Shoulders are one of the most commonly injured areas that I work with for clients wanting to return to physical activity. Let’s take a moment to talk about shoulder health in general, then move onto some pieces of information that can apply to any body area.
The Shoulder’s Role in Athletics
The shoulder needs to have a combo of strength, stability, mobility, and power in all directions in order to have a successful participation and athletic activity, especially with any sport that requires you to go into an overhead position.
A shoulder by design isn’t created to bear weight. It’s a ball and socket joint similar to our hips. This allows it to be very mobile, but mobility can potentially lead to instability.
Our hips have a capsule of ligaments surrounding them to give stability, because they were designed to bear weight. Our shoulders don’t have that capsule, so we are able to reach out and around better. As we evolved, that mobility has led us to having more potential for injury not only in athletics, but in life in general.
Why does the shoulder get injured in athletics?
There’s truly no one specific cause or reason. It’s often due to multiple of the following, adding up together:
Poor exercise technique (when performing movements)
Poor strength (asking your body to do more than it’s capable of)
Poor endurance (not training for sustained periods of movement)
Repetitive motions (the same movement over and over again)
A traumatic event (a fall, specific injury in the gym)
Nervous system dysregulation (a HUGE part of injury potential - more on this a bit later)
Lack of adequate and intentional warm-up
Poor focus on recovery (not just what you do in the gym, but what you do outside of it as well)
This list is not exhaustive - are there some other things that might contribute? Absolutely. We will talk about a few of these pieces a little later in this writing.
Early intervention
Why is early intervention important? To get back to the things you love to do as soon as possible and limit the risk of chronic pain. Being prepared for the possibility of injury allows you to recover from it quicker.
There are two ways to look at strength training relating to injury:
Prehabilitation - working on improving strength, mobility, and power before an injury happens
Rehabilitation - returning to full strength, range of motion, and functional activity, following an injury or overuse.
To target prehabilitation (to prevent injury), we need to focus on 2 portions of training:
Nervous system regulation
Having a nervous system that is ready to be challenged seriously affects your ability to successfully prepare your body to prevent injury. You need to have a mind-body connection that takes into account your past experiences with exercise, injury, and your brain’s willingness to make a consistent change.
Exercise is uncomfortable. It’s supposed to be!
It allows you to push your body past its current limit to build strength. But if a nervous system is dysregulated - it makes it incredibly hard to make true strength gains to prevent injury.
An Adequate warm-up
Lifting weights = a big demand on the body, so we need to adequately prepare for success. Warm-up decreases the risk of injury and improves your performance in the gym. A warm-up with a focus on stabilization and engaging the support your body needs to perform repetitive motion during workouts can limit your injury risk.
Before workouts - in order to prevent pain from happening, make sure you prepare by doing your warm up!
Not just for your shoulder, but core as well (focus on stability)
Focus your exercises in all positions
Dynamic movement is better than holding a stretch
My (insert body part here) hurts – what should I do next?
When thinking about rehabilitation (following an injury), we wanna make sure that we’re addressing pain as soon as possible.
During your workout, you might notice pain when completing an exercise. From there, you stop and assess:
Where the pain is
Which motions cause the pain
How you would describe the pain (sharp, dull, achy, pulling, twisting, grinding, etc.)
After assessing the items above, you want to continue your workout. Before proceeding:
Talk to your coach or trainer if you’re together
Adjust the set (always can ask a coach or trainer for help with this!). You can decrease the weight or number of reps, or transition into a more supportive position for your exercise.
If adjusting the set doesn’t help to decrease the pain, you can always complete a different exercise that targets the same muscles.
After your workout is complete:
Consider the way that you feel immediately after, and the following day
Find ways to rest the area without completely immobilizing
Focusing on mobility without overwork is important. You should be able to complete a gentle, pain-free range of motion.
Prioritize all aspects of recovery to help set you up for success for your next training session
A question that I get asked very commonly is: “When should I seek out a second opinion for pain?”
If:
Pain continues after 1 to 2 training session
Pain doesn’t improve with rest and active recovery
Pain impact sleep or daily activities outside of the gym
Pain “just doesn’t feel right”
You don’t have to just live with pain - this causes our nervous system to become dysregulated and can prolong your recovery. When you live with pain, you start to lose your strength quickly, and it’s significantly more challenging to gain strength back.
Who can you seek out a second opinion from when experiencing pain?
A coach or trainer
A physical therapist (you don’t need a referral from a doctor in Alaska)
Your primary doctor
An orthopedic specialist
Shoulder health is important because it significantly impacts the way that we live and train. But all of the above information can be applied to any part of the body. Focusing on maintaining joint health and addressing injuries as they pop-up leads to a more consistent participation in activities.
How Breakout PT’s Approach is Different
Focusing on not only your physical health, but starting with your nervous system health is the basis of all evaluations with Breakout PT. As I indicated earlier in this post, if your nervous system is dysregulated, the process for improvement isn’t being maximized.
If you’re an active individual, you’re likely tired of being told you “can’t” do an activity, or you need to “choose something different”. I don’t share that same philosophy.
If an activity is meaningful to you, then it’s meaningful to me. I want you to be able to participate in your activities. Having a goal that is motivating to not only your brain, but your nervous system as well will help keep you motivated and your body prepared to do the work.
A Few Important Last Thoughts:
Make sure you share your experience with the people that are in your corner – that way coach/trainer, partners, and you (the athlete!) are all on the same page. It may be nothing, but you don’t want to be pushing through the pain that could be approved quickly with the right attention. A physical therapist is often a great place to start - as PT has the ability to evaluate and treat these small injuries before they become a big deal.
Gentle mobility exercises are key early on! You should not be pushing through pain with these, it should feel good. If it doesn’t, stop immediately and reach out to a professional to make a plan for next steps.
Recovery is the second most important part of injury rehabilitation (the first being everything included in prehabilitation!). This also allows you to work towards decreasing pain in the moment. Doing nothing (completely immobilizing) oftentimes can prolong the healing timeline.
This may look different for different people, but the main recovery focus should be on hydration, adequate fueling, quality sleep, and soft tissue work as needed.
Ready to focus on a different approach for your shoulder and nervous system health?
Contact me on my website below for a FREE Discovery Call: breakoutptandwellness.com
Wishing you strength, health, and unrestricted participation in your favorite activities!
