How to bounce back from shoulder injury

A specially designed programme is of critical importance to help players return to action effectively.

Indian ’keeper Wriddhiman Saha arrives in Kolkata after his surgery.   -  PTI

Indian wicketkeeper Wriddhiman Saha’s injury has raised a lot of questions. But as a professional sportsperson, one has to move on and seek the best remedial measure to come out of the injury and return to the squad with full fitness.

As far as Saha is concerned, he is a very fit player in all aspects and a very dedicated professional who always looks out to push boundaries. He is a silent warrior about his fitness regime and his overall fitness.

The recovery protocols need to be monitored professionally to get him back to the squad. The slap injury is believed to take at least four to five months to heal and for the athlete to get into full fitness and range of movement. To get into this process there are many exercise protocols available to get the shoulder strength and stability back. Some of the exercises — to move in a positive direction with professional help — are listed below.

The player’s goals are very important in achieving what one hopes to achieve, which will also reduce the margin of error in recovery. Since Saha is a top-class wicketkeeper, he needs to work on the specifically designed programme for his goal. An individual’s injury prevention and recovery programme has to vary according to the skill set. For example, a fast bowler’s needs are totally different from a wicketkeeper’s needs in use of the shoulder musculature compartment, the angles, the force generated and the force reduction. So a specially designed programme is of critical importance to help players return to action effectively. The following guidelines would help in understanding the needs.

Prevention vs recovery

Different sets of exercise regimes may be required for prevention and recovery of shoulder injuries. Some of the exercises are for prevention and some would be used for recovery, but there may be some crossover exercise patterns. If one had already undergone a surgery, the protocols would be totally different in the recovery phase.

90/90 external rotation.   -  R. Ragu

 

The diagnosis

If one has experienced chronic and repetitive shoulder pain over a period of time or whether it is a new but very painful injury, your next step is to see a sports medicine doctor or physical therapist immediately. Especially if you have already tried some conservative treatments such as sports massage, dry needling, active release therapy etc.

Different strokes for different folks

The treatment and exercise protocols for a rotator cuff strain, labrum tear, frozen shoulder etc can be totally different for each player’s unique anatomy, symptoms, diagnosis, goals, time frame and skill set. Make sure the programme is customised to the injury rehab and prevention programme to one’s unique needs and goals. Here is where a personalised massage therapist or a personal trainer plays a crucial role in alleviating long pent up aches and pains.

Range of motion exercises

A labrum injury typically causes a ‘loose’ shoulder or one may feel like the shoulder is falling out of the joint. Sometimes the motion that you have in your shoulder may not be normal. Exercise to restore the normal Range Of Movement (ROM) may be necessary before progressing to any strength protocols.

ROM may include: Passive ROM exercises — Cable exercises and active range of motion exercises. Be sure to move your shoulder through its full ROM and stop if you feel pain or shoulder instability as you perform the exercises.

Shoulder proprioception and balance

Good balance in your shoulders is essential to effectively use your arms. Awareness of where your shoulder is in space as you move around is important, and this is called proprioception. To help and improve your shoulder proprioception, isometric or dynamic shoulder exercise may be done with a resistance band. A Bosu ball or wobble board may be used as an unstable surface.

Shoulder retraction.   -  R. Ragu

 

Scapular stability work

The scapula stabilisation exercise is most important for your entire shoulder joint complex, and it should not be ignored when working on exercises after a labrum tear. You may also work on scapular strengthening and stability using machines/ free weight/ bands/ wrist weights.

Rotator cuff strength

Rotator cuff strengthening may be done after a labrum tear. The labrum improves stability to your shoulder joint and a tear may make your shoulder unstable. Strengthening the rotator cuff can help improve the dynamic stability of your shoulder joint.

Exercises for your rotator cuff can include: Isometrics work, resistance band/ tubing strengthening, shoulder active ROM exercises with a dumb-bell/ wrist weights and weight bearing exercises for shoulders.

Return to full function and range of movement

The most important factor is to help you return to your normal function and activity. Everyone’s skill set level is different, so this part of your rehab should be personalised to your needs in a step-by-step progression with constant monitoring. This would help you to return to action soon with the full ROM.

Exercise protocols for shoulder compartment — External rotation, Wall angles, IYT, 90/90 external rotation, shoulder retraction and bent elbow wall glide.