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Shoulder Stability in the Overhead Athlete

The shoulder is one of the most complex parts the body. It consists of four separate joints that are linked together by multiple muscles, tendons, and ligaments that provide both mobility and stability to the shoulder. The shoulder is a “ball and socket” joint with the socket portion being shallow and therefore providing very little stability via the bony anatomy. As a result, you have to rely on other structures to keep your arm securely inside the shoulder blade. When your arm is at rest your shoulder is primarily stabilized by the joint capsule that fully encloses both the ball and the socket. During arm movement the stabilization process is much more complex and requires the four muscles of your rotator cuff to fire to maintain proper positioning of your shoulder joint. 

The action of lifting your arm up above your head requires movement from both your shoulder blade and your arm in order to reach your full range of motion. For this movement to be performed correctly, it requires the proper muscle firing patterns in the shoulder complex. Athletes tend to forget about the small stabilizing muscles of the rotator cuff during their workouts and instead focus on the larger muscle groups, i.e. the pecs, deltoids, lats, etc. These big muscle groups, especially the “pushing” muscles which are used frequently in sports, can become overdeveloped in comparison to the small stabilizing muscles and result in injuries from this muscle imbalance. One of the most common issues from a muscle imbalance like this is that the small rotator cuff cannot compete with the larger muscles and is unable to perform its job of providing small rotational movements to the ball part of the joint to prevent it from hitting into the socket during arm movements. 

It is important to remember that the rotator cuff is not only firing during athletic activities, it is also responsible for proper positioning of your arm and shoulder blade while you sit with good posture. Since these muscles are required to fire constantly throughout the day it is important that they are trained in very high repetitions to increase endurance. Increasing the endurance of the rotator cuff during the offseason will also assist in maintaining the integrity of the muscles throughout the season of an overhead athlete. During the season, the rotator cuff experiences plenty of stress through the deceleration portion of throwing or shooting. This repetitive stress causes the rotator cuff to “stretch out” and lose the ability to function at 100%. This is why it is important to remember that overhead sports require full kinetic chain movements for maximum power.  It is vital to keep the core and hips strong and mobile as well in order to decrease the stress placed across the shoulder during the throwing or shooting motion. 

A proper off season strengthening program is necessary to minimize an athlete’s risk of injury and to maximize his or her success during the season. There are various “prehab” shoulder programs available for athletes to follow online, but it is important to remember that not all shoulders are created equally and different sports place different demands on the body. The shoulder must be managed differently while the athlete is in season and after the season to allow for proper recovery of the muscles in the joint. In conclusion, each and every shoulder is created differently and must be managed following specific guidelines catered to each individual. It is crucial to find the correct balance of mobility and stability for the overhead athlete to be able to reach his or her peak performance.

Click HERE to check out a short video of exercises that you can do at home to help improve your shoulder stability!

  • Use a light weight and keep your elbow tight in against your side as you rotate your arm until your palm is parallel to the ground.
  • If you want to challenge your athlete and add core strengthening into the exercise; have them perform this exercise in a side-plank position to increase the difficulty of the exercise by incorporating oblique and glute activation.

By: Dr. Abigail Dingle, PT, DPT, OCS, SCS, CSCS