CD - Australian Fitness Network

AUTHOR’S BIO
REGULAR FEATURE
COMMON INJURIES:
5 TIPS TO SAVE YOUR SHOULDERS
Paul Wright, BAppSc (Physio), DipEd (PE)
46 NETWORK WINTER 2010 www.fitnessnetwork.com.au
Paul is the owner of Get Active Physiotherapy with clinics inside Fitness First clubs at St Leonards (Sydney) and Kotara
(Newcastle) and can be contacted on 1300 891011. His DVD range (including a session on Shoulder Injury Rehabilitation
and Injury Prevention for Health Professionals) can be previewed and purchased at www.getactivephysio.com.au .
Paul has also recorded a CD titled How to Increase Profi ts from your Health Business, which all Network members can
access for FREE at www.healthbusinessprofi ts.com/freecd
�Shoulder pain is one of the most common problems
treated by physiotherapists and sports physicians,
and is particularly common in those who participate
in health and fi tness-related activities.
In past articles I have talked about some of the most
common conditions that we see related to the shoulder,
including referred pain, dislocation and impingement;
however, in this article I will give a more general overview of
the recommendations we make to our physiotherapy clients
to assist in the prevention of shoulder related injuries.
ANATOMY AND PHYSIOLOGY
In basic terms, the glenohumeral joint (the joint between
the humerus and the glenoid fossa of the scapula) is a multiaxial
ball and socket joint that allows an amazing degree of
movement. However, this freedom is achieved at the expense
of stability and security and is often the cause of many
dislocation and instability-related issues.
Due to the relatively shallow socket provided by the
scapula, the glenohumeral joint requires support and
assistance from other structures to improve stability. These
support structures include the glenohumeral ligaments,
glenohumeral joint capsule and a thin rim of fi brocartilage
around the glenoid called the glenoid labrum. These support
structures assist in keeping the humeral head in contact with
the glenoid fossa during movement of the shoulder joint;
however, they do not prevent dislocation.
The glenohumeral joint is supported and controlled by four
small muscles that make up the rotator cuff group – these are the
supraspinatus, infraspinatus, teres minor and the subscapularus.
These small, but very important, stabilisers are easily overloaded
and injured due to poor program design or exercise technique.
Many of the following injury reduction techniques focus on
reducing the load on these small joint stabilisers.
Supraspinatus
Spine of Scapula
Teres Minor
Humerus
Infraspinatus
TIP 1: LIMIT OVERHEAD EXERCISES
Many gym training programs involve extensive overhead
pressing movements. Intensive overhead movements are
often overrated and can lead to shoulder problems.
When you look more closely at the available range
of motion in the typical military press, at the start of the
movement the shoulders are already in 70 to 80 degrees
of abduction, and, depending on the width of your grip, at
the end of the pressing phase you may only be at 130 to 140
degrees. This equates to a movement of only 60 degrees at
most. If you subscribe to the ‘time under tension’ philosophy
for hypertrophy, then it stands to reason that this reduced