Baseball Shoulder Injuries Pt.2

Baseball Shoulder Injuries Or Want To Prevent Them? Let's Start Thinking New School Shoulder Health!

Part 2 By Dr. Norm Eng

In Pt. 1 of this series, I left off discussing the significance of the supraspinatus. It's a tiny muscle in the shoulder yet it is the pinnacle of shoulder stability and motion. Before we discuss rehabilitative strategies, we need to understand the consequences of neural inhibition and scapulo-humeral rhythm (aka movement between the shoulder blade and arm).

The supraspinatus is not a large muscle yet its proper function is very important in shoulder stability. When a shoulder injury occurs it has been hypothesized that the supraspinatus can undergo selective neural inhibition, thus eventually leading to atrophy of the muscle's cross sectional area when compared to its counterpart on the other side of the body.

Your body basically decreases innervations to a muscle due to kinetic or kinematic dysfunction like those seen in Upper Cross Syndrome.  In many instances it is such neural deficit that creates the weakness, until  neuro - musculo synergy is restored.

Let's think new school and first discuss the coupled motion between the humerus and the scapula. As we laterally raise our arm, the shoulder blade should rotate counterclockwise and elevate. As we lower our arm in adduction, it should rotate clockwise and depress.

To keep things simple, retracted and depressed scapulae are beneficial for proper movement and stability of the humerus and protracted and elevated scapulae is bad for such. Such scapulo-humeral dyskinesis can often be caused by Upper Crossed Syndrome (UCS) as tight upper traps tend to hold the scapula in an elevated position. Thus, any abduction of the humerus can impinge the supraspinatus tendon. Coupling the impingement with a neurally inhibited muscle is a recipe for disaster. Now athletes and non-athletes alike will end up with an unstable shoulder and pain that can manifest throughout the shoulder girdle. Sounds like a bad combo to me!

So how do we create better functionality in the supraspinatus? Shoulder pressing 300lbs? Lateral raises with 50lb dumbbells? Cuban rows with heavy weight? WRONG!! Bulky does not equal better! This may only aggravate the supraspinatus tendon as it can become impinged between the acromion and the head of the humerus.

Ever hear of K.I.S.S (and not the rock band)? This acronym stands for "Keep It Simple, Stupid," and that needs to be the starter approach. Let's think small simple movements. For example, try retracting or squeezing your shoulder blades together with your arms straight down to your side and palms facing outward. Try activating middle traps and rhomboids without shrugging your shoulders.

To activate middle traps and rhomboids, pretend you're trying to pinch a penny in between the lower portion of your shoulder blades. Difficult isn't it? It'll be especially difficult for baseball players because they're always in a flexed and stooped position with shoulder blades protracted and elevated.

Now here comes the challenge. Practice this motion along with depressing your scapulae. This can be done by retracting your shoulder blades then reaching for the floor while maintaining a retracted position. Simple shoulder blade retraction is a difficult position to maintain, but the longer you can do it the better the improvement in scapulo - humeral rythym.

In Pt. 3, Dr. Eng will discuss specific rehabilitative exercises for a healthy shoulder.

Norman is a licensed Doctor of Chiropractic specializing in sports therapy and rehabilitation. He is also a certified strength and conditioning specialist through the National Strength and Conditioning Association. He received his doctorate from the University of Bridgeport College of Chiropractic in 2007 graduating summa cum laude.

Norman has treated numerous athletes in events like the New York City Marathon and The Gold Cup Soccer Tournament. He was also a strength and condition consultant to the University of Bridgeport athletic department. Norman is particularly fond of techniques like ART® (Active Release Technique) and Graston Technique in his treatment approach. For questions or comments Dr. Eng can be reached at neng7@hotmail.com

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