Many shoulder injuries in overhead or throwing athletes can be prevented by following pitch counts, rest and a proper stretching program throughout the year. Proper conditioning (range of motion, stability and strength), mechanics and recovery time are all important factors in preventing injuries. The following are preventative exercises that may be incorporated into the routines of any athlete.
Range of motion exercises may be performed daily; strengthening exercises can be performed three to four times per week as tolerated. Further advancement of functional and sports specific exercises should be done under the supervision of an athletic trainer, physical therapist or strength and conditioning specialist.
Range of Motion Exercises
Hip and Trunk Mobility
- Hip Flexor Stretch – Lunge Position – while kneeling, bring one leg forward. Shift body forward until a stretch is felt in the front of the back hip. Hold for 20 seconds, repeat 3x each side.
- Adductor Stretch – Sideways Lunge Position – stand with feet wide apart as shown. Shift weight to one side until stretch is felt in the groin muscles of the other side. Hold for 20 seconds, repeat 3 x each side.
- Hip Rotator Stretch – Figure 4 – while lying on back, bend both knees towards chest. Then, cross one foot over the front of the knee of the other leg. Stretch should be felt in the glute muscles of the leg crossing over the knee. For a deeper stretch, try to reach forward. Hold for 20 seconds, repeat 3x each side.
- Scorpions – Lie on your stomach, begin by turning at your hip and attempting to touch your foot to hand (see picture). You should feel the stretch in your hip flexors, quads, and abdominal wall. Hold for 10 seconds and repeat 5x each side.
Shoulder and Upper Back Mobility
- Shoulder Cross Body Stretch – with elbow straight and shoulder down, bring arm across your body. Use the opposite hand to further pull towards your body as shown. Stretch should be felt in the back of your shoulder. Hold for 20 seconds, repeat 3x each side.
- Towel Stretch – start by holding a towel with the non-affected arm. Drape it behind your back with your affected arm at the bottom, non affected on top. Grab towel behind your back and use non-affected arm to pull the affected up your back in internal rotation. Hold for 10 seconds, repeat 10x.
- Shoulder Sleeper Stretch – start by lying on your side with the affected arm on the bottom. Your affected arm should be bent at the elbow and forearm pointed upwards towards the ceiling as shown. Next, use your unaffected arm to gently draw your affected forearm towards the table or bed for an inward stretch. Hold for 10 seconds, repeat 10x.
- Shoulder Corner/ Doorway Stretch – while standing at a corner of a wall, place your arms on the walls in the shape of a “W” so that your elbows are bent and pointed towards the ground as shown. Take one step forward towards the corner. Bend your front knee until a stretch is felt along the front of your chest and/or shoulders. Your arms should be pointed downward towards the ground. Hold for 20 seconds, repeat 3x.
- Thoracic Rotations – while in a crawl position, lower your buttock a little towards your feet to get in a lower position as shown. Next, with a hand behind your head, rotate your body and your head to the side, then return. Hold for 10 seconds, repeat 5x each side.
Scapular Stability Exercises
- Scapular Depressions and Squeezes – Start by squeezing your shoulder blades together. Next, push your arm down towards the floor. As you do this, your shoulder should drop a few inches. Keep your elbow straight and wrists extended the entire time. Perform 3 sets of 10 reps.
- Standing Rows with elbows bent – Holding elastic band with both hands, draw back the band as you bend your elbows. Keep your elbows near the side of your body. Perform 3 sets of 10 reps.
- Horizontal Abduction – While holding an elastic band with your elbows straight and in front of your body, pull your arms apart and towards the side as shown. Perform 3 sets of 10 reps.
- Lat Pull Downs – Hold an elastic band with both arms in front of you and with your elbows straight. Your arms should be elevated. Next, pull the band downwards and back towards your side as you bend your elbows. Perform 3 sets of 10 reps.
- Serratus Punches – using a band or a light dumb bell. Lie on your back holding a small free weight or soup can with your arm extended out in front of your body and towards the ceiling. While keeping your elbow straight, protract your shoulders forward towards the ceiling and then lower back down in a control motion. Do not allow your shoulder to raise towards your ears. Keep your elbow straight the entire time. Perform 3 sets of 10 reps.
- Wall Slides – Position yourself against the wall with your bottom, shoulders, head against the wall. Position your arms in the field goal position (try to keep the back of your hands and elbows against the wall). Keeping all of the above points of contact squeeze your shoulder blades back and move your arms into a Y position then slowly back to the field goal position. Perform 3 sets of 10 reps.
Rotator Cuff/Shoulder Strength Exercises
- Shoulder External Rotation – While holding an elastic band at your side with your elbow bent, start with your hand near your stomach and then pull the band away. Keep your elbow at your side the entire time. Repeat 3 sets of 10 reps.
- Shoulder Internal Rotation – While holding an elastic band at your side with your elbow bent, start with your hand away from your stomach, then pull the band towards your stomach. Keep your elbow near your side the entire time. Repeat 3 sets of 10 reps.
- Shoulder Abduction in the Scapular Plane – with exercise band anchored low behind you, take the ends of the band with both hands. Starting at your side, elevate your arms in a forward/lateral direction. Your elbows should be straight and the movement should occur in the plane of the scapula or 45 degrees to the side. Do not let your shoulder shrug upwards unless instructed to go over shoulder level height. Repeat 3 sets of 10 reps.
NOTE: The information above is for educational purposes and should not be interpreted as the sole course of action to be taken to prevent injury. If at any point during this exercise program you feel faint or experience pain, stop immediately.
Always consult with your physician before beginning any new exercise program for a proper physical and orthopedic examination. Further advancement of functional and sports specific exercises should be done under the supervision of an athletic trainer, physical therapist or strength and conditioning specialist.
If you or someone you know has experienced a sports injury, request an appointment with one of our sports medicine experts.