Rehab for Shoulder Injuries

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Feeling shoulder pain after nailing a hit or big block? You're not alone. A recent study at the Marshfield Clinic, Marshfield, Wis., found that as many as 45 percent of elite volleyball players suffer from suprascapular neuropathy. Caused by nerve impingement, this condition can weaken shoulder muscles, in turn leading to rotator cuff problems, including tendonitis.

Rotator cuff tendonitis or impingement is the most common shoulder injury among volleyball players, according to Dr. Robin West, an orthopedic surgeon with the University of Pittsburgh Medical Centers. "The second most common is the labral tear," West says, "and the most common type of labral tear is the superior labral tear or SLAP tear."

"Rotator cuff tendonitis is more of a chronic problem," West explains. "You'll typically have a pain with overhead activity and occasional night pain when sleeping on that side." But tendonitis can usually be corrected through rehab and reduced overhead activity. Cortisone shots directly into the shoulder are effective for reducing inflammation, but oral anti-inflammatories typically don't work.

"Tendonitis can go on for six to eight months," West says. "So if you keep re-aggravating it, it's not going to get better. Once it starts, knock out the symptoms by cutting back practice time or the number of days you do it per week."

A SLAP tear is an acute injury, according to West, who has worked with the Pittsburgh Steelers and athletes at the University of Pittsburgh and Carnegie Mellon. "This injury can occur when you reach out for a ball. You might feel a sharp pain in the front of the shoulder." Overhead activity and pulling heavy objects can exacerbate the tear.

"Rehab alone usually does not help a labral tear. It needs to be corrected surgically," West says. SLAP tears can be corrected with arthroscopic surgery, which is minimally invasive; however, post-surgery rehab lasts three to six months, depending on the tear.

If you feel any shoulder pain, contact your physical therapist, athletic trainer or doctor. He or she will properly diagnose your situation and prescribe a plan that will keep your shoulders and your game strong.

Wingin' It?

Your body is the best cheater in the world. When one body part is wounded, surrounding parts contort and manipulate to compensate for it. Unfortunately, cheaters never win. When your body starts changing its natural ways, more injuries can follow—especially in the case of shoulder injuries. When the stabilizing muscles are fatigued, the shoulder blade (scapula) moves improperly. Dean Ochi, Cleveland Clinic athletic trainer, says, "When it hurts to lift the arm above the head, people compensate by shrugging the shoulder before lifting the arm. This causes soreness in the trap muscles, neck pain and other problems."

Ochi refers to improper scapula movement as "winging." Winging can result in rotator cuff injuries, because these muscles attach along the shoulder blades.

You can check your scapula for winging by reaching behind your back with your elbow pointing down, like you are scratching your lower back, and leaning against a wall. If your shoulder blade touches the wall before the rest of your back, you have a winging scapula.

To prevent winging, strengthen the muscles that rotate the scapula. This maintains proper positioning of the shoulder when performing overhead activities. If you think your scapula wings, contact your team athletic trainer, physical therapist or doctor to correct the problem.

Preserving Shoulder Health

Maintaining full range of motion is the first step in preventing shoulder injuries. This can be done by stretching the shoulder and rotator cuff muscles. However, stretching the surrounding muscles, including the pecs, triceps and biceps, also preserves shoulder health.

Pec Stretch 1

  • Stand in a doorway with legs apart, one in front of the other
  • With arms forming a T, lean forward into a stretch
  • Hold for 30 seconds
  • Raise arms up to form a V and repeat

Pec Stretch 2

  • Kneel on the floor with arms folded and resting on the seat of a chair
  • With lower back flat,, lower chest into a stretch
  • Hold for 30 seconds

Triceps Stretch

  • Pull elbow behind head until stretch is felt
  • Hold for 30 seconds
  • Repeat with opposite arm

Biceps Stretch

  • Seated, place arm on a table behind you
  • Apply gentle force down and forward through shoulder
  • Hold for 30 seconds
  • Repeat with opposite arm

Photo Credit: Getty Images // Thinkstock