Abstract

In the field of strength and conditioning, it is invariable that conditioning professionals will encounter an athlete having shoulder pain. This will happen even more frequently if you work with athletes who perform repetitive overhead movements. These athletes can be susceptible to shoulder impingement through a multitude of factors. Throwing athletes are one group who will usually encounter shoulder pain. One of the factors that cause shoulder pain is tightness within the posterior capsular tissues of the glenohumeral joint. Tightness within the tissues can develop from the repetitive stresses that are placed on the shoulder by the eccentric forces of the throwing motion during deceleration of the upper extremity. Posterior capsular tightness is often coupled with anterior glenohumeral capsular laxity. This combination of tissue imbalance, biomechanical throwing errors, and rotator cuff fatigue allows for anterior migration of the humeral head with impingement of the subacromial tissues. The most significant subacromial tissues would include the biceps tendon, supraspinatus tendon, and subacromial bursae. Wilk et al. have described this posterior capsular tightness as a reversed capsular pattern. A normal capsular pattern of the glenohumeral joint will present with the most significant loss of range of motion occurring in external rotation and the least in internal rotation and horizontal adduction. It is crucial that an athlete experiencing shoulder pain undergo a thorough examination by a trained professional to properly assess for tightness and/or laxity of tissues surrounding the shoulder joint. Stretching and mobilization of tissues that are already possessing hypermobility can lead to even greater impairment and injury. Impingement of the shoulder joint can involve several soft tissue structures as noted above. This impingement will usually lead to pain, tissue inflammation, altered upper-extremity patterning/biomechanics, and impaired athletic performance. Alteration of shoulder mechanics in the overhead athlete can lead to increased stresses being placed on the medial aspect of the elbow. Overstressing the medial elbow structures with distractive forces can also cause stress with compressive forces to the lateral elbow structures. Ultimately the athlete can lose practice time and/or the ability to compete because of the upper-extremity pain and dysfunction. Maintenance of proper flexibility and mobility of the posterior glenohumeral capsular tissues is critical in injury prevention of the repetitive overhead athlete. Proper stretching of the posterior capsular tissues should be an integral part of the athlete’s exercise program. Textauszug