Monday, 23 July 2012

How to Improve Shoulder Stability

Whether you are training for improved sport performance, for health or to look good on the beach, a healthy shoulder is an essential training prerequisite. There are many important components to a healthy shoulder, one of them being shoulder stability. While the rotator cuff muscles play an important role in shoulder stability, they are not always trained in the most useful way for this goal.
Not always the best way to get improve shoulder stability
The rotator cuff consists of a group of muscles that originate on the scapula (shoulder blade) and insert into the top of the humerus (upper arm bone). We often use the acronym SITTS to describe them. Below is a list of the SITTS muscles and their isolated function:
  • Supraspinatus: abduction (assists the deltoid in raising the humerus)
  • Infraspinatus: external rotation (rotates the arm out)
  • Teres Minor: external rotation (rotates the arm out)
  • Teres Major: internal rotation (rotates the arm in) (note: this one has not traditionally been in included in the SITTS - it used to be referred to as SITS)
  • Supscapularis: internal rotation (rotates the arm in)
Traditionally we trained these muscles dynamically according to their isolated function. For example, many people have done external rotations to train the infraspinatus & teres minor. While this is not always a bad idea (e.g. early rehab, structural imbalances), training these muscles dynamically in their isolated function is not what they do in real life. The main real-life function of the rotator cuff muscles is to assist in glenohumeral stability. When the rotator cuff muscles all contract together, they pull the head of the humerus into the Glenoid fossa (shoulder socket) and provide stability for the shoulder joint.
In their excellent DVD Secrets of the Shoulder, Gray Cook and Brett Jones discuss another important aspect of shoulder stability - grip. When you grip something hard, you get an irradiation effect that sends a wave of stability up your arm. Stronger grip = more shoulder stability.
The practical application:
Okay, enough theory. Here is the application to all this - use exercises that force your shoulder and your grip to lock in and hold a position. The shoulder can get a lot of stability training from simply doing the best exercises with a packed shoulder and a tight grip. However, you can provide additional stability work with an exercise called Bottoms-Up carries. This little gem was brought to the strength & conditioning community by Dr. Stuart McGill and made even more famous by Mike Boyle in his book Advances in Functional Training: Training Techniques for Coaches, Personal Trainers and Athletes. For this exercise, you hold a kettlebell upside down with your hand at shoulder height and go for a walk. The kettlebell naturally does not want to stay in this position so you have to grip it tightly and lock the shoulder into position to prevent giving yourself a concussion. In addition, you  also get some nice functional core stability work from holding this position while you walk.

For those who do not have access to kettlebells, I have found the using a weight plate that has a built-in handle creates a similar effect (see video below). If you have a shoulder condition/injury, run things by your appropriate therapist first. If you want to add some shoulder stability work to your training, try bottoms-up carries a few times a week. A sample workout would be: walk 30 meters, rest 30 seconds, switch hands and walk back, rest 30 seconds. Repeat for 1-3 sets. Start light and stop if it causes bad pain. Start too light to get the movement down and gradually increase to more challenging loads. Remember this as an accessory exercise, not something to brag about PR's (personal records).

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