoulder blades facing away from the wall. Bring the arms across the chest and then lean back into the wall while moving side to side to find trigger points.
Photo Sep 09, 5 23 32 PM

Self Trigger Point Using Lacrosse Ball for Middle Trap/Periscapular Muscles

  • Upper Trapezius – This is usually a huge tension point and very sore on many athletes. Put the Lacrosse Ball/golf ball on the lower neck/upper shoulder area and turn slightly into the ball. The athlete can also tuck the chin in and rotate their head in the opposite direction to lengthen the muscle (in this picture she would look to the left armpit.
Photo Sep 09, 5 23 42 PM

Self Trigger Point Using Lacrosse Ball for Upper Trapezius

  • Pectoralis Major and Minor – Another favorite, usually best done on the edge of a floor or mat. Place the lacrosse ball on the front of the shoulder/chest area, below the collar bone and near the arm pit. Lean down on the lacrosse ball and then move around the pectoralis muscles to find trigger points
Photo Sep 09, 5 24 39 PM

Self Trigger Point Using Lacrosse Ball for Pectoralis Major

Summary Thoughts

Many of these exercises can be added in during circuits or events, in order to save time and space. Along with this,  once the athletes are shown the proper form for the exercises they can perform them on their own. Elastic bands, golf balls, and lacrosse ball can be bought for very cheap. They can put them in their gym bags so they are always available and can be used when they get some spare time. I personally feel that these exercises have a very important role for all athletes, and with some education they are not hard to perform. They are a great tool to utilize after heavy conditioning, or when athletes complain of muscle soreness.

I’m not alone in this idea, I have talked to many high level coaches who stress these types of exercises as well. At national congress I sat in on a few of Valeri Liukin’s lectures, and he mentioned that all of his girls do a shoulder pre-hab circuit. The have their own elastic bands in their bags and use them before each practice or meet. He has a pretty good track record so, I was happy to hear him say it. Along with this, many well establish college teams and also many of the national team members keep this as a staple in their repertoire.

As it pertains to coaches, I would suggest using the same bands and tools as the athletes within the gym. Especially on days you will be spotting a lot, I believe they are excellent ways to potentially reduce the risk of shoulder problems in coaches. If you exercise separately at a workout facility, I believe it is easiest to place them within workout routines as an “active rest”. That way you can perform the exercises and find time for them a few days a week. If your curious, try some of them on your floor after reading this post.

I hope that from the last two weeks of posting you view the topic of shoulder safety differently for both athletes and coaches. Next week I will begin another important topic dealing with flat feet within gymnastics, and why it should be on your radar as well. As always feel free to share the information, discuss your ideas, and comment. Best of luck,

Dave

References

  • Manske R., et al. Current Concepts In Shoulder Examination of The Overhead Athlete. IJSPT Oct 2013; 8(5): 554 – 578
  • Myers, TW. Anatomy Trains: Mysofascial Meridians for Manual and Movement Therapists. Second Edition. 2009
  • Cook G., et al. Movement –  Functional Movement Systems: Screening, Assessment, Corrective Strategies.  First Edition. On Target Publications, 2010.
  • Oscar E. Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction. Lotus Publishing: California; 2012
  • Page P., Frank C.C., Lardner R.. Assessment and Treatment of Muscle Imbalances: The Janda Approach. Sheridan Books; 2010
  • Brody LT, Hall CM. Therapeutic Exercise: Moving Toward Function. Third Edition. Baltimore, MD: Lippincott Williams & Wilkins; 2011.
  • Peak Performance: The Research Newsletter on Stamina, Strength and Fitness. Shoulder Injuries: Prevention & Treatment. 2004; Peak Performance Publishing, Goswell Road, London.
  • Magee D. Orthopedic Physical Assessment. Fifth Edit. St. Louis: Saunders Elsevier; 2008.
  • Neumann DA. Kinesiology of the Musculoskelatal System: Foundations for Physical Rehabilitation. First. St. Louis: Mobsy Inc. 2002:103 – 111.