Tag Archives: shoulder injury

Using the Overhead Squat Assessment to Identify Reductions in Punching Quality

The overhead squat assessment promoted by NASM (Clark & Lucett, 2011) provides a useful evaluation of the functional status of the latissimus dorsi during a common movement (video example here). The OHS requires that both trunk extension and shoulder flexion occur simultaneously, either or both of which may be altered if the muscle has become chronically shortened and tight. When the lats are hypertonic, shoulder range or motion (ROM) is altered due to excessive internal rotation and depression of the humerus, which further affects the actions of the scapula. This can be seen when an individual’s arms habitually fall forward past the line of the torso during the eccentric phase of the squat in an OHS evaluation, which is an indication of the arthrokinematic (joint movement) compensations needed to accommodate functional ROM as the muscle attempts to maintain a shorter distance between origin and insertion (for an excellent visual of how this occurs, take a look here).

Rear view of the latissimus dorsi. Note the broad connection to the pelvis, and the insertion on the humerus. An overactive (hypertonic) lat will cause alterations in shoulder and hip function, impairing good technique by reducing strength and mobility, while increasing the chances of an avoidable chronic injury.

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Corrective Exercise Concepts for Striking

Regular feedback from practicing strikes against resistance (hitting bags etc.)  is essential in the fighting artist’s training regimen. As important as hitting is, it can be over done. In order to prevent muscular imbalances, that in turn lead to avoidable injuries and performance impairments, measures to counter or correct them must be included in programming. The following guidelines are designed to assist instructors and students in both improving performance and preventing injuries associated with training.

Conditioning Guidelines:
  • If you are conditioning the anterior (chest and shoulder) musculature, don’t neglect the posterior (back). These muscles form force-couples of agonistic and antagonistic action; if one side is chronically short and tight, the other will be long and spastic, and vice avers. Neither condition is very efficient, and will likely  lead to a more serious injury.
  • If you are conditioning the large prime movers (ie, pectorals), don’t neglect the smaller stabilizers (ie, subscapularis).
  • For every session of bag intense work,  consider including 2-3 days of active recovery for the chest and shoulder muscle and associated striking & conditioning actions (see below).
  • For every 3-4 weeks of regular striking, include 1 full week of active recovery into your training routine. Don’t worry about de-training in a week’s time- this takes up to 4 weeks of inactivity to become significant.

Tissue Quality:

  • Muscle and connective tissues remodel along lines of force.  Repeated actions, particularly forceful ones, will alter tissue extensibility, elasticity and mobility, and potentially effect nerve tissue mobility (especially in the case of the brachial plexus and it’s divisions).
  • Corrective exercise and self myofascial release are  recommended to provide the optimal length/tension relationships for the agonist/antagonist muscles, and break up fascial adhesions (“trigger points”, “knots”) within and between muscle tissues. This helps to promote efficient technique as well as protect the shoulder joint and cervical-thoracic spinal systems.
  • For SMR, hold sustained pressure on areas of tight and tender muscle for a full 30 seconds. A foam roller can be used for most exterior muscles, but a tennis ball or lacrosse ball is needed to access smaller, deeper ones. Avoid SMR in bruised, ruptured or acutely sore tissue.
  • For static stretching: hold each stretch for 20-30 seconds, repeat x 2 times per day, especially after hitting bags/pads/makiwara.
  • Avoid extensive static stretching immediately before engaging in heavy, intense striking work. A light pendulum stretch can activate the rotator cuff muscles and mobilize the superior thoracic outlet and sub-acromial space, which may be tight from training/fighting in a “hunched” posture.
Stretching & Myofascial Release Techniques 
Prime Movers (these vary in their contribution or action according to the strike in question):
  1. Pectorals : Flex, internally rotate and adduct shoulder arm at shoulder, pec minor specifically pulls the scapula forward and down. Do one at a time, avoid the double arm “hanging” doorway stretch.
  2. Triceps: Extends forearm. This muscle is heavily used in straight-arm punches and strikes.
  3. Biceps: Flexes and supinates forearm. Used heavily in hooks and uppercuts, the flexion of the upper arm at the shoulder, as well on the return to guard from a strike. Counter intuitively, the biceps has a major role as both a mover and stabilizer for straight punches; it is often neglected because of the assumption that punching is dependent on the triceps (or momentum, in some circles).

Stabilizers (these vary in their contribution or action according to the strike in question):

  1. Subscapularis: Shoulder internal rotator. There are also ways of performing this using a stick or towel for assistance, but starting out in the lying position makes it easier to monitor the head of the humerus (upper arm) to ensure that it is not rotating forward.
  2. Teres Minor and Infraspinatus. Shoulder external rotators. Notice that she is not forcing her arm down. If the head of the humerus wants to bulge forward and the shoulder up off of the table, don’t push it past this point.

Synergists:

  1. Levator Scapulae: Scapular elevator and medial rotator,  neck rotator and lateral flexor. This muscle attaches the cervical vertebrae to the upper medial aspect of the scapula. The upwardly rotated, “hunched” position that many fighters adopt during bag work and fighting can shorten and tighten this muscle.
  2. Upper Trapezius: Assist in elevation and retraction of scapulae. This region of the trapezius may be tight from forward shoulder “hunched” posture common to fighting and training.

Primary Antagonists:

  1. Rhomboids: Retract and elevate scapula.  These may be lengthened and inhibited from the forward shoulder “hunched” posture common to fighting and training.
  2. Latissimus: connects the humerus to the lumbar and thoracic spine, adducts, extends and internally rotates arm at shoulder. These are often tight in people who kick a lot or engage in excessive “air punching.”  Hint: if you can’t do a squat with the arms stretched overhead and keep the hands in line with your ears, or can’t help but fold at the waist as opposed to the hips, the lats need serious  attention to restore mobility to your shoulders.

Relevant surface muscles of the back and chest

Deeper relevant muscular anatomy

Shoulder Exercises Article on SportsBulletin.Com

Follow this link for a few suggestions for exercises that may help you prevent, or deal with a shoulder injuries.

http://www.sportsinjurybulletin.com/archive/0034-shoulder-injuries.htm