The info and video in this post came about because I’m in the process of putting together a really cool 4 part article series about shoulder pain in gymnasts. Also, this week in the gym my boss was doing a flexibility circuit, and knowing that some of our girls have super flexible shoulders she asked me if I could come up with pre hab stability exercises for them to do instead. This made me so happy that she was making the coaching decision to separate our gymnasts this way, and it made me want to put this post together even more. I think it would be helpful for all coaches/gymnasts to approach training with their gymnasts in this way. I have been spending an incredible amount of time reading and researching about shoulder problems in relation to gymnastics. This is because of some gymnastics patients I have in the clinic, but also because I have been building more science based shoulder pre-hab/gymnastics drills/conditioning for our girls team.

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One of the patterns I have picked up on from my experiences coaching and working with gymnasts with shoulder issues is that we sometimes develop tunnel vision and hyper focus on the shoulder. This seems to be especially true when it comes down to a gymnast with “unflexibile shoulders”. There is a TON that goes into why a gymnast may have trouble getting their arms fully overhead to extreme ranges for gymnastics skills. A few examples include:

  • How well the gymnast’s core is working as a stable base for movement, or how well  they are using it during gymnastics skills
  • How well their middle /thoracic spine is moving, and if they are using their middle spine motion properly
  • How well the shoulder blade is doing its job to help the shoulder joint with motion and control
  • How the neck/ cervical spine position is during skills in relation to the moving shoulder
  • Muscles that influence the shoulder joint getting tight from training or conditioning, then not being treated with recovery/mobility work
  • Non balanced conditioning for all areas around the spine, chest, and shoulder creating imbalances
  • Problems related to the brain over using certain muscles when others aren’t doing their job ,which leads to some muscles appearing to be tight.
  • Simply having technique errors with gymnastics skills. where the gymnast may not understand they need to use certain areas to get their arms overhead, rather than cheat and compensate with other areas
  • What the gymnasts is doing the other 20 hours during the day that they are not in the gym creating problems related to posture and movement (are you hunched over forward at your desk or phone reading this?)

In reality, these are just a few examples and the list could go on for different scenarios as every gymnast moves differently. There can be situations when the gymnast doesn’t have enough motion, situations where the gymnast has too much motion, and situations about certain parts not working well together that can all lead to pain. But I hope you can see that there is a lot more to it than just the shoulder itself.

In conjunction with the tunnel vision concept, I think that it comes to reality during practice when we focus so much on how much the shoulder can move, and not how the gymnast’s entire body system or movement chain links together during skill work. You can’t vault without having a good run, board position, entry, flip mechanics, and landing. Same concept applies here, can’t have good shoulder joint motion/performance without sound mechanics in the core, thoracic spine, shoulder blade, cervical spine, and other areas.

There are tons of gymnasts that already have plenty of shoulder flexibility because they are inherently mobile individuals. This is sort of natural selection, because chances are they didn’t continue on with gymnastics to a high level if they weren’t super gumby like and being bendy.  Cranking on that gymnasts shoulder more is not only probably torture for that gymnast, but it can also be extremely dangerous, and is likely decreasing their gymnastics performance in some way.

This gymnast doesn't need more shoulder stretching

Lots of shoulder flexibility, doesn’t need to get cranked on

I will be very honest, I absolutely cringe sometimes watching coaches/gymnasts in videos online or in a gym crank on shoulders for flexibility when in reality the shoulder may not be the issue at all. It actually may be the opposite, the shoulder may have plenty of motion and another area is not doing it’s job to help out. Although this creates the overall picture that the bridge/back handspring/bar swing/vault may still looked out of whack, remember it may be because of an issue outside of the shoulder. It actually may not be related to mobility or flexibility at all. A gymnastics analogy would be if two different gymnasts were both not landing the same back full on floor, but one person’s problem was related to the back handspring being too high and the other was related to the their twisting mechanics. Each gymnast needs different drills and coaching to get to the problem.Giving the twisting mechanics gymnast back handspring drills likely wouldn’t get them anywhere fast, and visa versa for the other gymnast.  The same idea holds true for addressing the way the body moves, different solutions for different problems.

Shoulder Hyper mobility and laxity, this gymnast needs to control this motion, not get stretched for more

Shoulder Hyper mobility and laxity, this gymnast needs to control this motion, not get stretched for more

Some coaches or gymnasts may see this bridge and say that her shoulders need to “open more” to get a full bridge, then pull her into a bridge stretch at her shoulders

Photo Jun 12, 7 43 34 PM

However, when you look at her overhead shoulder motion not in a weight bearing bridge posiiton, she actually does have mobile shoulders

Photo Jun 12, 7 43 49 PM

As can be seen with these two tests and by working through an assessment her thoracic mobility (middle spine not moving like it should) is really the bigger issue that is making her bridge limited.

