Tracy Fober wrote the following ?the rehab bias against overhead movements and reduction of movements to only targeted rotator cuff stuff and scapular work that never allows the arm to elevate above 90-120. This is in spite of the fact that they want people to have “full ROM” and that in the real world, athletes fully flex and abduct and do combos of this all the time. ? Tracy this is something I have fought against for years. It is based on flawed research that just looked at the shoulder scapula relationship and failed to take into account the whole kinetic chain. I focus on the shoulder hip relationship that, is what is most important. Also impingement is not an overhead problem, to quote Gary Gray, ?it is a getting to overhead problem.? Therefore we need to focus on how they get over head. Usually it related to weakness and lack of awareness in the trunk and tightness in the hips. There is no pain when the arm is overhead and no pain when the arm is at the side. The pain occurs just as the hand is raised past the shoulder. This should give us a huge clue that focusing on the rotator cuff is not the answer. Look at the mechanics of getting overhead, Stretch the lats and the pecs, not the shoulder. As far as exercises incline pull ups and push-ups, ring pull-ups and push-ups, front pull downs and crawling are the way to go. Some people eliminate bench press for the overhead athlete, I think straight bar bench press should be eliminated. Dumbbell bench is OK, but not a major focus. As an aside this is the third year I have worked with University of Michigan Women?s swimming and they have virtually eliminated shoulder problems. A big reason is that they have stopped working on the shoulder and focused on the linkage of the hip to shoulder. High volume of reps on the rings and med ball core is the answer.
