Training for Injury Prevention of the Shoulder

1. Training for Injury Prevention of the Shoulder Paul Pursley PT CSCS University of Iowa Hospitals and Clinics

2. Non-trainable Variables • Appropriate Gear • Good Genes • Good Sportsmanship • Bad Luck

3. Trainable Variables • Sport Specific Skills • Flexibility • Strength • Balance • Biomechanics

4. What Kind of Throw are We Training For?

5. Phases of the Overhead Throw • Wind-up Phase • Cocking Phase • Early cocking phase • Late cocking phase • Acceleration Phase • Deceleration Phase • Follow Through

6. Wind-up Phase • Single limb stance • Core musculature

7. Cocking Phase • Early Cocking Phase • Minimal muscle activation at global shoulder • Late Cocking Phase (Front foot planted) • Moderate Pectoralis activity • Cocking completed by Pec/Lat

8. Acceleration Phase • Pectoralis Major • Subscapularis • Latissimus Dorsi • Teres Major • Serratus Anterior • Trunk/LE MM

9. Deceleration Phase • Posterior Deltoid • Infraspinatus • Teres Minor • UT/MT • Rhomboids

10. Standards for IR/ER Ratio • ER approx. 66% of IR strength during isokinetic testing. • Reminder of importance of rotator cuff and scapular stabilizers

11. Strength Training…

12. Thrower’s “Ten” • Thrower’s 12 • Shoulder Extension, Shoulder Flexion, IR/ER at 0° abduction, IR/ER at 90° abduction, High/Middle/LowRows, Scapular Punches (Dynamic Hug), Throwing Acceleration, Throwing Deceleration. • On the Field Resistance Tubing Exercise for Throwers: an EMG Analysis. Journal of Athletic Training. 2005 Jan-Mar, 40(1) 15-22

13. Shoulder Extension

14. Shoulder Flexion

15. IR/ER at 0° Abduction

16. ER/IR at 90° Abduction

17. High/Middle/Low Rows

18. Scapular Punches”Dynamic Hug”

19. Stabilization • High speed resisted target reach • Pertubation training • Body weight resisted • UE walking • UE weight bearing on unstable surfaces

20. Multiple Joint Lifts • Push Press • Clean and Snatch • High Pull • Bench Press

21. Multi-Planar Lifts • PNF Pattern DI/DII • Dumbbells, Kettle Bells, Resistance Tubing, Cable Column • Resisted Overhead Throw

22. Plyometrics • Med Balls • Anterior-Chest pass • Posterior-posterior throw • Body weight • Box push-up

23. Periodization • Off Season • Hypertrophy/Endurance Phase • 6wks, 60-70% 1RM, 10-12 repetitions • Low intensity-High volume • Strength Phase • Increase to >80% 1RM, 5-8 repetitions • Initiate plyometric training

24. Periodization • Preseason • Power Phase • 6-8 weeks prior to competition phase • Lower volume-Increased intensity • 90% 1RM • Allow full recovery between sets

25. Periodization • Competition Phase • Low volume-High intensity • Sport Specific Considerations • Length of season • Aerobic vs. Anaerobic • Impact vs. Non-impact

26. Principles for Implementation • Incorporate into existing practice • Exercise selection • Thrower’s “10” • Stabilization Exercise • Medicine balls for anterior and posterior shoulder plyometrics • Body weight resisted • Pull-ups • Dips • Rope climb • Peg board

27. Thank You!