Getting it overhead with a twist

4 March 2013 / Dr Mun Khin Chan / /

 

Our shoulders get an absolute beating over our lifetime, in fact studies have found that 28% of people under the age of 60 with asymptomatic shoulders (without pain) had evidence of rotator cuff damage and 54% for those over 60years (1), and these are the lucky ones…without pain.

I think most people have an appreciation for the functional need to be strong overhead across the lifespan, crossfitters and olympic lifters in particular, place an enormous emphasis on the capacity to take weight from the ground and put it overhead, and rightly so. However, the last thing we want happening in our quest for increase performance, health and independence is injuries.

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Nice
The loading of overhead lifts such as strict presses, clean and jerk, snatch, push press, crossfit style kettlebell swings etc. is fantastic full body strengthening if you are able to achieve the optimal body position to allow the shoulder to be stable and packed, doing the least amount of work as possible. Unfortunately not all of us using these lifts are getting there.

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To get into this optimal position the shoulder needs some help from the thoracic spine (T-spine), or the upper back. The best way to take some load off your shoulders is to ensure you have good thoracic spine (T-Spine) mobility primarily the ability to extend and rotate. If you are in a rounded position with your  T-Spine, you place the shoulder joint in a forward position blocking it from using its full range. Other than looking crap from the side there are a couple of important issues with this position:

1. It can result in subacromial jamming, causing you to mash the tissues between your humeral head (top of the upper arm) and the acromion (boney structure at the point of your shoulder) = tears/ inflammation/ pain.

2. It requires you to arch you low back (lumbar spine) to make up for the lack of range at the shoulder/T-Spine = potential for low back aggravation/pain.

3. Your head position will move forward causing a pokey chin posture = increased susceptibility to neck problems/pain.

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Don’t be that guy
Because of the oblique angle of the facet joints in your T-spine you can add a great deal of extension range by improving your rotation. So try this t-spine rotation exercise to improve your overhead position and save those shoulders:

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Starting position

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Middle: Pause at end of each exhalation, inhale and rotate some more

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Finish: After three breaths/rotations reach the arm. Pause and return to the start
Key Points:

1. Make sure you support the top leg with a pillow or foam roller
2. Take a deep breath in, exhale and rotate stop when you run out of air, pause, take another deep breath and repeat.
3. Drive the rotation by turning your head
4.Try to relax your lower body completely
5. The upper leg must be at or above 90degree at the hip

The aim is to have both shoulder relaxed and flat on the floor.
Repeat 3-4times each side.

References:

1. Sher JS, Uribe JW, Posada A, et al. Abnormal findings on magnetic resonance images of asymptomatic shoulders. J Bone Joint Surg Am. 1995;77:10-15

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Dr Mun Khin Chan

Dr Mun Khin (MK) Chan Orthopaedic Surgeon Specialist Upper Limb Surgeon | Shoulder | Elbow | Hand | Trauma Dr Mun Khin (MK) Chan is an Australian fellowship-trained orthopaedic surgeon specialising in upper limb surgery, with expertise in shoulder, elbow, wrist and hand conditions, as well as orthopaedic trauma. He holds a Bachelor of Medicine and Bachelor of Surgery (MBBS) from the University of New South Wales and is a Fellow of the Royal Australasian College of Surgeons (FRACS) and the Australian Orthopaedic Association (FA OrthoA). Dr Chan completed advanced fellowship training in shoulder, elbow, hand and wrist surgery, with additional expertise in arthroscopy (keyhole surgery), joint replacement and sports-related injuries. His clinical interests include rotator cuff tears, shoulder arthritis, elbow injuries, tennis and golfer's elbow, carpal tunnel syndrome, Dupuytren's contracture, trigger finger, wrist conditions and orthopaedic trauma. Dr Chan works closely with each patient to develop personalised treatment plans tailored to their condition, lifestyle and goals. He consults at MTP Health in St Leonards and East Tamworth Medical Practice, and operates at North Shore Private Hospital, Northern Beaches Hospital, Westmead Private Hospital and Tamara Private Hospital. Alongside his clinical practice, Dr Chan is actively involved in orthopaedic research, has presented at national conferences, published in international peer-reviewed journals, and contributes to the education of future doctors and allied health professionals. He was awarded the University of Newcastle Dean's Award for Excellence in Teaching. Fluent in English, Cantonese and Malay, Dr Chan is committed to helping patients understand their condition and treatment options so they can make informed decisions about their care.