Credit: @theprehabguys

This article will go through a 7 Month, 3 Phase Shoulder Injury Prevention Program. This Program was designed for in-season handball players, however, these principles will apply for any overhead athlete.

We have collaborated with Dr. Alex Cascone from Tennis Prehab Lab breaking down a study conducted in 2017 by Andersson et al. which examined the effects of shoulder injury prevention program implemented 3x/week during a 7-month handball season. The study was a prospective cluster randomized control trial that included participation of 45 teams equating to 660 players.

The program was developed to improve:

1. Shoulder internal rotation (IR)

2. Shoulder external rotation (ER)

3. Scapular muscle strength

4. Kinetic chain & Thoracic Spine mobility

5 exercises were selected & were employed as the teams’ warm-up &, took approx. 10 mins. to perform. These 5 exercises were progressed in 3 phases.

Impairments are similar for most overhead athletes including: Total shoulder rotation (ER>IR), ER weakness & scapula dyskinesis (faulty shoulder blade movement). This will cause anterior humeral head translation, posterior cuff tightness, chronic capsular stress ultimately resulting in potential rotator cuff & labrum pathology.

Results of this study demonstrated a 28% lower risk of shoulder problems & 22% lower risk of substantial shoulder problems in the intervention group compared with the control group who performed routine warm-up.

PHASE 1 OF 3: WEEKS 1-6

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1. Push up plus w/ Trunk Rotation: 3 x 8-16 reps

a. Drive shoulder blades toward the floor & out

b. Maintain push up plus position, scapular stability during trunk rotation.

2. Standing Y with resistance band: 3 x 8-16 reps

a. Maintain neutral spine position

b. Do not shrug shoulders

c. ER shoulders (thumb pointed up) during arm elevation.

3. Quadruped trunk rotation w/ ball: 3 x 8-16 reps

a. Maintain neutral lumbar spine position

b. Maintain shoulder stability of grounded arm during rotation

c. Exhale as you rotate through the T/S

4. Sleeper Stretch: 3×30 second holds

a. Lie on side & ensure shoulder blade is blocked by ground

b. Gently press on hand to stretch the post cuff

5. Standing 90/90 ER: 3 x 10-20 reps

a. Maintain 90° at the shoulder and elbow

b. Maintain scapular stability (avoid shrugging shoulder)

c. Slowly lower med ball down to floor