NSCA article on training and shoulder injuries

Overview of Shoulder Injury Considerations in Training

Training clients with shoulder injuries requires personal trainers to adapt exercises to accommodate injuries and maximize recovery. Collaboration between personal trainers and physical therapists is essential for a safe transition from rehabilitation to performance.

Importance of Collaboration

• Benefits of Collaboration:

  • Personal trainers working with physical therapists can streamline recovery for clients.

  • Training within one's expertise ensures safety and effective outcomes.

Statistics and Insight

• Resistance Training Injuries:

  • Approximately 35% of resistance training injuries occur at the shoulder.

  • Most injuries stem from improper loading and faulty lifting mechanics.

Anatomy of the Shoulder

• Structure:

  • The shoulder joint comprises the scapula, humerus, and clavicle.

  • The glenoid fossa helps support the movement of the humerus during exercises.

• Rotator Cuff Muscles:

  • Key muscles include supraspinatus, infraspinatus, teres minor, and subscapularis which stabilize the shoulder during various activities.

Injury Risks

• Common Mechanisms:

  • Injuries result from overload, muscular imbalances, and improper mechanics.

  • Modification of Exercises Needed:

    • Some exercises may be too stressful for clients with specific limitations, such as limited shoulder flexion.

Training Modifications

Exercise Execution

• Range of Motion Adjustments:

  • Modifying depth and angle of exercises can significantly reduce shoulder strain.

  • Use props (e.g., rolled towel for pressing) to limit range while still allowing functionality in workouts.

Specific Exercise Considerations

• Push-Ups and Bench Presses:

  • Elbows should remain at about 45 degrees abduction to limit stress on the shoulder.

  • Consider using a floor for push-ups instead of a bench to decrease load.

• Landmine Press:

  • Recommended alternative to traditional presses as it decreases stress on the shoulder by not emphasizing end-range elevation.

Progression and Recovery Strategy

• Collaborate for ROI:

  • Open dialogue with medical professionals to determine the recovery stage and appropriate progression.

  • Use light resistance and low-load modalities initially to increase shoulder comfort and strength.

Effective Exercise Variations

• Row Variations:

  • Lower rows (0-45 degrees shoulder abduction) are beneficial for those with shoulder injuries, helping to strengthen muscles without excessive strain.

• Vertical Presses and Pulls:

  • Traditional presses may be limited; instead, a landmine or scrape press can be more tolerable as recovery progresses.

Concluding Guidance

• High-intensity training can resume post-injury with clear protocols for modification of load and exercises.

• Proper communication between trainers and rehabilitation professionals is key to ensuring the client’s safe return to strength training and athletic performance.