Friday, July 25, 2014
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Shoulder strengthening for throwing athletes

The scapula is the keystone of the upper body. All upper extremity motion depends on how well or how poorly the scapula moves. When the scapula is weak, both the shoulder and elbow are at an increased risk of injury.

Shoulder strengthening for throwing athletes

Team West pitcher Jazmine Ayala in action Wednesday. Team Southeast from McLean, Virginia was defeated 9-0 by Team West from Tucson, Ariz., in the 2013 Little League World Series Championship game Wednesday night Aug. 14, 2013 in Portland. (AP Photo/The Oregonian, Ross William Hamilton)
Team West pitcher Jazmine Ayala in action Wednesday. Team Southeast from McLean, Virginia was defeated 9-0 by Team West from Tucson, Ariz., in the 2013 Little League World Series Championship game Wednesday night Aug. 14, 2013 in Portland. (AP Photo/The Oregonian, Ross William Hamilton)

The scapula is the keystone of the upper body. All upper extremity motion depends on how well or how poorly the scapula moves. When the scapula is weak, both the shoulder and elbow are at an increased risk of injury. In the normal healthy shoulder, the scapula moves properly and creates a stable base allowing the rotator cuff muscles to control the shoulder.

When the individual throws or reaches overhead, the scapula dictates the position of the arm and minimal stress is placed on the shoulder and elbow. When the scapula moves poorly however; that relationship is reversed and the arm dictates the position of the scapula. This often leads to shoulder injuries such as impingement, rotator cuff strains/ tears, and labrum tears. In the elbow, it can lead to ligament sprains/ tears and muscle strains. The scapula can be compared to the core; without a solid core, poor performance and injuries often result. The same holds true for the scapula.

Dynamic sports such as baseball, softball, volleyball, and swimming often lead to scapula dyskinesia or poor scapula position.Any scapula weakness will contribute to poor performance, increased pain, soreness and injury. Many athletes believe they have a strong upper body and don’t learn about their scapula weakness until after they feel pain.

Poor scapula positioning can be identified by a shoulder that is hunched forward, low, protracted (moved to side), or winging. Next time you are at the beach take a moment and see how many people have forward rounded shoulders. This is caused by weakness of the middle back muscles (between the scapulae) as well as tightness of the pectoralis and latissimus. Strengthening of the middle back muscles can be performed by squeezing the shoulder blades back (scapula retraction) and keeping them low during light weight rowing exercises.

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Do NOT allow your stronger upper trapezius muscles (between the neck and shoulder) to do the work. For correct posture, keeping your shoulders back and sitting up straight is essential (turns out mom was right after all!) There are many other exercises that strengthen the serratus anterior, lower and middle trapezius that promote proper scapula movement. These exercises should be taught by a qualified professional such as an athletic trainer or physical therapist.

Tightness of the chest (pectoralis muscles) and lattissimus occurs from repetitive overhand motion (swimming, throwing, etc), poor posture, and poor exercise selection at the gym. Many athletes, young and old, prefer to work on their beach muscles: chest, lats, biceps, upper traps with the false sense that this will help their shoulder. Let’s face it, these exercises make you look bigger and stronger; showing off toned back muscles on the beach does not have the same effect as flexing your biceps and chest.

Overworking these “beach” muscles, however, place your shoulder and scapula in a very poor position as they become extremely tight. Overhead athletes should rarely perform exercises strengthening the chest, upper traps, or lats such as bench press, shrugs, and pull-ups. Instead, focus on stretching the chest and lats, strengthening the mid back muscles, and being aware of correct posture.

The other common mistake overhead athletes often make is over emphasizing rotator cuff strengthening. Some rotator cuff strengthening is OK, but the scapula must be strengthened first and foremost. Once the scapula is strong, a limited amount of rotator cuff exercises such as internal and external rotation and shoulder raisesare fine to do when the scapula is stabilized (fully squeezed back).

These guidelines will place the shoulder and scapula in an optimal position. If you use your shoulder in sports, the scapula is the cornerstone to your health and peak performance.


Read more Sports Doc for Sports Medicine and Fitness.

Brian Cammarota, MEd, ATC, CSCS, CES Partner at Symetrix Sports Performance
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Kelly O'Shea Sports Medicine & Fitness Editor, Philly.com
Robert Cabry, M.D. Team Physician for U.S. Figure Skating, Assoc. Team Physician for Drexel; Drexel Sports Medicine
Brian Cammarota, MEd, ATC, CSCS, CES Partner at Symetrix Sports Performance
Desirea D. Caucci, PT, DPT, OCS Co-owner of Conshohocken Physical Therapy, Board Certified Orthopedic Clinical Specialist
Michael G. Ciccotti, M.D. Head Team Physician for Phillies & St. Joe's; Rothman Institute
Julie Coté, PT, MPT, OCS, COMT Magee Rehabilitation Hospital
Peter F. DeLuca, M.D. Head Team Physician for Eagles, Head Orthopedic Surgeon for Flyers; Rothman Institute
Joel H. Fish, Ph.D. Director of The Center For Sport Psychology; Sports Psychology Consultant for 76ers & Flyers
R. Robert Franks, D.O. Team Physician for USA Wrestling, Consultant for Phillies; Rothman Institute
Ashley B. Greenblatt, ACE-CPT Certified Personal Trainer, The Sporting Club at The Bellevue
Eugene Hong, MD, CAQSM, FAAFP Team Physician for Drexel, Philadelphia Univ., Saint Joe’s, & U.S. National Women’s Lacrosse
Julia Mayberry, M.D. Attending Hand & Upper Extremity Surgeon, Main Line Hand Surgery P.C.
Jim McCrossin, ATC Strength and Conditioning Coach, Flyers and Phantoms
Kevin Miller Fitness Coach, Philadelphia Union
Heather Moore, PT, DPT, CKTP Owner of Total Performance Physical Therapy, North Wales, Pa.
David Rubenstein, M.D. Team Orthopedist for 76ers; Main Line Health Lankenau Medical Center
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