Shoulder pain whether it’s transient or chronic, is one of the most common conditions we see at our clinic among the athletes who train and compete in mixed martial arts and other combat sports.Shoulder pain whether it’s transient or chronic, is one of the most common conditions we see at our clinic among the athletes who train and compete in mixed martial arts and other combat sports. The most common shoulder disorders we come across are rotator cuff impingement syndromes, tendonitis, and rotator cuff tears.
The shoulder is the most mobile and flexible joint in the human body, yet it is only held together by four rotator cuff muscles, a joint capsule, and ligaments. Consequently, it is an area that sustains a lot of overuse from basic activities of daily living and even more when placed under loads from training or competition.
If you have pain in the front of your shoulder with overhead activities or when reaching across your body, you may be suffering from a rotator cuff impingement syndrome. As the name suggests, there are structures in the shoulder that get “impinged” or pinched beneath the acromion as the arm is elevated or reached overhead. A common cause is from repetitive use or overtraining. If muscles in the shoulder girdle and rotator cuff are not balanced, it is common to develop an impingement syndrome. When the muscles that stabilize the shoulder blade and keep it pressed against the ribcage are shortened or hypertonic, normal range of motion about the shoulder joint will be limited. So in essence, every time you raise your arm above your head, or throw a cross or hook, your rotator cuff muscles can become trapped, irritated, and eventually torn.
Shoulder impingement syndromes quite often lead to tendonitis or tendinosis of the rotator cuff. Almost 90% of the time in our practice we see some degree of tendonitis of the supraspinatus muscle when there is a shoulder impingement syndrome. Over time, continuous impingement of the rotator cuff can lead to microtears or full thickness tears when acute trauma is involved.
What’s the solution?Listen to your body. Chances are if you keep doing the same motion over and over and you continue to have pain or discomfort, it won’t magically disappear. Find a competent sports doctor, chiropractor, or physical therapist that can assess your shoulder and put you on a program to stretch what’s tight, strengthen what’s weak, and mobilize the joints that aren’t moving properly. We also have good success using ART (Active Release Techniques) along with traditional physical therapy modalities like ultrasound and electrical stimulation to rehab shoulder injuries.
The following exercises are the ones we generally prescribe to our patients that have weak rotator cuff muscles or problems with shoulder stability. We recommend our patients do three sets of 12-15 reps at a frequency of three times per week for about four to six weeks followed by an evaluation and changes or additions as necessary. Exercise bands and elastic tubing should be used initially and then progressed to light weights and cable machines. Some of these may be contraindicated in certain instances, so you should not do them if you experience sharp pain or locking in the shoulder. It is by no means recommended for everyone, but if you have shoulder instability these exercises will help strengthen the rotator cuff.
1. Shoulder External Rotation (Figure 1A and 1B)
2. Shoulder Internal Rotation (Figure 2A and 2B)
3. Supraspinatus/Shoulder Abduction (Figure 3A and 3B)
4. Shoulder Retraction (Figure 4A and 4B)
5. Shoulder External Rotation with Arms Elevated (Figure 5A and 5B)
6. Shoulder Internal Rotation with Arms Elevated (Figure 6A and 6B)
Photo is of Greg Souders (Mike Moses/Lloyd Irvin Purple Belt).
Contact info: Dr. John H. Park, D.C., C.S.C.S.Progressive Spinal & Sports Rehab10076 Darnestown Road Suite 200Rockville, MD 20850www.ProSpineRehab.comwww.yourMMAdoctor.comPhone: (301) 294-5101