Three Movement Considerations for Overhead Athletes
By: Aaron Page, DPT
With baseball season right around the corner, it is time to brush off the old leather and get your body, shoulder and arm ready to start throwing some heaters. To be fair though, this resource is not exclusive to baseball. In fact, anyone that will be throwing, swimming or hitting a volleyball this spring or summer can find a lot of good information on how to protect your shoulder.
When it comes to doing anything overhead (arms above shoulder height) there are a few main components that you have to consider:
- Thoracic (upper back) mobility
- Scapular (shoulder blade) control
- Glenohumeral (arm) control
Thinking of it broadly, your arm sits in the socket of your shoulder blade, and your shoulder blades sit on top of your thoracic spine… therefore if any one of those three components is not working with the others, they could be getting more stress than their counterpart instead of being shared by the whole system. That is when you are likely to end up with an injury. So, what is the best way to prevent that? It is likely that there are many factors as to why this may be happening. We do not want to lump all of them into one category, so keep in mind this “assessment” is meant to give you a general idea of where to start when it comes to protecting your shoulders.
If you’re already having pain, a formal evaluation may be necessary to see what structures are involved and how to address them directly. If not, try this quick self-screening tool to see how you’re moving.
How to Self Assess: The Wall Angel
This ‘wall angel’ shows how your upper back, shoulder blade and arms all move to get overhead. To perform this assessment, stand against the wall, feet slightly away so you’re leaning into the wall. Low back, upper back and elbows against the wall to start. Keeping elbows and upper back against the wall, rotate your arm to bring the back of your hands back to the wall, palms are now facing forward with back of hands and forearms against the wall. Lastly, slide the back of your arms up overhead, as if making a snow angel, against the wall. If you can’t keep your back, forearms, or hands against the wall without “cheating”, it is likely you need some mobility work to get into a safe starting point and improve strength to keep your shoulder safe in the overhead position while swimming, hitting a volleyball, or throwing that baseball.
First check: Upper Back (Thoracic Mobility)
If you feel as if you can’t keep your upper back against the wall without excessively arching your low back, or shoving your head forward you may have some limitations in your thoracic extension (think bringing your chest bone up while pulling your shoulder blades down towards your back pockets). If this is the case you could be compensating at the low back, or around the shoulder to make up for that lack of motion—adding to stress. Does this sound familiar?
What needs work: Spine Motion
The fix: Kneeling Thoracic Extension with Lat Stretch
Try the Lat Stretch with Dowel to help improve that upper back extension, and stretch your lats at the same time. This will help keep a more neutral spine while reaching overhead and be of less stress to the shoulders! Make sure not to excessively arch low back, think ‘neutral.’
Second check: Shoulder Blade Control (Scapular Mobility)
If you can’t get your forearms or hands against the wall even before sliding upwards, it’s likely you’re having some limitations in your scapular, or shoulder blade motion. Oftentimes this can be due to tightness from the front: either in your chest/pecs, or weakness in the muscles that control the position of your shoulder blade.
What needs work: Poor Form
The fix: Chest Openers
Both of these movements, Open Books and Prone 90/90 with External Rotation are meant to improve both spinal and shoulder blade motion. This combination is meant to work on both shoulder blade motion and strength.
Final Check: Arm Control
Lastly, if you can’t keep your hands against the wall as you slide your arms up it’s likely you have double trouble, both with range of motion and strength.
What needs work: Poor Form
The fix: Posterior Arm Motion & Control
By performing some soft tissue work with the foam roll on the back side of your shoulder blade and the lats, that can free up some workspace for that shoulder to spin in the socket. That being said, once you have the motion, you have to have the strength to control it! Give these a go for the final step.
This may seem like an oversimplification, but if your shoulder muscles aren’t moving well, or controlled well in this drill imagine trying to use those same muscles to swim or throw! Work on a few of these and keep an eye out for additional information on more advanced exercises for throwing.