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Dr. Clay Simons – Dana Point

For those of us who enjoy circling the black line for several hours a day, the chances of getting pain or discomfort in your shoulder increase. People do many things once they have the pain, such as ice, PT, and/or rest — but here are a couple of things you can do to help prevent the pain in the first place.

1. Posture

We spend a lot of time slouched forward with rounded mid/upper back and forward head postures, sitting at our desks, staring at our phones, Netflix binging, etc. If you spend a lot of time in these postures most of the day, it does not magically go away once you hop in the pool, where you have to be tall, straight, and long to perform your best. Make sure when you are sitting that you are not slouching all the time — even breaking it up a few minutes per hour will help. Try to keep your spine straight and your ears aligned with the tops of your shoulders. Be aware and fix it when you think of it. Slouching for short periods is not bad, but be aware of it and don’t “live” in that position.

2. T/S mobility

For the shoulder joint to work properly you need to be able to move your spine, specifically your mid-back, with rotation and extension. Going back to posture: When you slouch much of that forward bend comes from the thoracic spine. To help counter the forward bend: spend some time doing T/S extensions on a foam roller; place the roller across your back, cradle your head with your hands, and arch backward. Keep your stomach tight to minimize the arch in your low back, and keep the focus on your mid-back. You can work several spots throughout your mid-back, starting a little below your shoulder blades and working up to just above your shoulder blades. You can also work the rotation component by doing rotations. Start on all fours, and with your R arm, reach down and under your chest as far as you can to the L, hold for a few seconds, then bring your R arm back and reach up to the sky on your R, repeat several times, and then switch sides.

3. Rotator Cuff strength

Everyone has seen the classic internal/external rotation with bands — these are great and have their place but are not always the answer. Expand this by adding wall ball stabilizations by holding a ball against the wall and making small movements in multiple directions from the shoulder. I like doing star shapes or the alphabet to train your rotator cuff to work as one functioning unit to stabilize your shoulder joint in all plains. You can also do your internal-external rotations in different positions. The classic one is what we call a 90/90 where your arm is out to your side, elbow even to shoulder, and elbow bent to 90 degrees — now stabilize and rotate forward and backward here. I recommend starting this one lying down with the band around your opposite foot, staying within the range that your shoulder stays back on the table without rolling forward.

4. Scapular stability

“You can’t fire a cannon out of a canoe” is my favorite quote when it comes to rotator cuff strength. You can strengthen your rotator cuff all day long, but all 4 of the rotator cuff muscles attach to the scapula, so if that scapula is not stable, all your rotator cuff strengthening is useless. Do variations of rows, weight-bearing through your arms, and I’s/T’s to help stabilize your scapula in multiple planes.

Weight Bearing: this is where the classic push-up comes in but don’t be afraid to branch out, do different hand positions, wide, narrow, staggered, or try walking on your arms like a classic wheelbarrow from elementary school. Planks can also be great for this.

I’s/T’s: Lie on your stomach and put your hands down at your side, palms facing down and now squeeze your shoulder blades together and use your shoulder blades to lift your arms, holding for 2-3 secs. For T’s, do the same thing except bring your arms straight out to either side with your thumbs up and lift your arms from the shoulder blades.

5. Swim with good form

This one should be the most obvious, but many people tend to track the number of yards they swim when in reality, you should be looking at how well those yards swam. Make sure you are swimming with the best form possible to minimize stress/strain on structures not designed to take that load. Swimming with good form will also allow you to swim faster, which is everyone’s goal anyway.

Also, remember that physical therapy can also be a preventative approach! A licensed physical therapist can help evaluate and assess you for any mobility restrictions or muscular imbalances and recommend a proper program!

Clay Simons

clays@rauschpt.net

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(949) 276-5401

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