Active Rehab: Overhead Flexibility

My personal goal in these weekly rehab posts is to prepare my body to safely learn some Olympic lifts next month (February), to document my progress along the way, and to educate whomever decides to read along in the process. Olympic lifts include two movements called the “clean and jerk” and the “snatch” and their many variations.

As you can see, these movements involve a significant overhead component (as well as strength, flexibility, and cardiovascular ability), and it has recently come to my attention that, while I’m fairly flexible in my lower body, I currently lack the ability to completely extend my arms overhead without making other compensations such as arching my upper back or pushing my head/neck forward.

No Compensations: Back Straight, Neutral Head. This is as far as I can raise my arms

Compensations: Back Arched, Head Forward

Shoulder: Joints

To narrow in on what may be tight around my shoulder, I’m going to look through the anatomy of the shoulder joint. The shoulder is composed of 3 bones (the humerus, scapula, and clavicle) and 2 joints:

1. The glenohumeral joint between the glenoid fossa  (a landmark on the scapula or shoulder blade) and the humerus (upper arm bone).
   
2. The acromioclavicular joint (AC joint) made up of the acromion process (bony landmark of the scapula or shoulder blade) and clavicle (collar bone).
   

Shoulder: Muscles

There are 5-6 “major mover” muscles that attach to these bones and cause movement of the arm at the shoulder. The major movements the arm can perform are: flexion (raising arm in front of body), extension (moving arm behind body), abduction (raising arm out to side), and adduction (bringing arm to side of body).

I’m classifying major movers as the muscles that move the arm in these two planes of motion:

1. Deltoid– a muscle at the top of the arm involved in flexion, abduction, and extension of the arm. Its name is deltoid because it is shaped similar to the character delta Δ.
   
2. Pectorals Major and Minor–the chest muscles, important in flexing the arms, for instance during pushups. (Sorry for the creepy picture face)
   
3. Latissimus Dorsi (also just known as the lats, because the full name is a mouthful and ain’t nobody got time for that). The lats are important for extension and adduction, or bringing the arms back to the body, as in pull ups or rows.
   
4. The Teres Major is a smaller muscle just above the lats that performs a very similar function to the lats, assisting with extension and adduction of the arms.
   
5. Other muscles of honorable mention in this category are the long head of the biceps, which crosses the shoulder joint and performs some flexion of the arm, and the long head of the triceps which also crosses this joint and performs some extension of the arm.
   
   

   Biceps

   

   Triceps

Then, there are the minor movers of the shoulder, primarily the rotator cuff muscles. These muscles mostly provide stabilization to the shoulder joint, holding the head (top) of the humerus in the correct position against the glenoid (socket) during movements and performing internal rotation and external rotation of the arm.

1. Supraspinatus– tiny muscle that assists in lifting the arm overhead and is frequently injured from lifting overhead.
2. Infraspinatus–external rotation
3. Teres Minor–external rotation
4. Subscapularis–internal rotation

There are other important structures of the shoulder including ligaments and the labrum, but I’ll discuss those at a later time when I expand on common injuries at the shoulder joint.

Weekly Rehab Fix

Last week I focused on tension in my neck through stretching the pecs, scalenes, and levator scapulae and soft tissue massage with a small ball in the pecs and traps. I didn’t do it every day, but I managed to do the routine 5 out of 7 days of the last week. It has helped with the post-workout headaches I was experiencing (none in the last week), but it hasn’t eliminated that “need to stretch” sensation in my neck or chest muscles. I’m going to keep these exercises in my rehab routine this week and do them at least every other day.

This week’s focus is on the lats and back-of-the-shoulder muscles like the posterior deltoid, infraspinatus, teres major, and teres minor. I’m adding in some small-ball-massage of my lats (just the thought is painful because mine are soo sensitive) and posterior deltoid area (the back side of the shoulder), a stretch for the lats, and 2 mobility exercises. Let’s see if this helps my overhead reach!

1. Small ball massage of the lats, 1 minute each side
   With the arm raised overhead, palm facing inward toward the head, sandwich the ball between the wall and the edge of your latissimus dorsi (on the side of the body, underneath the armpit). Gently massage back and forth.
2. Small ball massage posterior deltoid area, 1 minute each side
   With arms at sides or hugging your chest, sandwich ball between the back of the shoulder the wall. Massage around that shoulder area.
3. Wall Lat Stretch, 30sec each side, 3 times
   
4. Bench T-Spine Mobilization, 10 times focusing on form, nice and slow. You can use a broom stick, empty paper towel roll, or any stick that’s light.
5. Wall Slide with Upward Rotation and Lift off , 10 times, slow and controlled.

This routine should take less than 12 minutes to complete. I’ll update my instagram with pics through the week as I do these 5 exercises daily. Let me know if you give ’em a shot!