Daily Mobility Exercises by Dr. Kelly Starrett Forums General Shoulder instability overhead and clicking noises

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    • #71393
      AvatarMike Fulkerson

      I’m not sure if this is from old injuries or just bad genetics but my shoulders are a problem.  Always have stability issues overhead and I get all sorts of ugly clicking noises coming out of one of them when I do kettle bell swings as the kb is coming back down from overhead.

      I had an MRI years ago and based on that and doing some articulations the doc wrote this up:
      “R + L SLAP tear with scapular instability with impingement bilateral shoulders and poor posture”

      Doc said no surgery because it wasn’t bad enough so I did physio for a few months but it never seemed to get much better.

      Any ideas?

    • #76052
      AvatarNathan Richer

      following on MWOD’s theme of spine first, i would work on posture to make sure your spine has the right curves, and make sure your head is straight up and on the neck. is the head pushed forward? good posture should have the earhole lined up with middle of shoulder, middle of elbow, middle of hip, middle of knee, ankle bone.

      you should also examine your breathing. start working on converting to diaphragmatic breathing. if you are breathing from your shoulders or chest, it will fire up your traps and constantly drag your shoulders higher than they should, and could be causing your impingement problems.
      then comes the variety of mobs in/around the shoulder. i’d work a ball all around the shoulder: pecs, pec minor, traps, shoulder blade, lat, anterior serratus. make sure everything is loose and not sore to the ball’s touch.
      you should also look at some banded distraction mobs for the shoulder.
      last is motor control. it is likely that your traps are firing first when you lift overhead. other misfirings may be happening. this part you should find a good PT or coach to help you with. it is a bit hard to describe treatment in this area on a forum.
    • #76053
      AvatarMike Fulkerson

      Thanks for the advise.  Posture is definitely a huge issue.  I spend the vast majority of my time driving and working on a laptop.  I definitely need to focus more on finding desks of appropriate hights for laptop usage so I’m not always forced to tilt my head down to look at the screen.  Would it perhaps be a good idea in situations where a suitable desk can’t be found to sit crosslegged on the floor and tilt forward at the hips to maintain a properly organized spine and shoulders so as not to have to tilt the head down when working on a laptop?

      Are there any links you would recommend to develope this diaphramic breathing practise?  It seems like this would be a good thing to focus on in congunction with the 20-30% ab tension/belly-wack test since that is something I have also been thinking a lot about but haven’t put into regular/effective enough practise yet.

      I’ll definitely get on the ball rolling and banded distraction as soon as I get back to civilization where I can aquire said items.  Same with a good PT although that might take a little longer.  I’m still out in the bush for another 3 weeks.  Any other recommendations in the mean time?

    • #76054
      AvatarGeorge McLaney

      Ryan, I’d certainly recommend a standing desk if your work situation will allow it. When you drive, you might want to put a lacrosse ball or one of Jill Miller’s Yoga Tune Up balls on various parts of the posterior shoulder and t-spine and get a little motion in there. 

      For breathing, check out Jill Miller’s book The Roll Model. 

      As David Shen rightly said, spine comes first when it comes to trying to feed slack to the shoulder, and providing stability for it. After this, go after the relationship between the scaplula and shoulder . There are so many useful mob videos for tackling your issues, including: 

      (and just search for “t-spine” and “scapula” on MobilityWOD.com)

      Also, mobilize the position of restriction. If you’re having overhead issues you need to do some mobility work in the positions that are giving you grief. K-Star has all manner of variations for this. Particularly see the 2nd edition of Becoming a Supple Leopard (the overhead archetype) and the accompanying videos: 

      Hopefully some of this helps!
    • #76056
      AvatarNathan Richer

      RE: diaphragmatic breathing. I wrote a blog post and did some videos on how to train yourself: http://www.dshen.com/blogs/training/archives/how_to_train_for_abdominal_breathing_and_generating_intra-abdominal_pressure.html

      check out Phil White’s videos above. good stuff.
      the one thing i will recommend for shoulders is Sue Falsone’s DVD The Shoulder (http://www.otpbooks.com/mm5/merchant.mvc?Screen=PROD&Store_Code=OTP&Product_Code=VSFS&Category_Code=2). it’s an excellent quick explanation of the shoulder and scapula + proper function. then she goes into a few of her favorite corrective exercises. when you get back to civilization, i would highly recommend ordering it. if you can’t wait for the DVD, buy the downloadable versions.
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