T Nation

Shoulder Problems - Program?

I have winging scapulae, and am looking for a program that will allow me to simultaneously correct the problem and improve strength (duh). I’m afraid though that many exercises would worsen the winging condition. I know there are some articles out there, such as Neanderthal No More, but that provides more of a rehab program and doesn’t delve as much into complementary exercises that don’t or minimally aggravate existing postural imbalances. Perhaps it’s best to solely address imbalances first, then worry about a strength program later? Are these two goals mutually exclusive, or can I have my protein shake and drink it too?

You may find greater shoulder health outcomes if you start by undertaking a rehab program first to sort out the winging issues. Once that component is taken care of, you can then use your new-found shoulder stability and control, and work on global strength qualities. This would minimize your risk of secondary impingements. Essentially, you don’t want to be training hard with any scapular dyskinesias, as this would only force/cause compensatory mechanics at the shoulder girdle.

When dealing with the winging, you must address the root cause. Is is due to muscle weakness (e.g. serratus anterior)? Muscle tightness (e.g. pec minor)? Nerve injury (e.g. neuropraxia of the long thoracic nerve)? Imbalances or force couple alterations? Or a combination of the above. Once the source or cause of the winging is elucidated, you can then work on correcting it via proper proprioception, stretching (dynamic, passive and PNF), mobility and strengthening drills.

Hope that helps.
dc

Thanks dc, some good advice. Who might be best at diagnosing which specific causal factors I have? PT? Chiropractor? I’m assuming whoever it might be would also know the most effective types of rehab exercises to perform given their determination of the underlying cause(s) of the winging.

Either practitioner should be able to properly diagnose which factor(s) are pertinent to your situation as well as detail the proper steps to alleviate, minimize or avoid recurrence. It is more so the quality of the individual than the profession that I would take in to consideration.

I would encourage you to find a practitioner who not only states they “practice physical rehabilitation or therapy” but can answer your questions about it. Many therapy practitioners are sorely lacking in functional rehabilitation and exercise prescription. Find a practitioner who will take the time to listen to your concerns and work from the bottom up addressing all the functional, anatomical and physiological limitations or impairments.

Another item I would suggest to you is to do as much reading and learning about the anatomy and physiology of the shoulder. The more you know before going in, the better equipped you will be at understanding what is going on and preventing any further or future problems.

All the best.
dc

If I wasn’t off to bed I would be able to offer a longer response, but it would come out to be a wordier version of the following:

  1. Read Eric Cressey’s Shoulder Savers Articles

  2. Get Mike Robertson and Eric Cressey’s Magnificent Mobility

  3. Sign up for both of their newsletters

http://www.ericcressey.com/newsletter.html

  1. Use that information to develop a solid program and consider a phone consult if that isn’t hitting everything.

A really simple exercise from Tai Chi specifically to " return the shoulders into balance " as they say . Put each thumb on the matching shoulder R-R , L-L , then make the biggest circles you can with your elbows . Do them slowly and concentrate on the movement so it takes about five seconds to do a circle . Do as many each way as is comfortable .

My senior Ninjitsu instructor got us doing these years ago and no-one in our class ever got shoulder problems despite years of abuse ! Hope it helps you .

Good advice everyone but for my angle- i’d search for the Mike Robertson article ‘designer athlete’ if i were you mate. It may be the hybrid you were speaing of. Good luck

I start physical therapy for a left shoulder strain in about two weeks. I dumped a weight while doing db presses, and I pulled a muscle in my left shoulder. I am hoping I didn’t tear anything. I have full range of motion, so that is a plus.

I suggest just going to physical therapy.