By Nunzio Signore (B.A. CPT, NASM, FMS, PES)
This is the first installment of a series on the arms and shoulders that I will be doing over the next several weeks. Please be patient with some of the content in this first blog as it involves some brief anatomy that will make the next few installments much easier to grasp. I will make it as “user friendly” as possible without sacrificing the integrity of the blog. For those of you interested in learning about the terms you always heard and never understood this is a good read.
The nature of the movement in throwing a baseball is one of the most violent in all of sports. This can also be said for other “overhead sports” such as swimming, volleyball and tennis, to name a few. These movements can create inefficient movement patterns causing pain in the affected area. An athlete may not be currently experiencing pain (asymptomatic), but continuing to move improperly can eventually lead to acute pain (symptomatic). For the purposes of this series, we will be addressing these issues in regards to what causes them and what to do to avoid them ever reaching “threshold” (pain).
Introduction of the Major Players
1. The Rotator Cuff
The rotator cuff is a group of tendons and muscles in the shoulder, connecting the upper arm (from here on out referred to as the humerus) to the shoulder blade (scapula). The rotator cuff tendons provide stability to the shoulder; the muscles allow the shoulder to rotate.
Role: Its role is to keep the humerus in the socket (glenoid) during movement. The muscles that surround the cuff and help stabilize it (from front to back) are the subscapularis, supraspinatus, infraspinatus and teres minor.
The work load needs to be evenly distributed to all of these muscles to create adequate stabilization of the cuff. Working on one group without working on the others will only create an imbalance, somewhat like this tent below:
We use active stabilizations to help all these muscles work together while the arm is in an “ideal” position (centration):
2. The Scapula
Role: Its role is to properly position the arm in the glenoid during movement. If the scap does not move properly, the humerus will get from point A to point B any way it can. This generally causes irritation of the cuff from impinging. This can present with pain in the top or front of shoulder or even down to the elbow (more on this later).
The scapula also provides a link (via muscles attached to it) from the thorax to the arm, as in throwing movements. We use different types of drills to teach correct scapular movement on the thorax (discussed below). Here’s an example:
3. The Thorax
The thorax is comprised of the thoracic spine and the ribcage in which the scapula sits on.
Role: Its role is to provide a stable base of support for the scapula to move freely on. Without a stable base of support from the thorax, the scapula will have to compensate, much like trying to shoot a cannon from a canoe (I love this analogy).
So, putting it all together involves the scapula moving correctly on the thorax (ribcage) and the humerus (arm) moving correctly in the glenoid (socket). Here’s an exercise that teaches it all in one movement:
Just because you do not currently have shoulder or elbow pain doesn’t mean that you won’t. Correcting faulty movement patterns and training the muscles around the cuff to help stabilize it will help the humerus (arm) to sit solidly in the glenoid (socket) and help ensure that you’ll never reach threshold. These are some of the concepts we implement in our off-season programs for pitchers.
Please be on the lookout for Part 2 – Training the Shoulder.