Shoulder injuries are some of the most common injuries in sports. The shoulder is a ball and socket joint and has a huge range of motion in multiple planes of direction. The shoulder is impacted by a huge array of muscles including biceps brachii, brachialis, coracobrachialis, deltoids, infraspinatus, latissimus dorsi, pectoral, subscapularis, supraspinatus, teres major, teres minor, triceps brachii (short and long heads).
One of the most common injuries functional fitness athletes experience is a shoulder injury. Great demands of shoulder strength and mobility are often required to effectively and safely perform movements like pull-ups, muscle-ups, handstand, snatch, cleans, jerks, push-ups, bench press, and more.
Our first step to improving the health of any joint and reducing the risk of injury is to ensure the joint is functioning properly. The shoulder is capable of many movements including flexion, extension, abduction, adduction, rotation and circumduction. The problem is we live in a modern world in which we no longer use our shoulders to its full potential, and the saying goes "If you don't use it you lose it." Many of us find ourselves deskbound for hours at end without the need to move our shoulders much further than the keyboard, the mouse, or for a cup of coffee. In contrast our paleolithic ancestors may have found themselves using their arms to throw spears for hunting, climb to safety or acquire food, swimming across rivers etc. Yes, they may have evolved to do these activities for the sake of survival but regardless they used their bodies much more than we do today and as a result would have maintained healthier joints.
Have you ever watched a child play? How well can they squat and move their bodies? As we age and become more and more sedentary we start to lose our freedom to move. We don't stop playing because we grow old, we grow old because we stop playing.
Based on the huge majority of our movement assessments and growing research on shoulder pain and its correlation with lifestyle, work, inactivity, obesity and metabolic factors to name a few [1,2,3,4]. We realise our clients always need to improve the health of their shoulders for the demands of their activities or even simply for general joint health.
How to improve shoulder health?
We begin by addressing and prioritising movement deficiencies first such as rotation of the joint. This builds the foundation in order to open up a bigger workspace within the joint itself. Having a bigger workspace allows us to more efficiently make progress towards your health goals.
The Functional Range Assessment (FRA) we use at TSTM involves Controlled Articular Rotation (CARs). This can be defined as active, rotational movements at the outer limits of joint motion. These are the foundation of our mobility programmes and offer the client the best use of their time when it comes to improving mobility. CARs are used as a daily ritual/ habit to move the joints through their greatest rotational range of motion so that the range is not being lost. "If you don't use it you lose it"... déjà vu?
A key role of using CARs is the feedback provided to the central nervous system (CNS). The information coming from the peripheral tissue structures such as joint angle or the speed of a movement provide the CNS with consistent feedback of how the body can move in space.
In articulations, the capsule contains a very high number of mechanoreceptors - receptors that take in information about what is occurring with regards to movement - that can then send feedback to the CNS. These capsules happen to make up the deepest part of the joint. Therefore, they are the 1st to perceive movement, which is why it is important to prepare these joints before moving onto more advanced movements and strength challenges. In other words, this will allow for a safe and progressive workspace to apply further stimuli which will be more efficiently recognised by the body and maintained.
Therefore with FRA, our aim is to see how well you perform a CARs assessment to test particular movements like shoulder rotational capacity for the demands of your activity. If you are missing range, no amount of strength training is going to fix it! You can lift as much weight as you like until you get injured, but a more effective approach that would increase strength, mobility and movement efficiency would be to focus on fixing the joint.
To get you started here are 3 CARs that should be performed regularly to improve and maintain the health of your shoulder joint.
Perform each for 2-3 repetitions in each direction. As a morning routine perform these between 10-30% irradiation/ tension in the body. For a more effective stimulus such as a warm-up before training aim to perform this 70 % or above irradiation.
 Correlations of Neck/Shoulder Perfusion Characteristics and Pain Symptoms of the Female Office Workers with Sedentary Lifestyle, Bau, JG, et al. 2017
 Long-term patterns of chronic complaints of the arms, neck, and shoulders and their determinants. Van Hulst R, et al. 2016
 Lifestyle and metabolic factors in relation to shoulder pain and rotator cuff tendinitis: A population-based study, Rechardt, Martti, et al. 2010
 www.painscience.com, Frozen shoulder guide, Ingraham, Paul, 2019