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Training for Injury Prevention of the Shoulder
Paul Pursley PT CSCS
University of Iowa Hospitals and Clinics
Non-trainable Variables
Appropriate Gear Good Genes Good Sportsmanship Bad Luck
Trainable Variables
Sport Specific Skills Flexibility Strength Balance Biomechanics
What Kind of Throw are We Training For?
Phases of the Overhead Throw
Wind-up Phase Cocking Phase
Early cocking phase
Late cocking phase Acceleration Phase Deceleration Phase Follow Through
Wind-up Phase
Single limb stance Core musculature
Cocking Phase
Early Cocking Phase Minimal muscle
activation at global shoulder
Late Cocking Phase (Front foot planted) Moderate Pectoralis
activity Cocking completed by
Pec/Lat
Acceleration Phase
Pectoralis Major Subscapularis Latissimus Dorsi Teres Major Serratus Anterior Trunk/LE MM
Deceleration Phase
Posterior Deltoid Infraspinatus Teres Minor UT/MT Rhomboids
Standards for IR/ER Ratio
ER approx. 66% of IR strength during isokinetic testing.
Reminder of importance of rotator cuff and scapular stabilizers
Strength Training…
Thrower’s “Ten”
Thrower’s 12 Shoulder Extension, Shoulder Flexion, IR/ER at
0° abduction, IR/ER at 90° abduction, High/Middle/Low Rows, Scapular Punches (Dynamic Hug), Throwing Acceleration, Throwing Deceleration.
On the Field Resistance Tubing Exercise for Throwers: an EMG Analysis. Journal of Athletic Training. 2005 Jan-Mar, 40(1) 15-22
Shoulder Extension
Shoulder Flexion
IR/ER at 0° Abduction
ER/IR at 90° Abduction
High/Middle/Low Rows
Scapular Punches”Dynamic Hug”
Stabilization
High speed resisted target reach Pertubation training Body weight resisted
UE walking UE weight bearing on unstable surfaces
Multiple Joint Lifts
Push Press Clean and Snatch High Pull Bench Press
Multi-Planar Lifts
PNF Pattern DI/DII Dumbbells, Kettle Bells, Resistance
Tubing, Cable Column Resisted Overhead Throw
Plyometrics
Med Balls Anterior-Chest pass Posterior-posterior throw
Body weight Box push-up
Periodization
Off Season Hypertrophy/Endurance Phase
6wks, 60-70% 1RM, 10-12 repetitions Low intensity-High volume
Strength Phase Increase to >80% 1RM, 5-8 repetitions Initiate plyometric training
Periodization
Preseason Power Phase
6-8 weeks prior to competition phase Lower volume-Increased intensity 90% 1RM Allow full recovery between sets
Periodization
Competition Phase Low volume-High intensity
Sport Specific Considerations Length of season Aerobic vs. Anaerobic Impact vs. Non-impact
Principles for Implementation
Incorporate into existing practice Exercise selection
Thrower’s “10” Stabilization Exercise Medicine balls for anterior and posterior
shoulder plyometrics Body weight resisted
Pull-ups Dips Rope climb Peg board
Thank You!
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