Shoulder instability, if left untreated, can lead to a number of serious injuries. These may include rotator cuff tears and shoulder impingement. When a shoulder is unstable, the muscles surrounding the shoulder joint are not strong enough to support it during various ranges of motion. If the shoulder joint slides slightly out of place, it can result in a condition called shoulder subluxation. If the joint slides completely out of place, shoulder dislocation, a serious condition, may occur. A well-designed shoulder stability exercise program may correct the postural alignment and muscular imbalances that lead to shoulder instability.
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Exercises to Avoid
According to the American College of Sports Medicine, certain types of shoulder exercises can aggravate an unstable shoulder, and should be avoided. These include overhead shoulder presses, upright rows that bring the weights above shoulder height, incline bench presses, lateral pull-downs with the bar behind the head and lateral raises with the thumbs facing down.
Provided that there is no severe injury, certain upper body exercises can be modified to make them safer for people with shoulder instability. For example, the overhead shoulder press can be modified so that the arms are kept slightly in front of the shoulders. When performing a bench press, as you lower the weights, keep them a few inches above the chest. During the chest fly, keep the arms in front of the body, and perform the lat pull-down by bringing the bar in front of the body.
Some of the common misconceptions about exercise technique can lead to shoulder instability. Avoid exercises that involve an increased range of motion, such as those mentioned above, if you do them without the recommended modifications. While some people believe an increased range of motion helps strengthen and tone the shoulder, when the muscle is in a fully stretched position, it is at its weakest. Adding weight to this compromised position can result in tears or instability. The toning benefits of the increased range of motion are minimal, and constitute an unfavorable risk/reward ratio.
Shoulder instability may be the result of a sudden fall, a blow to the shoulder or repetitive overuse while executing poor form and improper postural alignment. An article titled "Genetic Causes of Joint Laxity," which was published in the April 2008 edition of Internal Medicine News, sheds additional light on this subject. According to author Howard P. Levy, in addition to a genetic predisposition to joint laxity, some people may increase hyper-mobility by performing certain types of stretching and yoga activities. Hyper-mobility is an undesirable condition, because it can compromise joint integrity. While the benefits of flexibility exercise are well known, exercises that take you outside the natural range of motion of the joint may cause instability. When choosing flexibility exercises, select exercises that enhance the range of motion for functional everyday activities. Avoid contortion-type stretches that are more suited to circus acts. Perform strength exercises in addition to flexibility training.
Types of Exercises
Although there are various types of shoulder stability exercises, those that support internal and external rotation are the most effective. They are easily performed using a resistance band that is attached to a secure object. For internal rotation, hold the band with the hand that is closest to the attachment. Press your elbow against your waist. Begin with your forearm at a 180-degree angle from your body. Keeping a stable elbow, bring your forearm toward the midline of your body. For external rotation, hold the band with the hand farthest away from the body. Begin with the forearm internally rotated toward the midline, and then rotate your forearm. Sets, repetition and training schedule will vary according to the advice of your physical therapist.