Shoulder Injury Fix

If you are a climber, you have probably experienced shoulder pain. It can be sudden or gradually come on with progressively worsening pain/popping/weakness. Usually if it is sudden and acute its because a foothold blows and all the weight falls onto your shoulder and it hurts, pops, or some combination of both. This is the type of injury that time will tell you whether or not you’ve done something serious like a dislocation or tear to the rotator cuff and/or labrum that would require surgery. The more common gradual onset injuries can eventually manifest themselves into a serious problem too, but can be prevented and reversed with exercise and functional training.

Gradual/Chronic injuries usually come about because of two main reasons. Overuse and poor body mechanics. These two factors can be connected and interdependent or completely separate to each other.

First overuse is simply understood as you use it too much and are not allowing proper recovery time. Most climbers do not realize that the body needs up 48-72 hours for full recovery following a hard climbing session. If you are climbing every other day your injury may be the result of the accumulation destroyed tissue that has no time to recover. Try taking more time off.

In the second case of poor body mechanics with the shoulder, body position is extremely important to be aware of. If you have a weak muscles and/or a muscle imbalance your body and shoulders will be taking additional force and strain to part of the shoulder that shouldn’t take the force. I am sure you’ve heard how climbers get rounded shoulders. It is the most common muscle imbalance in the sport of climbing. Let me describe what happens.

When we climb we usually try hard. Most of the time we try to reach holds that we can’t reach. To do this our body creates a compensation to achieve greater reach. We medical professionals call it increase shoulder elevation. Its a great thing because it helps us reach farther. We use our upper shoulder muscles to lift our shoulder blade higher to get the hold. See picture below.

Example of increase shoulder elevation to get a hold
Example of increase shoulder elevation to get a hold
What your shoulder should do after getting the hold. If your shoulder stays elevated as you begin to pull you have problems.
Example of what your shoulder should do after getting the hold. If your shoulder stays elevated as you begin to pull you have problems.

The problem is that if we are climbing all the time our upper shoulders get over developed and the opposite muscles, this being the muscles in our mid back, can get weaker compared to the other. To put it simply we start reaching above our heads and pulling down with increased shoulder elevation. Kinesiology shows that with increased shoulder elevation without the recruitment of our mid back will actually turn our strongest pulling down muscle, the Latissimus Dorsi, off, meaning it stops working. Once this happens we start compensating motions and the shoulder joint and muscles start taking more force trying to be the primary pulling down muscle.

Increased shoulder elevation
Increased shoulder elevation
Shoulder depression and mid back initiation before pulling.
Shoulder depression and mid back initiation before pulling.

In addition to this, our new weak middle back muscles and shoulder blade support muscles cause our shoulders to get pulled forward into protraction (forward shoulder posture). This puts our shoulder joint in a very poor position where we increase pressures inside our shoulder joint when we trying to move our arms up, down, and around. The increase pressure in the joint make us more susceptible to injuries like Impingement Syndrome, Bursitis, and overuse rotator cuff strains/tears and Labrum tears.

Here is an example that you can test on yourself to illustrate this point. Try to feel the difference lifting your arm above your head with your shoulders rolled forward versus locked back and down. You’ll probably notice things move more freely locked back and down. You can understand that if you are locked in the forward shoulder position because of front shoulder tightness and mid back weakness your actual shoulder joint is taking more detrimental force internally.

Bad climber posture (shoulders forward)
Bad climber posture (shoulders forward)
Lifting your arm in bad climber's posture
Lifting your arm in bad climber’s posture (shoulder forward posture)
Good posture with midback muscle recruitment
Good posture with midback muscle recruitment (shoulder blades locked back and down)
Lifting your arm with good posture and middle back recruitment.
Lifting your arm with good posture and middle back recruitment. Feels better!

So as a super passionate climber, trying hard, and not wanting to get injured, or have an injury and want to get better, what do you do? Think about how long it has taken your body and how much climbing it has happened for you to get these muscle imbalances. It is going to take some time to fix the imbalance. Your basic rehab plan should look like this..

Step 1: Rest control pain, its simple. If you are climbing through pain you need to rest until it stops. Then move onto step two.

Step 2: Exercise and stretch: Begin a routine doing the following exercises as pain permits.

Sets and repetitions: At least 12 each. Holding 3-5 seconds while focusing on squeezing your shoulder blades together and down. You have to do at least three sets of each. Three to four times a week.

First exercise: Back extension with shoulder extension

Modifying option: Do the arm motion without the back extension will isolate your shoulder blade muscles more directly.

Back extension with shoulder extension
Back extension with shoulder extension
Back extension with shoulder extension
Back extension with shoulder extension

Second: 90/90 with back extension

Modifying option: Do the arm motion without the back extension will isolate your shoulder blade muscles more directly.

90/90 with back extension
90/90 with back extension
90/90 with back extension
90/90 with back extension

Third: Flying Y’s with back extension

Modifying option: Do the arm motion without the back extension will isolate your shoulder blade muscles more directly.

Flying Y's with back extension
Flying Y’s with back extension
Flying Y with a back extension
Flying Y with a back extension

Fourth: Flying I’s

Modifying option: Do the arm motion without the back extension will isolate your shoulder blade muscles more directly.

Like the flying Y but arms straight overhead
Like the flying Y but arms straight overhead

Fifth: Push up with a plus

Most climbers do push ups. That kind of works, but this exercise is better. Keep your arms straight.

Push ups with a plus
Push ups with a plus
Push ups with a plus
Push ups with a plus

Sixth: Shoulder Depression

Keep your arms straight pushing down with your shoulders

Shoulder depression
Shoulder depression
Shoulder depression
Shoulder depression pushing down with the shoulders

Note on stretching: There are a number of stretches that you can do to help loosen your chest muscles. They include the doorway or corner stretch. You may also want to try wall angels. It is my opinion that the actual exercises are better than stretching.

Step 3: Return to climbing nice and easy. Once your pain has resolved and you’ve been doing the exercise program for at least a week go climb easy routes. Preferably in the gym. But don’t just throw yourself at it. Remember you are trying to use your back muscles again and its going to take time to re-educate your body and shoulders to move properly. When you reach for a hold consciously lock your should blade down and in before pulling. The harder routes you do early on the more likely you’ll be to fall into the old habits. Be aware of your body. And be progressive. Don’t be surprise if you get muscle soreness in new places. If this happens you a on the right path.

Closing thoughts: This is a very general outline for rehabilitation of chronic shoulder injuries. It is possibly the cure for everyone on a case by case basis. The shoulder is complex and there are many things going on.

I am not a doctor but do have a B.A. in Athletic Trainer and am certified by the American National Athletic Training Association. If your injury doesn’t improve with rest and at least 4 weeks of these exercises consult a doctor. And even then I would try a non-operative approach for at least 6 months before having any sort of surgery.

Try it!

Mike Dobie BA, ATC, sponsored climber

© All text, pictures, and media copyright Michael Dobie Do not reproduce in any way without consulting

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