Photo Jun 12, 7 44 27 PM Photo Jun 12, 7 44 33 PM

 

I do not recommend coaches try to do process above, refer to or consult with a medical professional who knows what they are doing. I made sure to narrow in on this to confirm a thoracic mobility issue. It’s really just to get the point across about how its more than just the shoulder. Tons of work stretching the shoulder might not fix the bridge issue, not to mention really uncomfortable for the gymnast.

Don’t Make An Unstable Shoulder More Unstable 

Right along these lines, I personally feel that certain shoulder stretches like a “skin the cat” position and an “over bridge” stretch that really pull on the shoulders aren’t appropriate for many gymnasts that already have excessively mobile shoulders. These mobilizations when done correctly can be fantastic for someone that is lacking good mobility or has restrictions, or someone who needs this large shoulder range of motion like men’s gymnastics for pbars, rings, dipping motions etc. In that case where they actually need more mobility we have a “back handspring drill for a back handspring problem” like I noted above in the analogy, but there are more ways than just pulling on a gymnasts shoulders to address the issue.

However, these same mobility exercises used on on very flexible or lax gymnasts can be problematic because it may not be what they need, nor what is safe for them. You may end up putting way more stress on the passive shoulder structures like ligaments and joint capsules which you definitely don’t want making more lax. They need whatever is left in those passive structures as support to help out muscles and other active structures. In fact, these gymnasts should be spending a lot of time on shoulder stability drills because we don’t want them relying on passive ligaments, capsules, and joints to keep their shoulder in one piece. They need the passive structures and active structures working to keep the shoulder from sliding all over the place, damaging certain shoulder areas, and limiting shoulder stability needed for gymnastics skills. Take this gymnast below who fits this category, this picture was for a reference but we actually don’t let her do this drill (and many others) because of her overall laxity.

Shoulder Hyper mobility and laxity, this gymnast needs to control this motion, not get stretched for more

Shoulder hyper mobility and laxity, this gymnast needs to be taught to control her shoulder mobility, not get stretched for more

I have unfortunately seen (and experienced in my career a gymnast) when a coach pulls/gymnast pushes on these type of static bridge and shoulder stretches causing pain that may be much more dangerous than beneficial. These stretches are usually intended for pec muscle stretch or other muscles on the front of the shoulder, which the coaches/gymnast may wrongly assumes is why pain is present. But in reality, it may be because they are stressing/pinching/irritating some of the joint structures like the rotator cuff tendons or biceps tendon. If you ask a gymnast where or what they feel in the stretch and they say “it’s sharp on the top/outside of my shoulder”,  this is NOT good and definitely not what you set out to accomplish.

Taking a super mobile shoulder joint and stretching it to be more mobile is not going to help the gymnasts performance and also may increase their risk of shoulder damage over time  with gymnastics training. It may be aesthetically pleasing and the gymnast may think it’s cool to bend their joints in half, but you have to weigh the pros and cons of their performance and injury risk.  As a coach or gymnast, I encourage you to stop and think about what is happening in that shoulder joint if you blast away stretching their shoulder during warm up/flexibility for 10 minutes, then ask that gymnast to grip up and swing bars for 45 minutes where forces up to 3x their body weight are going through that same super mobile shoulder. In my mind this could be one reason why shoulder instability might be an issue for many gymnasts leading to reoccurring pain and injuries. Even though every case is different and it’s hard to generalize, I think this is a pattern based concept we need to step back and think about in relation to all injuries, not just shoulders.

Quick Video 

I’m not going to dive into this very complicated topic too much for this post, because I want it to be on the shorter end. However more to come when I finish the shoulder article series I mentioned. But for now, take a look at this video where I walk through a few brief concepts about this topic with one of my gymnasts. I left out a lot of stuff on purpose and have also previously given her an entire assessment where we broke down her movement and gymnastics skills.Think more about the ideas behind it, not the nitty gritty stuff about how little/far her shoulders move, etc. I simply wanted to have a video out and get coaches/gymnasts thinking out there. Sorry in advance for some of it being choppy, lots of people walking around so I had to edit through some of it.

 

Hope all this little shoulder stuff was helpful for readers to see, more shoulder stuff coming out soon,

Dave

 

 

References

  • Reinold, M. Cressey, E. Functional Stability Training for the Upper Body; 2014
  • Andrews, J., Reinold, M., Wilk, K. The Athlete’s Shoulder. Second Edition, 2009
  • Paine, R., Voight, M. The Role of The Scapula. IJSPT: 8(5): 617 – 629; 2013
  • Manske R., et al. Current Concepts In Shoulder Examination of The Overhead Athlete. IJSPT Oct 2013; 8(5): 554 – 578
  • Oscar E. Corrective Exercise Solutions to Common Hip and Shoulder Dysfunction. Lotus Publishing: California; 2012
  • Andrews, J., Reinold, M., Wilk, K. Current Concepts in the Evaluation and Treatment of the Shoulder inOverhead Throwing Athletes, Part 2: Injury Prevention and Treatment. Sports Health: A Multidisciplinary Approach 2(2) 2010