It’s been a year since I wrote about shoulder injury prevention for martial arts athletes and is now time for an update.
Before reading any further, read this on the principles of injury prevention if you haven’t already as it is all relevant to shoulder injury prevention and I won’t repeat it here:
Shoulder injuries (traumatic or non-traumatic) in the martial arts are most common in the grappling sports (e.g. wrestling & judo) (ref) but do occur in striking aspects as well (ref). Traumatic (the rarer likelihood) occurring when landing onto the arm/shoulder, or being excessively forced into an unsuitable position (e.g. during submission). Non-traumatic (the more common) occurring after over-loading the shoulder tissue (muscles, tendon etc) in one instant or over time.
As previously mentioned, greater levels of muscular strength and power is associated with lower injury risk (ref), that means getting in the gym at least twice a week and pushing those shoulder muscles. The two main muscle groups most people will know to work would be the chest and back muscles. The chest or “pecs” are worked by pushing a weight straight forwards (e.g. bench press and all its varieties), the back shoulder muscles or “lats” are worked by pulling a weight towards you (e.g. rows, pulls ups etc).
What can not be ignored are the “Rotator Cuff” muscles, many people have heard of them, though I’m sure not many could actually tell me much about them. The rotator cuff muscles are a set of four small muscles that sit either side of your shoulder blade and go into the top of your upper arm bone (humerus). They have 2 roles; first is to provide stability and control to the shoulder joint, the second is to produce movement, one does inward rotation, the other three do outward rotation and help raising the arm up to the side.
It has been suggested that reduced external rotator strength is one of the big risk factors for developing shoulder injuries (ref) . Reduced shoulder external rotation strength has been found to be reduced in Judo athletes compared to other athletes (ref) and continuous gripping (common in many martial arts) has been found to fatigue the rotator cuff quickly (ref) hence trying to get these muscles as strong and durable as possible to tolerate the stresses and demands of combat is essential.
Hence doing external rotation exercises to strengthen the rotator cuff using weights, cables or heavy resistance bands, is all useful. Research is still unsure as to which is the best position to do it in (e.g. standing, lying on side, lying on front), but it is generally known that doing external rotation movements while the arm is 90 degrees out to the side leads to greater muscle activity (ref).
However there are plenty of other options for strengthening the cuff as well…
Exercises in an all fours position (closed chain to give them their official term) are also effective for producing high cuff activity (ref) by challenging stability and balance. Examples include:
Push up plus.
Twist & Raise (also known as threading the needle)
These plus a few others shown below in a video I did for Matt D’Aquino at Beyond Grappling.
The Scapula Mystery
For a long while it was thought that bad posture and abnormal shoulder blade position/movement (Scapula Dyskinesis) was a potential contributor to shoulder pain, and hence a risk factor for injury. However it is coming more to light that the evidence behind this is pretty poor (quality wise) and there is as much scapula normality/abnormality is those without shoulder pain as there is those with it (ref). Either way the proposed method of “correcting” this would be through strengthening the “scapula stabilising” muscles on the upper back. The good news is that all of the exercises above also target these muscles effectively as well (ref).
Will it work?
Andersson et al (2016) found that doing specific rotator cuff and scapula warm up exercises 1-2x a week in Handball athletes, reduced the amount of shoulder injuries compared to Handball athletes who didn’t (ref), though this hasn’t been specifically tested on martial arts athletes yet, but considering it is well know that increase strength and stability reduces injury risk, there is a good likelihood it will be effective.
Obviously all the other factors in regards to injury prevention play a part too: Load management, psychology, warm ups, rest & recovery etc and can all be managed as appropriate to reduce the injury risk as mentioned in injury prevention principles.
All is summarised in the video below:
And that’s about it.
All questions & feedback welcome, contact info is at the top.
Have a nice day,