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Painful shoulders. Worthing Physio discuss possible causes in tennis players and golfers.

October 18, 2014 by physicalrevolution No Comments »

This week i have been looking at the shoulder blade in relation to posterior impingement at our Worthing Physiotherapy clinic.

Simply put, this is when some of the sensitive structures such as the rotator cuff tendon get pinched underneath the posterior arch of the acromion of the shoulder blade as you can see in the picture below. Particularly vulnerable positions for this scenario are any positions which ask us to raise the arm and then rotate it backwards such as during an overhead smash or serve in tennis, backswing of the golf swing or in late cocking phase when throwing a cricket ball.


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It is important to understand the role the shoulder blade may have to play in these positions. When lifting the arm up and out to the side in preparation lets say for the tennis serve or the backswing in golf, then during the initial lift of the arm – the majority of our range of motion comes from the shoulder ball in the socket. The shoulder will generally move somewhere in the region of 3:1 in the initial phase. Then between 80 degrees and 140 degrees of arm elevation the shoulder blade moves predominantly more than the shoulder ball. It is not until the final phase between 140 degrees and 180 degrees that the shoulder ball motion overtakes that of the shoulder blade again – in the ratio of about 3.5:1. Thus, that critical phase between 80 and 140 degrees, the shoulder blade is rotating in predominantly three different planes of motion.

 

 

 

Namely 1. upwards : The average shoulder blade will tilt upwards roughly 50 degrees

2. Externally and 3. posteriorly – see explanation in the video below: The average shoulder blade will externally rotate about 24 degrees and tilt posteriorly about 30 degrees.


One exercise i like to carry out to ensure the shoulder blade is moving through these combinations of movement can be seen in the video below BUT remember – you can’t hope to train the muscles for the movement if the movement itself is restricted – we will look at how the shoulder blade may become restricted in these positions and how to remedy them in later blogs..


Hope this gives you some help/insight into any shoulder pain you may be experiencing in your sport.

Long live the Revolution !

 

Matt

 

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