Why Shoulder Mobility & Stability Should Be Trained Together

Jessica Bento, Physical Therapist (Creator DVRT Restoration Certification, DVRT Rx Shoulder, Knees, Pelvic Control, & Gait Courses)

Shoulders are something I see A LOT as a physical therapist and what might shock many is that I see it all the time in fitness pros and those that train a lot. When I heard renowned physical therapist, Lee Burton, say “not being able to raise your arms overhead is a health, not a fitness issue”, it was pretty profound. We often think that we have to gain enough mobility to do a specific exercise and when we can’t, alternative exercises are put in place (we will talk about these issues later). Instead of thinking about we need this type of mobility for an exercise, what about just understanding having such mobility is a sign of health?

I think of my mom when she was looking to a get a shoulder replacement, she wasn’t trying to accomplish any amazing feat of strength, but struggled to brush her hair and go out and golf (one of her favorite hobbies). When I look at people’s range of motion in their shoulders, if they can’t get their arms overhead (due to mobility, pain, or both), I wonder what is not working well with the rest of the body.

People often think of not being able to get the shoulders overhead as just an issue of shoulder mobility and place SOOOO much emphasis on everything around the shoulder and even the scapula. However, research tells us this can be a big mistake in improving our shoulder mobility. In fact, we need stability throughout the body in order to get our shoulder working optimally.

-This 2014 study, “Effects of lower extremity and trunk muscles recruitment on serratus anterior muscle activation in healthy male adults”, explains, “The shoulder complex does not function in isolation. Synchronized sequential rotation from the lower extremity (LE) through the trunk needs to occur in order for the shoulder joint to act efficiently in overhead sports. The shoulder is a part of the kinetic chain and the body is considered as a linked system of articulated segments. Each segment (LE, trunk, pelvis and upper extremity) in the kinetic chain has a specific role in ensuring that the UE performs efficiently in athletic endeavors. This coordinated sequencing of the segments is known as the kinetic chain. Sequen- tial activation of the LE, pelvis and trunk muscles is required to facilitate the transfer of appropriate forces from these body segments to the UE.”

-A 2012 study, “Kinetic Chain Abnormalities in the Athletic Shoulder ” shares, “Proper muscle activation is achieved through generation of energy from the central segment or core, which then transfers the energy to the terminal links of the shoulder, elbow, and hand. The kinetic chain is best characterized by 3 components: optimized anatomy, reproducible efficient motor patterns, and the sequential generation of forces. However, tissue injury and anatomic deficits such as weakness and/or tightness in the leg, pelvic core, or scapular musculature can lead to overuse shoulder injuries.”

-This 2000 study, “A Kinetic Chain Approach for Shoulder Rehabilitation ” states, “Kinetic chain shoulder rehabilitation incorporates the kinetic link biomechanical model and proximal-to-distal motor-activation patterns with proprioceptive neuromuscular facilitation and closed kinetic chain exercise techniques. This approach focuses on movement patterns rather than isolated muscle exercises. Patterns sequentially use the leg, trunk, and scapular musculature to activate weakened shoulder musculature, gain active range of motion, and increase strength. The paradigm of kinetic chain shoulder rehabilitation suggests that functional movement patterns and closed kinetic chain exercises should be incorporated throughout the rehabilitation process.”

So you see how most people address should mobility and issues is not really accomplishing the actual needs of the shoulder. Such strategies can be confusing, as an example, people often think the landmine press is a good substitute for going overhead, but it isn’t! When the anchor point is in front of our body, the weight gets lighter, reducing the stability that the core and lower body need to contribute for the shoulder. Instead, exercises like I show below are better progressions.

 

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We can also help shoulder mobility through the use of diagonal patterns like we see in PNF with lifts/chops. This 2017 study (Effectiveness of Proprioceptive Neuromuscular Facilitation (PNF) in Improving Shoulder Range of Motion) found that one session of PNF patterns can enhance shoulder mobility and function and 73% of patients said pain decreased. However, they found single sessions of magnetic field therapy, laser therapy and local cryotherapy do not improve the range of motion or diminish pain just after an intervention. That is why you see me focus so many times on integrated PNF patterns. You can see Coach Lauren Penton apply these strategies to these high school football players.

 

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You can see how our Mobility Training Balls (you can check out HERE) and Ultimate Sandbags allow us to train shoulder mobility, through better stability of integrating the whole entire kinetic chain. We can add in specific breathing exercises too in order to enhance all these exercises that allow us to build better shoulder mobility and health at once. The more we understand about how our bodies are designed, the better we can offer solutions.

Don’t miss a great opportunity to get the full training that leads to better mobility for 35% off with code “mobility” HERE

 

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