Saturday, November 04, 2006

Protecting Your Shoulders from Rotator Cuff Injuries

News Headline Nov. 4th, 2006 (Click here for full report):

SANTO DOMINGO, Dominican Republic (AP) - Pedro Martinez is recovering well from an operation on his right shoulder but said Friday he would consider retiring if he does not return to full strength.

"It's getting better and progress is above all what is hoped for," Martinez told The Associated Press. "To go back I have to recover, I have to be healthy. But if God doesn't want that, then I would have to think about giving it all up."

If you go ahead and click on MLB Injuries, you'll find the injury list. It's not surprising to see that the top injured baseball players are the pitchers suffering from arm-related injuries in their shoulders, elbows, forearms, wrists or fingers. No doubt shoulder-related injuries are the number one injury for baseball pitchers due to repetitive overuse.

When I talk about how to use cross training to prevent injuries, I happen to use a baseball pitcher as an example. As best conditioned as they are, even professional athletes cannot escape from injuries after all sorts of conditioning workouts from their top trainers. With top-dollar contracts in their pockets, they actually have to perform and are forced perform at the top of their games - fast balls, curve balls, etc. - hundreds and thousands of throwing over the years trying to strike out the batters. The end of the news story is "Martinez, just two strikeouts shy of a career 3,000, has two years left on his contract with the Mets." This could be end of his baseball career. I'm wondering if he has tried Yoga as a cross training and conditioning exercise. Perhaps he should have. Men do yoga, too.

For 9-to-5 working folks and weekend warriors, although you don't have to throw hundreds of balls, you still have to be careful in conditioning your body and shoulders to prevent from weekend warrior syndrome. It's frustrating to hurt your shoulders so painful that you cannot function fully doing normal daily activities or playing your sports. Perhaps you have difficulty reaching behind your back to grab your wallet or raising your arm to reach the seat belt. You may feel pain when trying to scratch the back of your head or even wash your hair. The pain could be such a disturbance to wake you up in the middle of the night. If so, you may be suffering from a rotator cuff injury.

Rotator cuff injuries such as tendonitis, bursitis or tears affect many people nowadays typically due to degeneration, bone spurs, trauma (accidents or sports related), overuse, and reduced strength and flexibility related to the aging process. The rotator cuff group consists of four small muscles and tendons that form a sleeve around the shoulder. They allow us to raise our arms overhead, move arms forward, backward, downward, side way and in circular motion. Working together with scapula (shoulder blades), the shoulder girdle joints and muscles allow us to perform all upper body functions and moves in all three planes and directions.

Shoulder pains can limit your strength and range of motion. Applying cold therapy on the affected area helps reduce inflammation, decrease pain and swelling, and speed up recovery. Rest, anti-inflammatory medication and therapeutic exercises are also helpful to return to pre-injury functional level. It may take as short as 4 to 6 weeks for a mild tendonitis and up to 18 months or longer following a surgery to completely recover, if ever. The nagging chronic soreness and limited range of motion (frozen shoulders) could be lingering around for many years to come. Consult your physician for diagnosis and proper treatment.

The key to preventing rotator cuff injury is to perform conditioning exercises prior to vigorous activities. Many weekend warriors try to pick up softball, baseball, football, you name it; and start to throw repetitively and forcefully without properly warming up. In addition, they are not likely well conditioned before the season like competitive athletes. As you can see, even professoinal athletes are not immune from injuries. This often leads to excessive strain on the rotator cuff and inevitable soreness, particularly with overhead movement or reaching behind the back.

I have some suggestions for you when performing weight training in the gym to prevent rotator cuff problems, particularly if you already have prior injuries:
  • When doing shoulder press and lat pulldown, avoid behind-the-neck movements as they put more stress and impingement on the shoulders.
  • When doing incline or flat bench press, do not lower the weights so that your upper arms are below parallel for the same reason.
  • When doing shoulder lateral raises or upright rows, avoid using too much weight that you have to shrug and swing your body to move the weight upward. In addition, avoid elevating your arms above 90 degrees - just enough to be in parallel with the floor at most.
  • Perform specific rotator cuff exercises to strengthen, stretch and stabilize your shoulder and scapular joints. See a post-rehab specialist or trainer for customized conditioning exercises.

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