Training for Injury Prevention of the Shoulder

Paul Pursley PT CSCS

University of Iowa Hospitals and Clinics

Non-trainable Variables

Appropriate Gear Good Genes Good Sportsmanship Bad Luck

Trainable Variables

Sport Specific Skills Flexibility Strength Balance Biomechanics

What Kind of Throw are We Training For?

Phases of the Overhead Throw

Wind-up Phase Cocking Phase

Early cocking phase

Late cocking phase Acceleration Phase Deceleration Phase Follow Through

Wind-up Phase

Single limb stance Core musculature

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

Acceleration Phase

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

Deceleration Phase

Posterior Deltoid Infraspinatus Teres Minor UT/MT Rhomboids

Standards for IR/ER Ratio

ER approx. 66% of IR strength during isokinetic testing.

Reminder of importance of rotator cuff and scapular stabilizers

Strength Training…

Thrower’s “Ten”

Thrower’s 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

Shoulder Extension

Shoulder Flexion

IR/ER at 0° Abduction

ER/IR at 90° Abduction

High/Middle/Low Rows

Scapular Punches”Dynamic Hug”

Stabilization

High speed resisted target reach Pertubation training Body weight resisted

UE walking UE weight bearing on unstable surfaces

Multiple Joint Lifts

Push Press Clean and Snatch High Pull Bench Press

Multi-Planar Lifts

PNF Pattern DI/DII Dumbbells, Kettle Bells, Resistance

Tubing, Cable Column Resisted Overhead Throw

Plyometrics

Med Balls Anterior-Chest pass Posterior-posterior throw

Body weight Box push-up

Periodization

Off Season Hypertrophy/Endurance Phase

6wks, 60-70% 1RM, 10-12 repetitions Low intensity-High volume

Strength Phase Increase to >80% 1RM, 5-8 repetitions Initiate plyometric training

Periodization

Preseason Power Phase

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

Periodization

Competition Phase Low volume-High intensity

Sport Specific Considerations Length of season Aerobic vs. Anaerobic Impact vs. Non-impact

Principles for Implementation

Incorporate into existing practice Exercise selection

Thrower’s “10” Stabilization Exercise Medicine balls for anterior and posterior

shoulder plyometrics Body weight resisted

Pull-ups Dips Rope climb Peg board

Thank You!