Training for Injury Prevention of the Shoulder

1
Training for Injury Prevention of the Shoulder

• Paul Pursley PT CSCS
• University of Iowa Hospitals and Clinics

2
Non-trainable Variables

• Appropriate Gear
• Good Genes
• Good Sportsmanship
• Bad Luck

3
Trainable Variables

• Sport Specific Skills
• Flexibility
• Strength
• Balance
• Biomechanics

4
What Kind of Throw are We Training For?
5
Phases of the Overhead Throw

• Wind-up Phase
• Cocking Phase
• Early cocking phase
• Late cocking phase
• Acceleration Phase
• Deceleration Phase
• Follow Through

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Wind-up Phase

• Single limb stance
• Core musculature

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Cocking Phase

• Early Cocking Phase
• Minimal muscle activation at global shoulder
• Late Cocking Phase (Front foot planted)
• Moderate Pectoralis activity
• Cocking completed by Pec/Lat

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Acceleration Phase

• Pectoralis Major
• Subscapularis
• Latissimus Dorsi
• Teres Major
• Serratus Anterior
• Trunk/LE MM

9
Deceleration Phase

• Posterior Deltoid
• Infraspinatus
• Teres Minor
• UT/MT
• Rhomboids

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Standards for IR/ER Ratio

• ER approx. 66 of IR strength during isokinetic
  testing.
• Reminder of importance of rotator cuff and
  scapular stabilizers

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Strength Training
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Throwers Ten

• Throwers 12
• Shoulder Extension, Shoulder Flexion, IR/ER at 0
  abduction, IR/ER at 90 abduction,
  High/Middle/Low Rows, Scapular Punches (Dynamic
  Hug), Throwing Acceleration, Throwing
  Deceleration.
• On the Field Resistance Tubing Exercise for
  Throwers an EMG Analysis. Journal of Athletic
  Training. 2005 Jan-Mar, 40(1) 15-22

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Shoulder Extension
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Shoulder Flexion
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IR/ER at 0 Abduction
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ER/IR at 90 Abduction
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High/Middle/Low Rows
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Scapular PunchesDynamic Hug
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Stabilization

• High speed resisted target reach
• Pertubation training
• Body weight resisted
• UE walking
• UE weight bearing on unstable surfaces

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Multiple Joint Lifts

• Push Press
• Clean and Snatch
• High Pull
• Bench Press

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Multi-Planar Lifts

• PNF Pattern DI/DII
• Dumbbells, Kettle Bells, Resistance Tubing, Cable
  Column
• Resisted Overhead Throw

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Plyometrics

• Med Balls
• Anterior-Chest pass
• Posterior-posterior throw
• Body weight
• Box push-up

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Periodization

• Off Season
• Hypertrophy/Endurance Phase
• 6wks, 60-70 1RM, 10-12 repetitions
• Low intensity-High volume
• Strength Phase
• Increase to gt80 1RM, 5-8 repetitions
• Initiate plyometric training

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Periodization

• Preseason
• Power Phase
• 6-8 weeks prior to competition phase
• Lower volume-Increased intensity
• 90 1RM
• Allow full recovery between sets

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Periodization

• Competition Phase
• Low volume-High intensity
• Sport Specific Considerations
• Length of season
• Aerobic vs. Anaerobic
• Impact vs. Non-impact

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Principles for Implementation

• Incorporate into existing practice
• Exercise selection
• Throwers 10
• Stabilization Exercise
• Medicine balls for anterior and posterior
  shoulder plyometrics
• Body weight resisted
• Pull-ups
• Dips
• Rope climb
• Peg board

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Thank You!