Shoulder 'Dislocation' Stretch

[Daverlee]

Hi,

What are the views of Physios on this stretch. It involves stick/dowell/theraband grasped pronated with extended arms, elevated overhead and down the back. All with extended arms then repeated overhead to the front of the body. Aim is to narrow the grip over time as mobility increases.
Used as a dynamic warm-up/exercise do you think this is an effective exercise to boost mobility of the shoulder joint or dangerous for inflexible shoulders?

Thanks

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[Dr Damien]

Dear Daverlee

Im having some trouble picturing this exercise...what ever the stretch you want to give, I think you want to consider how recent the dislocation was and how many dislocations the individual has had before you prescribe any exercise stretching exercise...

Cheers

[Daverlee]

Hi Dr Damien,

No the stretch would not be used for anyone with a history of dislocations or stabilisation concerns. It is just the name for the stretch. Link below for description of stretch:
How to Perform Shoulders Dislocations | StrongLifts.com

Combined with a good thoracic mobility programme it seems to work well and i am looking at it more closely and working through it myself 20wks post rotator cuff surgery (small supraspinatus tear) . I was just looking for any contraindicated view of this stretch.

Thanks!

[Dr Damien]

Dear Daverlee

thanks for the enlightenment, had no idea thats what there were called...do you?

Off the top of the dome

I would suspect that this exercise will be good if you entire cervicothoracohumeral complex is in tip top shape... I also feel it may be used for a post up rotator cuff as an advanced exercise...because it combines a good stretch working concentric/ eccentrically, however a thorough assessment is needed prior...
The other arm helps stabilize the thorax helping to recruite the scapulo spinal muscles...it looks good however you were hoping we would give our opinions on where you feel contraindications may exist is it not...

1) client with neck disorders, this should be sorted out first before giving them this exercise...as from the picture, I can already see one client going into a hike and his neck appears sideflexed an rotated left...this person will develope serious neck issues if he continues with this exercise...

2) I would say clients with an impingement syndrome should be carefully assessed before prescribing this exercise...if the cannot achieve painless abduction within the required range then they shouldnt do it...likely that if the scapular hasnt got enough range of motion, an impingement can occur...


3) recurrent shoulder dislocations will be a no no...instability definitely a no no...

4)i feel clients with arthritic shoulders will not be able to do this...there is a risk of aggravating their symptoms, they are better of with pendular exercises, mild arthritis probably...

The only downside to this exercise is i do not feel it will allow for good scapulohumeral rythmn (because the bar limits fluidity of transition from internal to external rotation...Ive tried it on myself and I keep getting clicks in my left shoulder), throught the range of flexion and abduction...good exrtenal rotation is needed, if your cervicothoracohumeral complex is rubbish...you could seriously hurt yourself...
A thorough assessment will be needed before i prescribe this for anyone and if I have to...I will do it in supine..

There are safer ways to improve the mobility of the shoulder, I feel...

Can you tell me how you have used this exercise? and what reports you have obtained from people who have been doing it.


Thank you for the clarification earlier

[salsaqueen99]

Dear physio in (cyberspace),

I too am interested in your perspectives about this stretch since I am a personal trainer and public servant (during the day).
I injured my shoulder 4 years ago and as a personal trainer and injured dancer I would be interested in your perspectives on how to 1) improve scapula mobility and 2) thoracic mobility. In January 2010 I compressed the ulnar nerve which has affected my ability to use the computer for long periods of time and to type.

I have been working on scapula stability for about 4 years now and have good strength but my scapula mobility is still poor. It seems to get stuck and because it sticks it causes the levator and neck muscles to do more work. I would be interested in advice on potential exercises I could try. I also have poor thoracic mobility but it improves after lying on a foam roller and manipulation from my physio.

Because of the constant flare ups in levator and infraspinatus along with the nerve compression, he is suggesting that I consider a CT scan guided cortisone injection around the nerve root C5/6. I am hesitant because 1) it is invasive, 2) there is a possibility that it may not work and 3) his diagnosis may not be correct. Can anyone shed light on some potential options or considerations other than a cortisone, and how I can increase scap mobility.

Suggestions or literature I can look at to try to increase mobility and considerations other than cortisone are greatly appreciated.
Many thanks in advance.

[Daverlee]

Hi Dr Damien,

Thanks for the reply. Agree with all of your comments.
I only recommend and adminster for those with injury free shoulders, good external rotation and no signs of instability or impingement issues. Pre-requisites of good thoracic mobility and scapular control also required.

Also i only use a therband (or similar) which allows a wider grip, muscle activation and less transition issues throughout the movement.
I also agree that there are many other safer shoulder mobility exercises however i do like this one for working the chest (pec minor/major) dynamically with the shoulder complex.
Thank you for your feedback


Salsaqueen:

Thoracic mobility has been paramount to myself and many of my clients. I have found this compounded with postural symptoms (lower/upper cross syndromes) are the cause of many imbalances and pain.
Some of the best mobility exercises i have logged come from experience but best summarised by Mike Boyles articles T NATION | Joint-by-Joint Approach to Training T NATION | Essential 8 Mobility Drills -. I like his approach to many common training issues and from a history of working with injured and high performing atheletes.
Many of these items can be found on ptonthenet also - just look for thoracic mobility drills, things like threadneedles etc are great. Getting to a stage where mobility leading to stability then leading to strength is key

Scapular mobility, control and strength are key to healthy shoulders. There are alot of exercises as you probably know. Good serratus function is paramount in addition.

For your other items noticed above - think this needs to go to the doctors to comment.

Thanks