Should clients with shoulder injuries continue with overhead activities?

Recently, i have been getting a number of 'shoulder problem' clients. almost 90% of them had to do with an inhibited subscapularis which resulted in an elevation of the glenohumeral joint therefore causing the acromium to impinge the supraspinatus. It doesn't help that tight pec minor causes an anterior tilit of the scapular which reduces the sub-acromial space. In such cases, foam rolling the external rotators and anterior serratus will not help one bit since the subscap is right under the ribs behind the scapular.

I suggest doing some stretches followed by light activation work of the subscapularis using light dumbell prone internal rotation and anterior serratus (AS) wall slides to activate both the subscap and AS before going into your weight routine. This may help alleviate the pain.

If it is an unstable AC joint, you might want to get some taping done to stabilize the joint and do elevated or basic side bridges to strengthen the joint.

However, if it still hurts, refer out. Get a qualified soft tissue therapist to help you release trigger points and adhesions in the subscap, pec minor and infraspinatus. Mulligans technique and taping are great for resolving instability in the AC joint but proper corrective work is still required to strengthen the ligaments in the joint.

Once you are better, i would suggest redesigning your workout program to have at least a 3 : 1 pull to push ratio i.e. do more deadlifts, pull ups and rows to push ups and shoulder presses. Shoulder and bench presses should be done in neutral grip at least until the shoulder pain has been eliminated. It is good practice to deload one week of the month with neutral grip presses to give your shoulder joint a 'break".

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