Shouldering the Summer Load

May 2, 2004
Outside Magazine
Outside magazine, June 1996

Shouldering the Summer Load

Before you climb, paddle, spike, or throw, make sure your shoulders are ready for the special strain of this season's sports
By Cory Johnson

Christian griffith spent hours in the gym working every conceivable part of his body before winning the Canadian National Sport Climbing Championships in 1992. But like many of us, he ignored one crucial joint, and six months later, at the 1993 Vancouver Invitational, he paid the price. "I was on the very last hold, with my hand over and behind my head, pushing out into the rock," says Griffith. "Then my foot slipped, and I was left hanging by my arm. But I was pushing out so hard, my deltoid just shot the humerus out of my shoulder socket like a watermelon seed."

Shoulder injury is rarely so dramatic, but consider that your top two joints carry the load of many summer sports, from the river to the rock face. Yet they're surprisingly fragile, at risk for myriad injuries, including muscle strains and tears, tendinitis, and dislocation. The fun-stopping results: pain, reduced mobility, and--if you don't pay attention--permanent damage.

A shoulder's vulnerability stems from a design that favors downright miraculous mobility over stability. The ball portion of the joint--the head of the humerus bone, Griffith's watermelon seed--is held in place by three stringy muscles known as the rotator cuff. These crucial muscles are overlooked by most strength regimens. Meanwhile, many athletes work hard at classic weight exercises to develop the trapezius muscles, which cover the scapula, or shoulder blade; the deltoids, which cover the shoulder socket itself; and the latissimus dorsi muscles, which wrap under the arm from chest to back. After all, these are the muscles that move the arms. Yet it's easy to give the rotator cuffs the attention they deserve (see "The Weight Way to Shoulder Stability"). It's a kindness that will be repaid. Taking your shoulders for granted can lead to peril in any number of summer pursuits.

Paddle Sports
Shoulder dislocation is the single most common serious injury endured by canoeists and kayakers. "Almost all elite paddlers have blown their shoulders," says Dr. Peter Goth, founder of the Bryant Pond, Maine-based Wilderness Medical Associates and author of the Outward Bound Wilderness First Aid Handbook. "Physics just sets them up. You often get your shoulder into what I call the baseball position, with your arm over your head and your elbow out--like you're throwing a baseball." From that position, Goth says, it takes a relatively small amount of force at the end of the lever--your arm--to pop the shoulder ball out of the socket. Of particular concern is the high brace, in which many whitewater kayakers make the mistake of reaching high overhead to gain leverage as they plant the paddle to keep from flipping. The result is an arm in the "baseball position" with a dangerous amount of torque from the paddle. Goth's advice: Keep your arms below shoulder level. "If you can't see your hands while facing forward, you're at risk."

If you're a swimmer, be on the lookout for injuries from repetitive motion. For you, a rotator cuff injury typically won't be dramatic--it'll come on slowly, as you build mileage and speed in your workouts. And by then, about all you can do is heed the old Henny Youngman gag: "Doctor, it hurts when I do this!" "Then don't do that!" If you experience recurring pain, stop your swimming routine--there are no easy-on-the-shoulder strokes--apply ice to the ache, and see your doctor if your condition doesn't improve. The strain of swimming freestyle with your head out of the water and the constant "baseball position" demanded by throwing and blocking place water polo players at even greater risk.

"Shoulder injuries are among the most common injuries in our sport," says Dan McDonough, coordinator of sports medicine for the U.S. Olympic volleyball teams. The culprit, however, is not explosive arm-swinging during serves and spikes. Rather, slowing down the arm after hitting the ball stresses the rotator cuff muscle in the back of the shoulder. "Most volleyball players have well-developed chest muscles that help with acceleration of the arm," says McDonough, "but the muscles that slow down the swing--the rotator cuff and trapezius--are usually much smaller and more prone to strains and tears."

McDonough says the key is to emphasize those underdeveloped muscles in weight training and to know what pain means--good advice for athletes of any stripe. "If the pain recurs every time you play, or if it's there when you wake up in the morning, it's time to take it easy." Indeed, McDonough cautions his athletes to avoid sleeping with their arms over their head, a stressful position for the rotator cuffs. "Sleep," he says, "is a time for repair."

"Climbers used to get shoulder tendinitis," says Griffith, who at the height of his career was ranked seventh by the American Sport Climbing Federation. "That's because of all those big-muscle exercises, like one-arm pull-ups and pull-ups with weights around our waists." Nowadays, as climbers focus on flexibility, balance, and moderate strength training in keeping with the sport's increasingly explosive gymnastic style, dislocations like Griffith's are more common. In addition to strengthening the rotator cuff muscles, the best way to prevent this type of injury is to be careful when your shoulder is in the "baseball position." Just a few months after he'd dislocated his shoulder, Griffith found himself right back where he'd started. "I got to exactly the same kind of overhanging corner, and I was terrified," he says. "But I took it slow and didn't let my arm get too high above my head. I ended up being the only person to do the route--and won the competition. My injury, a potential weakness, ended up being a benefit. It forced me to focus where other people were being too aggressive."

Cory Johnson wrote "Bodies of Evidence" in the March issue.

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