Today on social media I saw a post by a training facility of a “trainer” manipulating / stretching a 12-year old’s shoulder into external rotation. His reason was because and I quote “the athlete was experiencing arm pain due to inflammation in the shoulder”. Just watching it made me feel like this.
Manual manipulations into provocative positions being done by strength coaches that don’t fully understand the anatomy can be a season- or even career-ender in young athletes. It may look good on the gym room table, but it may be doing way more harm than good. Why? OK, let’s get into just a few of the reasons why.
Let me first say that static stretching can be a good thing when implemented properly. However, regarding manual manipulations, except for post-op surgery (which at that point should be done by a licensed PT or orthopedic), I honestly can’t think of a single reason why anyone should ever stretch a shoulder into external rotation, ESPECIALLY with young adults that are experiencing pain or inflammation.
Nature gave us the glenohumeral joint and designed it for mobility. In fact, it’s the most mobile joint in the body. The surface area of the humeral head (ball) is roughly 3-4 times the size of the glenoid cavity (socket) that it sits in. This unfortunately also makes it one of the most unstable.
Laxity / lack of strength in young athletes – If you combine the sub-optimal ball and socket ratio, with the fact that young athletes who are still growing and have not yet built up the necessary strength to help create stability in these already lax areas, then you better know what you’re doing. Many times, that tightness is the body laying down trigger points as a protective device to create stability in areas where they are chronically unstable due to laxity issues (see below).
So, you can see why stretching an already unstable joint such as the shoulder especially in younger athletes can not only make it more unstable but can be a recipe for disaster. A better solution may be utilizing some good stability exercises to create some good stiffness around the adjacent joints.
If it’s bone, then leave it alone – Many athletes have what is called humeral retroversion. This is a natural adaptation/shift of the arc in the throwing arm that results from throwing at a young age while the growth plates are still open (images courtesy of PT Mike Reinold).
As the diagram above demonstrates, everyone has a different arc which allows for different degrees of ER from athlete to athlete. So, before you stretch, you better find out if it’s bone or soft tissue that’s limiting you at end-range. If it’s bone, you’re better off leaving things alone.
So, buyer beware. Do yourself a favor do your homework and ask questions and make sure the guy touching your arm has had extensive experience in working with overhead athletes.
See ya’ in the gym…
By Nunzio Signore (BA, CSCS, CPT, NASM, FMS)