Shoulder Training
Good shoulder training is important for any hockey player because the player's shoulders are what they will use for checking. Also, the shoulders are where they will most likely receive a hit or how they will go into the boards after a hit. Therefore, knowing the basics of shoulder alignment and function are very important.
Understanding the Shoulders
I think the best place to start learning about shoulders is Shirley Sahrmann. If you are not familiar with her work I highly recommend you read her book, Diagnosis and Treatment of Movement Impairment Syndromes.
Normal shoulder alignment is such that the shoulder joint should be just below T1 in the horizontal axis. The scapula should be flat on the Thorax and parallel to the spine. The humeral head should be in the glenoid fossa such that only 1/3 of the head is in front of the acromion and there should be no rotation so the antecubital crease faces anteriorly and the olecranon faces posteriorly.
If there is poor alignment of the shoulder several problems can arise. The shoulder joint can be elevated, depressed, or forward. The scapula can be downwardly rotated, depressed or elevated, abducted or adducted. The humerus can be anterior, superior, or rotated. The problems I encounter most often with hockey players are the scapula tilting anteriorly, humeral head gliding anteriorly and the humerus being rotated medially.
In this situation more than 1/3 of the humeral head is forward of the acromion and the cubital fossa is medial and the olecranon faces laterally.
Underlying Causes of Shoulder Dysfunction
There are many things that can be the underlying cause of this posture. However, there are some things that seem to be the most common culprits.
The acromion tilts forward because the scapula is poorly aligned due to shortened pec minor. The pec minor can be lengthened by stretching and deep breathing that activates the diaphragm. It is nearly impossible to self stretch the pec minor. It must be stretched by a partner.
Anterior humeral glide is caused by dominance of the pec major and deltoid over the rotator cuff muscles, especially the subscapularis. This problem can be corrected by strengthening or activating the rotator cuff. Medial rotation is caused by the pecs and lats becoming too short and over powering the rotator cuff muscles as well.
Methods to Improve Shoulder Function
The first course of action to take is quality soft tissue work. (read more about soft tissue work here.)
Using foam rollers and static stretching will be very beneficial for players with poorly aligned shoulders. Next is making quality decisions with regard to exercise selection. We will do no overhead pressing with a straight bar. All overhead pressing is done with kettlebells and our bench pressing is done mostly with dumbbells although we will occasionally do a straight bar bench press.
Kettlebells held in the rack position are the best way to overhead press because with all the weight of the bell on the back of the hand the rotator cuff must work very hard to stabilize the shoulder. Also, when pressing with KBs or DBs the weights are rotated and the exercise is performed in a spiral pattern. This bypasses an abducted and externally rotated position which will reduce shoulder impingement.
Also, we will perform carries and presses with the kettlebells held in a bottoms-up position. I feel that the bottoms-up position activates the rotator cuff, especially the subscapularis muscle. I think this is important in off setting anterior humeral glide because part of the subscapularis's function is to pull the head of the humerus posteriorly.
Performing medial and lateral rotation lying supine on a bench is good rotator cuff strengthening. Quadruped rocking is a great way to push the head of the humerus posteriorly into the glenoid fossa.
Rotational pulling patterns are excellent shoulder training as well.
The List of Exercises That Should Be Avoided
Overhead pressing with a straight bar: This exercise causes impingement due to the forced abduction and external rotation.
Empty can: The empty can test is fine for assessing impingement. However, it should not be used as an exercise because it causes impingement. Sahrmann states in her book, "A commonly used exercise that increases the risk of impingement of the greater tuberosity of the humerus against the coracoacromial ligament is shoulder abduction to 90 degrees or more with the humerus medially rotated." Sahrmann, page 214.
Shrugs: The traditional style of performing shrugs is a poor exercise. As Sahrmann states in her book shrugs are OK if they are performed overhead only. "The exercise of shoulder shrugging with the arms at the sides (the glenohumeral joint is in downward rotation) is usually not a desirable exercise because it reinforces the activity of the rhomboid and levator scapulae muscles, contributing to the dominance of these muscles." Sahrmann, page 208. "Shoulder shrugs with the arms in the anatomic position should be avoided because this movement pattern encourages levator scapulae and rhomboid muscle activity rather than the desired activity of the upper trapezius muscle. However, with the arms held in elevation, the shoulder shrug exercise emphasizes upper trapezius activity." Sahrmann, page 221
