The last installment discussed muscle length and it's role in swimmer's shoulder. Once again, this part the largest role with swimmer's shoulder, but muscle strength and timing are also influential. 

Muscle Strength 

Once you have your muscles in a better resting position, strengthening other muscle be used to increase strength through the new range of motion. The following exercises improve the strength of the posterior rotator cuff, scapular stabilizers and upward shoulder rotators.

As someone raises their arm, their shoulder blade upwardly rotates, elevates, and posteriorly tilts. If you watch a typical swimmer raise their arms overhead and view their shoulder blades, you can see all kinds of discrepancies and erratic movements. This simple task can challenge athletes, especially when they are lowering their arm slowly. Another abnormality is when the swimmer’s shoulder blade “wings” to the point that a coach could grab behind the shoulder blade. Winging can result from one weak upward rotator muscle – the serratus anterior. Scapular dyskinesis (alteration in scapular muscle activation) increases from 37% to 68% at the midway point of practice and to 73% at three-quarters of practice (Madsen 2011). More staggering, after the full training session a total of 82% of the swimmers demonstrated scapular dyskinesia (Madsen 2011). This indicates poor endurance strength of the scapular stabilizing muscles exist secondary due to training. 

internal rotators was not greater than controls (Batalha 2013).

This suggests the rotator cuff muscles are not strengthened properly (specifically the volume and intensity). A forgotten role of the rotator cuff muscles is to depress the humerus, fighting against the overactive peripheral muscles (deltoid) (Richardson 1986).

Posterior rotator cuff strength is essential to endure repeated lengthening and stress. Rapid lengthening requires larger force production, then rapid shortening. Therefore, extra strength in these muscles is needed to handle the required force.

Stable shoulder blades are a must in any overhead movement. Those with immobile shoulders have poor shoulder strength. I like to imagine the shoulder blades as the foundation of the upper body. If you have a house with poor foundation, you've got a dangerous house. It is essential to build a strong foundation, to endure stresses without injury and to increase force production either with a house or shoulder.

The upward rotators help move the shoulder blade and control it through the desired range of motion. Many overhead athletes have excessive range of motion, enabling them to produce more force. Unfortunately, many of these athletes don't have the control and stability to utilize this new range of motion. These muscles can help utilize the range of motion and prevent injuries.

Another group of weak muscles are those in the front of the neck. These attach to the collar bone and influence movement on the collar bone, which connects to the scapular. Swimmers with one sided shoulder pain have altered neck strength (Hidalgo-Lozano 2012). 

Once again, follow the rules or you'll pay the consequences...trust me you don't want to find out.

Rules:

1. Starting Position: Face down with your knees bent and head on the ground. Flatten your back as instructed. Tuck your chin.
2. In all of the following exercises, as you bring your arms up you will have a tendency to arch your back. In order to target the correct muscles and not cheat through the thoracic and lumbar spine, only perform the exercises with the back flattened. 
3. Stop if the exercise causes pain. 

3-Point Robber 

This exercise will cause maximal scapular stability activation.

Bringing your hands behind your back, pull your shoulder blades down and in. Hold this position for five seconds, then release. Perform five repetitions with five second holds.

3-Point External Rotation 

Unlike traditional external rotation exercises, the 3-point external rotation forces pure shoulder motion with minimal compensations. For this exercise, while keeping your elbows at your sides, move your shoulders into the compact position, then perform an “I don’t know” motion, moving your shoulder blades down and in.

3-Point Y 

Keeping your arms as straight as possible (at 11:00 and 1:00), bring both arms in front of your body with the thumbs facing upwards. Raise the arms as high as you can, remembering to raise them only as far as you can to maintain your starting back position. Lower the arms slowly and repeat.

Conclusion

Various exercises accomplish the same tasks as the aforementioned. From my experience, these are the basics which help swimmers strengthen neglected areas. Stay tuned for our next installment on muscle timing and motor control!

If looking for more on swimmer's shoulder, consider purchasing the COR Swimmer's Shoulder System.