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Triathlon Magazine Canada - - CONTENTS - By Me­lanie McQuaid

Pre­vent­ing Shoul­der In­jury

While swim­ming is, in the­ory, a rel­a­tively in­jury-free sport, the one area of the body sus­cep­ti­ble to swim is­sues is the shoul­der. Pre­hab ex­er­cises strengthen the ar­eas of the body that are the most vul­ner­a­ble to stresses from ev­ery­day move­ment. By strength­en­ing these mus­cles, pos­ture and align­ment can be im­proved and the stresses of repet­i­tive ex­er­cise mit­i­gated.

Phys­io­ther­a­pist and for­mer na­tional team swim­mer Matt Rose has cre­ated a pre­hab pro­gram that tar­gets the ro­ta­tor cuff and bi­cep ten­don to pro­tect the shoul­der from in­jury. Pre­ha­bil­i­ta­tion fo­cuses on strength­en­ing sup­port­ing mus­cles to fa­cil­i­tate proper biome­chan­ics in move­ment to avoid the ne­ces­sity of re­ha­bil­i­ta­tion.

The con­stant ro­ta­tion of the shoul­der joint dur­ing swim­ming puts stress on the mus­cles of the ro­ta­tor cuff which is com­prised of four small mus­cles: the supraspina­tus, in­fraspina­tus, teres mi­nor and sub­scapu­laris. Fo­cused work on these mus­cles is more ef­fec­tive for main­tain­ing shoul­der health than heav­ier weights for the larger prime mover mus­cles in the shoul­ders as the lim­i­ta­tion for most triath­letes is not brute strength, but cor­rect mo­tor pat­terns and f lex­i­bil­ity. “Most shoul­der in­juries oc­cur af­ter a long break or dur­ing a build in vol­ume (the steeper the build the more likely to in­jure),” ex­plains Rose. “These ex­er­cises are key dur­ing the off sea­son and build ups in train­ing,” he continues.

The only equip­ment re­quired is ei­ther rub­ber tub­ing or re­sis­tance bands. At­tach one end of the tub­ing to a door or fixed ob­ject so that the band will be at ap­prox­i­mately waist height. Rose ad­vises ath­letes to “lock the shoul­ders gen­tly down and back – about 90 per cent down and 10 per cent back.” This lock should hap­pen with each re­peat fol­lowed by an “un­lock” of the blades to pro­gram the proper pat­tern.

Rows

Be­gin the ex­er­cise lock­ing the shoul­der blades down and back. The key is to not al­low any move­ment in the shoul­der blade when row­ing with the arm. While hold­ing the tub­ing or pul­ley in one hand, you will first lock your shoul­der blade. While main­tain­ing the lock, pull the arm back un­til the el­bow is bent to 90 de­grees and re­turn for­ward to the start­ing po­si­tion, fol­lowed by un­lock­ing the blade (re­lax be­tween each rep). The shoul­der blade moves to po­si­tion be­fore the arm pulls back and re­mains locked when the arm re­turns for­ward.

In­ter­nal and Ex­ter­nal Ro­ta­tion

With each rep of in­ter­nal and ex­ter­nal ro­ta­tion you will lock the shoul­der blade ( be­fore) and un­lock it (af­ter). For ex­ter­nal ro­ta­tion, lock the el­bow at your side, bent at 90 de­grees, stand­ing straight. Lock the shoul­der blade down and back, pull the arm the fur­thest from the an­chor point away from the body. Pull the tub­ing di­rectly away from your body, keep­ing your el­bow an­chored to your side. The mo­tion is like a gate open­ing and clos­ing. Con­tinue for one minute and work to­wards two min­utes per side.

For in­ter­nal ro­ta­tion, stand per­pen­dic­u­lar to the an­chor point and grasp the tub­ing with the hand clos­est to the an­chor. Take one lat­eral step away to put re­sis­tance on the band. With the el­bow held close to the body, ro­tate the arm away from the an­chor point to­wards the body then re­turn to the start­ing point for in­ter­nal ro­ta­tion. Re­mem­ber to lock and un­lock the blade with each rep. Start with one minute. Work to­wards two min­utes per side for each di­rec­tion.

Rose sug­gests tak­ing about three sec­onds to move in each di­rec­tion for a slow con­trolled move­ment.

Push-Up Plus

Be­gin in a plank po­si­tion or the start of a push-up po­si­tion. While keep­ing el­bows locked straight, raise up as high as pos­si­ble and lower down slowly in be­tween your shoul­der blades, all with­out bend­ing the arms. Mov­ing the hand po­si­tion around can make this ex­er­cise more or less chal­leng­ing. For in­stance, try stag­ger­ing the arms for­ward and back or make them wider apart. Re­mem­ber to keep the shoul­ders down, away from the ears and the arms straight for this ex­er­cise. Start with 20 rep­e­ti­tions.

Train­ing the cor­rect move­ment pat­tern is the key to pre­hab ex­er­cises. Fo­cus most of your at­ten­tion on qual­ity over quan­tity.

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