Fix Gymnast Related Shoulder Pain!

Are you a frustrated gymnast who is missing time from practice due to painful or clicking shoulders?

Have you been told by the doctor to just rest it or stop doing gymnastics?  

Gymnastics requires a combination of strength, power, endurance, flexibility, balance, and control in order to enable gymnasts to perform the amazing skills necessary for competition.  One of the areas of the body that can result in pain due to injuries is the shoulder joint. The shoulder joint is a ball and socket joint in which two bones connect (head of the humerus and glenoid fossa of the scapula).  This joint is one of the unique one’s in our body because it was designed for mobility as we can move our shoulder joints in all planes of movement and we have a lot of motion to move through in order to reach and perform everyday activities (reaching behind back, washing hair, etc.).  However, the sport of gymnastics requires even greater mobility demands on the shoulders in order to perform bar routines, back walk overs on the beam, or tumbling passes during floor exercise.

The first step to getting rid of a cranky shoulder is to first get a proper diagnosis by a medical professional.  They will determine the structure at fault whether it is the rotator cuff tendons, glenoid labrum, or a specific muscle.  However, the key to fixing your problem is determining the root cause of why your pain started in the first place. In the shoulder and especially with gymnasts, it usually comes down to either a mobility or stability issue.  

Let’s talk about mobility first as this is usually not thought of in the case of a gymnasts as you may be thinking “how could I be tight when I can do all these crazy contortionist type of skills” and most healthcare professionals who do not work with a lot of gymnasts tend to make that assumption as well.  The main mobility issue is not in the shoulder joint itself (the capsule and ligaments) but is in the soft tissue surrounding the shoulder joint (latissimus dorsi, teres major, and pec major muscles). This is especially common as the gymnast gets older due to adolescent growth spurts and the increased hours of training required in Junior Olympic levels 7-10.  There is a ton of strength and conditioning that is being done during those 20-25 hours of practice per week. If the gymnast is not taking care of the soft tissue mobility to combat all the strength and conditioning work then that could lead to limited overhead mobility causing an impingement of the rotator tendons and thereby creating shoulder pain with any overhead activities such as handstands and tumbling skills.  

The other main issue that tends to be a problem for gymnasts is a stability issue.  This is very common in gymnasts because a fair majority of them have what we call loose joints and that is probably the reason they got selected at an early age to participate in the competitive program at your gym.  If you didn’t have normal or more than normal mobility in your joints then you really would find it difficult to perform the skills necessary for gymnasts (think natural selection). Therefore, most of these girls work on flexibility and mobility from an early age and that can tend to create imbalances around the joint if not counteracted with good joint stability work.  In the physical therapy world we call this a movement coordination impairment meaning the muscles that provide stability to the shoulder joint (rotator cuff and scapular stabilizers) are not kicking in at the right time when they should or are being overpowered by the bigger stronger muscles like the lats and pecs as previously mentioned. Therefore, the goals is to “wake up” the sleepy muscles by retraining them with specific exercises that usually require hands on feedback by a skilled therapist and a lot of weight bearing exercises through your arms on unsteady surfaces (balance board, BOSU ball, stability ball).  These exercises create an unstable environment for the shoulder, thereby causing the deep shoulder muscles to have to kick in to perform correctly.

To summarize, the key to preventing and treating shoulder pain is to determine if your problem is a mobility or stability problem and then perform specific exercises to address those areas in order to fix your current problem or prevent it from coming back.  Stay tuned for future posts relating to specific shoulder mobility and stability exercises you can do to keep you happy and healthy doing what you love!

Are you a gymnastics parent who is wondering what it will cost your daughter in the long run if she continues to work through the pain?

There are solutions to these problems (besides quitting gymnastics)

At SPARK Physical Therapy, we have a unique treatment approach that focuses on solving these problems with our clients.  Our goal is to help keep your gymnast active while recovering from injury by staying in the gym and guiding them in ways to modify their skills and training, rather than eliminating gymnastics!  We combine manual hands-on techniques with guided supervised exercises to help your gymnast get stronger, pain-free, and perform at their peak level to get them back to full speed in the gym.

If you’re in the Wallingford, CT area and are a gymnast that has been dealing with injuries we can help. We’d love to chat for a few minutes and see if you are a good fit for what we do. Fill in the contact request and we’ll set up a free 10-minute phone consultation with a doctor of physical therapy

Thank you for taking the time to read,

Duane