Improve Shoulder Health: Work Proximal to Distal

It goes without saying that the shoulder is commonly injured among throwers. Unfortunately, most shoulder prehab and rehab programs begin and end with cuff strength exercises, and that’s it. When it comes to shoulder health keeping the ball in the socket is the name of the game, and there is a lot of factors that come in to play to ensure that happens.

Work proximal to Distal

Everything starts with core control, or lack thereof. All humans have a normal lordosis or natural arch to their lumbar spine, but what happens with many athletes is that this natural arch becomes excessive.

So what does this have to do with the shoulder?

The body is a stack of joints designed for either mobility or stability. When the lumbar spine is unstable, that dictates your rib positioning. If the rib cage is flared upward the scapula cannot upwardly rotate to stabilize the shoulder.

Consider this when programming your core training. It’s less about movement and more about core control, whether it is anti-extension or anti-rotation. A great place to start would be with deadbugs and back to wall shoulder flexion. Both these exercises get the arms up over head while encouraging core stabilization, and can easily be thrown into a warm up or used as fillers during your workout.

T-Spine Mobility

As you work your way up the chain you’ll see athletes that present either overly kyphotic (hunched over) or with a flat thoracic spine, and both can have their complications.

An athlete with an overly kyphotic T-spine cannot get enough extension to get the arm up and will compensate with either lumbar extension or a forward head posture in order to get there. Side Lying Windmills and bench T-Spine Mobilizations do a great job getting these athletes to extend and rotate their T-Spine.

But, not every baseball player needs to work on thoracic mobility drills. For a large number, if not most sit with a very flat T-Spine. This pattern can lead to a position where the scap can’t actually rotate up and around the ribcage with the arm. Spinal Flexion Drills are going to be very beneficial for these athletes.

Lower Trap & Serratus Anterior

The lower trap and the serratus anterior are often the forgotten muscles when it comes to arm care. Without them there is no keeping the ball in the socket. The lower trap and the serratus work together to give the scap posterior tilt and upward rotation as we bring our arm above our head.

If you ever see an athlete with their scaps poking out the back of their shirt their T-Spine is likely flat, and the serratus/low traps are likely weak and inactive. We'll have these athletes doing activation and strengthening exercises for these muscles 3-4 days a week.

Without even mentioning the cuff there is a lot that has to happen to keep the ball in the socket and keep the shoulder healthy. Cuff strengthening is still really important and I tend to micro dose our baseball players programs with some sort of cuff strengthening, timing, or irradiation exercises nearly every day. But, if you really want to optimize shoulder health and performance make sure everything else down the chain is in check.