13 Mar Shoulder instability is not going to be improved by strength training….wrong!
DO YOU SUFFER FROM SHOULDER INSTABILITY? CLICK HERE TO BOOK AN APPOINTMENT TODAY!
Shoulder instability is a relatively common finding within the physio room. It can present following an acute traumatic injury, such as a dislocation, or from repetitive overuse activities, such as activities that require repetitive throwing actions like in Cricket. Regardless of the mechanism of injury, the bottom line is, the pathology linked to the injury is the same. The passive structures (Bones and ligaments) become over stretched or torn, losing their tensile strength, resulting in instability of the joint.
We’ve had many patients attend our clinics over the years, with a fear of working out in the gym, due to what they’ve been told by other health professionals. Currently, there’s no high quality evidence to suggest that people with shoulder instability, shouldn’t work out in the gym. In fact, what the evidence does suggest is that strengthening the active (muscles) structures, is imperative for preventing further injury to their shoulder.
Strength programs for instability of the shoulder are actually quite straightforward. As physiotherapists we want to find the position you’re not only comfortable, but also challenged in. For acute traumatic dislocations, this might be below shoulder height while the shoulder settles down, however for patients with overuse injuries, they may be more comfortable above shoulder height.
Once a starting point is obtained, it’s then about progressing and challenging the patient in different planes of movement. For example, as the muscles of the shoulder are required to work harder, the further our hand is away from our body, we might start our patient in the front plane (lifting arm straight up), before progressing them to the coronal plane (lifting arm up by their side).
Along with functional activities, such as lifting the arm above head, it’s imperative to also have isolated exercises that focus on strengthening the rotator cuff. Now, historically physiotherapists do this with a rainbow of therabands, but our preference is dumbbells, due to the higher demand that they place on muscles of the shoulder.
Once our patients are starting to achieve some meaningful strength around their shoulder, we then like to challenge them with unstable exercises through the use of banded push ups or rope based exercises. Exercises on unstable surfaces increase the neural input into the muscles, thus challenging the whole shoulder girdle, rather than just the isolated muscle groups.
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Like any rehabilitation program, the final step before moving onto sport specific drilling, is speed and power work. There’s many ways to build speed and power around the shoulder, but the most important thing is to be specific to the activity that someone is wanting to get back too! It is imperative that we incorporate movements of the trunk and lower body in these exercises in the gym. After all it is more meaningful for the body as these areas also work in activities like throwing.
Once we’re happy our patients have gained strength, capacity, speed and power, we will then progress them to more sport specific drilling. Remember once you have returned to sport, it doesn’t mean you stop there. Performance in sport in those early stages is still a component of rehab!
So in summary, don’t be scared of the gym if you’re a sufferer of shoulder instability! Call your physio and get stuck in, the best thing you can do is build shoulder strength and capacity, and the only way to do that is progressive exercise that needs to include gym based exercise.
If you are a victim of shoulder pain and it is stopping you in your tracks in the gym don’t worry because we are here to help. Our constant drive is to help as many people as possible live active lives and have them perform the activities they love!
So call us on (03) 9370 0345 or click here so we can get you exactly where you want to be.