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Shoulder Surgery Or Rehab

Boy, this topic sure pops up often. Shoulders take a beating in this life. First thing to determine: Are you actually injured, or is there something else going on? From Byron, consider the following in answer to a query about a vague shoulder injury:

Impossible to say what's injured, if anything. All we know is your shoulder isn't functioning properly when it's abducted. Very common problem.

• Read more on shoulder exercises to strengthen and support the rotator cuff.

If your shoulder is seriously hurt or the injury isn't healing, here's a conversation about how to begin your medical path to rehab or possible surgery.

Active release or other soft tissue therapy (optional step but really worthwhile). This can really speed up your stretching efforts.

Stretch the pecs, lats, and subscapularis until you have adequate or better flexibility. Physical therapists have simple tests for what constitutes adequate flexibility. Until you're flexible, your efforts to get strong will only get so far.

Strengthen the rotator cuff and the muscles that control the scapula (more on this below). Use a wide variety of exercises. If the exercises you're using aren't having the desired results, try others. Work as hard on upper back and shoulder stabilizer strength as you do on pecs and biceps.

• I hope you haven't had a shoulder injury and happened on this page by accident. Beauty! Then you'll want to start doing preventative shoulder therapy exercises now, and keep it up for life!

• This pdf link from the Diesel Crew offers both rehab and prehab exercises for the shoulder, and the Diesel Crew's You Tube intro to shoulder health video clip, and this link to their [[http://www.youtube.com/watch?v=A0ONHZmsFec|longer and fabulous shoulder rehab exercise video.

• In this article you'll find an explanation of the different types of impingement including those that are caused by type two and three acromions.

• From The Stretching Handbook, here's an useful article: Frozen Shoulder and Rotator Cuff Injury: A Guide for the Treatment and Prevention of Shoulder Injuries.

• For both prevention and rehab, here are the exercises you'll need for rotator cuff work.

• You'll also benefit from pectoral stretching for good shoulder health, and more of Byron's thoughts on shoulder health here in the forum.

• From Eric Cressey, here's a two-part shoulder saver strategy from T-Mag: Part One and Part Two. And here's his original work, Cracking the Rotator Cuff Conundrum.

• Also over on T-Mag, Mike Robertson writes Shoulder the Load.

• Dave had shoulder surgery and has these thoughts to share about pre- and post-shoulder surgery. Further discussion on Dave's rotator cuff repair and shoulder rehab.
  • And you'll want to continue training as best you can, not thru the injury, but around it.

  • Training around an injury can really teach you a lot about yourself, the exercises you use and your training tenacity.

  • Let's look to Bill Hartman and Mike Robertson for Push-Ups, Face Pulls, and Shrugs for Strong and Healthy Shoulders.

• Here's a look at the shoulder horn in use; you can pick one up over at IronMan's Home Gym Equipment -- a little pricey maybe, but enough people have had positive results from it to make it worth a look.

• Ken O'Neill offers up this personal look at rotator cuff rehab from the original DolfZine site.

And back to Byron for the finisher:

Just some general observations to add. The rotator cuff is just four little muscles. They get beat up for two reasons: One, they're little muscles with a big job, and two, they are in a position where the joint will literally grind them up if the shoulder isn't functioning properly. This grinding up is "impingement" and if you hear a click or pop at a certain point in a certain movement, you're wise to address it because over time that little abrasion will cause big trouble.

In many cases doing rotator cuff exercises alone will fix both problems. Strong rotator cuffs will (1) be better able to do their job without getting injured from the strain, and (2) will help keep the shoulder moving properly.

Strong external rotators alone do not insure healthy shoulder movement. If you are not flexible in the pectorals, you're going to have trouble. The muscles that control the scapulae have to be sufficiently strong - rhomboids, mid and lower traps, and serratus. And finally, even if everything is strong and loose, if you have messed up coordination / motor patterns, you can still have trouble.

Bench pressing is a big problem. It can contribute to tight pecs, which can cause weak scapular retractors, and it can foul up motor patterns. If you're going to bench, you have to keep an eye on these things.

Believe it or not, pulling work can actually contribute to the problem. Just because you're strong on chins, don't assume your shoulders are well balanced and functioning properly. Rowing with the elbows out, pulling the bar to a spot somewhere pec level or higher, with a good pause at the top - that's a better test, and certainly not a complete test.

Overhead pressing with good form can help build the upper back muscles and the right motor patterns. Overhead squats can build active flexibility in the chest and strengthen the upper back tremendously. The little exercises are great but there are some big ones that really help too.