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Wednesday's with WVPT
Author: Ryan Hubbard
December 21st 2016 - Shoulder Impingement: Why your shoulder(s) may hurt when you swing
 
Happy holidays to all the NHGA members and golfers out there!  Hope your holiday shopping is going better than mine.  For today’s edition of “Wednesdays with Willem Verweij” I wanted to talk about some common shoulder dysfunctions we see and typical reasons for shoulder pain in golf. Shoulders are the 4th most common injured area of the body in golf for amateurs.  First, I think it is important to understand the basic anatomy of this region in order to understand potential dysfunction.  The shoulder joint is the articulation between the ball of the upper arm bone (humerus) into the socket (glenoid) formed by the shoulder blade (scapula).  The shoulder blade is then fixed upon your rib cage (thorax) by many muscles.  The activation and timing of all these muscles are essential for the shoulder complex to have optimal range of motion.  Although the hip (see last week) and the shoulder have similar joint structure, the shoulder is much more unstable because of the shallowness of the socket.  This joint therefore relies on its ligaments and muscles for stability.  In order to reach the arm overhead during the backswing (trail arm), the shoulder blade must contribute ⅓ of the needed motion and the humerus bone must move the remaining ⅔ of motion.
 
In the last article I discussed the hip, but mentioned how the shoulder can “impinge” itself if it needs to compensate for lack of range of motion in another part of the body.  Sometimes the mechanics of the shoulder joint itself can be flawed and be the cause of the impingement.  What is impingement?  Well there are two primary types: Internal vs External. 
 
External impingement is when the bony protuberance (also known as a tuberosity) on your arm bone pinches against the acromion of your shoulder blade with overhead motions.  If this occurs repetitively then the tissues (rotator cuff and bursa) between these two structures can become inflamed, pinched, and even torn.
 
Internal impingement occurs when the lead shoulder comes across your body in the backswing the ball of the humerus pinches against the front part of the socket. The reverse may occur to the back part of the socket during the follow through. This is a common mechanism for tears of the labrum, which acts as cartilage around the rim to deepen the socket.
 
Here are some of my favorite shoulder mobility and shoulder blade stability exercises to help improve shoulder mechanics and reduce chance of impingement.  These are some you can do at home with little or no equipment (no excuses on those snowy days):
 
  1. Bird Dog with Shoulder Flexion:  http://www.mytpi.com/exercises#bird_dog_with_shoulder_flexion
  2. Half Kneeling Chop:  http://www.mytpi.com/exercises#chop_-_rotation_half-kneeling
  3. Palm Up Club Lifts:  http://www.mytpi.com/exercises#palm_up_club_lifts

 
If you are experiencing any shoulder pain or have any questions regarding a current injury.  Don’t hesitate to contact us at (603)335-4700 or email me directly at ryan@wvphysicaltherapy.com, we would be happy to help.  Happy Holidays!

 

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