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Push/Pull and the overhead athlete...

Okay, so I have had some questions regarding pushing and pulling movements in the upper body and, how they potentially effect the overhead athlete. So, lets investigate.

People always say that if you push more than you pull, you may end up with shoulder problems. Does this work the same way if I pull more than I push? Can I still be potentially creating a movement impairment? I am a baseball player and I was wondering about this since the shoulder is a big area of concern when it comes to injury.

This is a great question. I do agree that if we push more than we pull, we can be potentially setting ouselves up for some shoulder and postural issues (IE, the guy who bench presses all the time, has his shoulders rounded forward and his knuckles dragging on the ground like cro-magnon man). Also, we lead extremely anterior lives. We sit a lot all day (well most of us) and we type on a computer. All of these positions of daily living place us in a difficult position when it comes to postural patterns. Remember, our posture (spine) has lots of plasticity. It will mold itself to the posture that we maintain daily. If this posture happens to be sitting at a desk and hunched over a computer, then you may be in trouble.

Now, to answer your question about pulling more than pushing. No, I don't think there is going to be as much of (if any) issue with doing a higher ratio of pulling movements to pushing movements in your weekly training program. I am basing my belief on two principles:

a) As stated above we live in a very anterior world, so the extra pulling will help to balance out what we do all day.

and

b) Extra pulling leads to extra strength in the muscles that support the scapula. This helps build scapular stability, which in turn helps to stabilize the humerus within the joint during functional movement.

Now, how does this apply to you as a baseball player (or any overhead athlete really)?

First things first, in order to get your hands overhead properly (and safely) a lot of things have to happen (recall my blog entry entitled "getting there is not important has how you got there" referring to joint mobility and exercise range of motion). If you DO have a potural problem, lets say excessively rounded upper back (kyphosis), getting your hands up overhead in a safe manner is going to be difficult, as the scapula will not be moving properly (and wont be efficiently stabilized) in order to complete the task. This allows the hummerus to migrate anteriorly and superiorly (pressing up into the subacromial space) because we lack the control needed to properly stabilize it (exert a downward pull). This can lead to what is termed "impingement syndrome."

This lack of humoral control and the impingement which follows will lead typical gym go'ers to just throw in some extrenal rotation exercises. They then keep on going with their same old training routine. While some external rotation exercises are great, the problem is that things like 'weak external rotators' or 'shoulder impingement' are not isolated events. There is a reason why this has happened. Part of it may be poor postural control (IE kyphosis, aneterior tilt to the scapula, winging of the scapula, etc) and some of it is related to having weak scapular stabilizers (lower/mid trapezius muscles, rhomboids, serratus). So, instead of just throwing in some external rotation work (which is helpful, don't get me wrong), you need to look further than that and get to the bottom of the issue.

Working on scapular stabilizer strength, thoracic spine mobility and shoulder flexbility can be very beneficial to the overhead athlete as it helps the strengthen supporting structures of the shoulder joint, which in overhead sports is open to a variety of injuries.

SO, long story short...No, I do not think that extra pulling (or scapular stabilizer work...which I call remedial shoulder work in my programs) is a bad thing for you to do (especailly as an overhead athlete).

refernces:

Sharkey NA, Marder RA, The rotator cuff opposes superior translation of the humeral head., Am J Sports Med. 1995 May-Jun;23(3):270-5.

Neumann, Donald A., Kineseology of the Musculoskeletal System: Foundations for Physical Rehabilitation, Mosby, 2002.

Hope that helps,

Patrick