Put Your Back Into It: Shoulder Health in Ultimate

Shoulder injuries and tightness are super common amongst ultimate players, especially on their throwing side. Even young and new players show signs of trouble brewing. I recently did a quick assessment of about 100 high school-age ultimate players, and of those 100, 49 needed significant shoulder mobility work, with 28 of those players only needing intervention on their throwing-arm side. I’m sure many people reading this article have had their share of shoulder issues even if it’s never gone past tightness or soreness after a long tournament. As a community of players and coaches, we should have a better understanding of why these problems occur and what to do about them!

First, a question: why do shoulder injuries and issues happen in ultimate?

There are some aspects of the sport that we can’t change that contribute to the high incidence of injury (the asymmetrical nature of throwing and pivoting and the ballistic nature of laying out and contact). But things we can control, like how much we understand and take care of our bodies, are a huge part of the picture. Flatballers throw an awful lot– for years and years, really– usually with just one arm. When unmitigated, that kind of repetitive motion creates all kinds of chronic tightness and stress. Also, many players’ arm action isn’t well-supported by the rest of their body – the arm and its connectors are left to do all the work because of functional issues with kinetic chain. When weakened by repetitive motion and isolated by poor movement quality, the complex joint of the shoulder is additionally in acute danger of injury from impact like laying out and contact.

Crappy! Here’s what I think we should do to start turning this disturbing trend around…

We can educate ourselves about the shoulder and how it functions. Many strength and conditioning coaches (and most physical therapists I know) consider the shoulder to be a unit that includes the whole front/top/back of your upper body– it’s not just a ball and socket joint (Kstar does a great job explaining this). Many athletes think about the shoulder as the place where the arm attaches, which is functionally incorrect – a healthy shoulder is able to do what it does (be mobile in a big, multi-planar range) because of the support structure from the rest of the upper body (primarily scapular stability and mid-back mobility, though there’s a whole host of other musculature and connective tissue that help out).

There have been a couple articles recently dealing with throwing that I’ve followed with interest, particularly Benji Heywood’s about throwing without the body and Kyle Weisbrod’s rebuttal. Here is my opinion from a biomechanical perspective: thinking about throwing and teaching throwing as an arm-only movement is problematic because it’s counter to the way the body is meant to function. What we think of as “good shoulder mobility” involves more than you might think – it requires having good mid-back mobility, and also good scapular stability. Try this easy self-test to see if you have a shoulder mobility restriction – if you do, the arm is doing too much work to crank the disc around. Treat the arm as if it attaches to and is supported by your body and we’ve got a shot at avoiding injury and increasing power.

The shoulder and its muscle attachments. From Google Images.

We can do the off-the-field work necessary to address the asymmetries, weaknesses and/or postural problems that make your shoulder vulnerable.  There’s a host of videos on my YouTube channel that you can put into your lifting program or your foam-rolling-in-front-of-the-TV time (or does that just happen in my house?). My favorite bang-for-the-buck movement to work on the host of issues caused by throwing, particularly the connection between shoulder, upper body, and core problems, is this fancy TGU (Turkish Get-Up – here’s a basic version with lots of explanation from the fabulous Tim Morrill and I). Breaking up soft tissue restrictions is an absolute must — double up a couple lacrosse balls and get some mid-back mobility, for starters. Improving your posture is a different kind of work that requires us to be mindful, making changes in how we sit and carry ourselves. It’s good work, though, because poor posture makes it difficult to engage the posterior chain (rhomboids, lats, traps) and causes your pecs to tighten. These are the muscles that should working to support your shoulder/arm when you throw, so having a tight mid-back and rounded shoulders means you’re hanging your shoulder out to dry when you step on the field.

We can prepare the shoulder unit for the work it’s about to do during a practice or tournament. Okay, it’s pet peeve time. This is an area I would really like to see change for the better in our community. I see way more people foam rolling their legs on the sidelines before playing these days (yay!) and I see great attention being paid to preparing the lower body for ultimate by stretching, doing mobility exercises and doing line-to-line warm up drills (again, yay!). But the other thing I’ve seen for the 20 years I’ve been watching ultimate players is that hardly anyone does anything for their upper bodies or their shoulders in warm up. I’ve seen players foam roll, get their hips moving, and then get up and start throwing. And most team warm ups don’t include any upper body component at all. Ultimate is all about throwing and catching, yet the only way most people prepare themselves to throw and catch is to throw and catch. We can do better than that! Get down on the lacrosse ball and break up tissue adhesions before you start throwing. Add these exercises for mid-back mobility and shoulder mobility/scapular stability into your team’s warm-ups. And if you have time and feel awesome, this one is good for working different planes of shoulder mobility, and the straight-leg sit-up is great for same-side core engagement.

We can practice and teach good game mechanics and self-care while still responsibly emphasizing repetition. The only way to get better at throwing is throwing — same goes for laying out. But doing those things over and over with your arm out on the edge of a gangplank is asking for trouble. What’s a good coach or veteran player to do? First of all, take responsibility for yourself by making sure you’re doing things the way that’s best for your body. Second, note that people are watching you. Just like young players earn how to break the mark by watching Ben Wiggins on YouTube just as much as by watching his instructional RISE UP videos, they’ll learn how to care for their bodies by watching you perform your own routine just as much as by listening to your instruction. Show them the good stuff!

Finally, talk about throwing from a healthy functional perspective as well as a performance perspective. You don’t have to know everything about how the supraspinatus supports the throwing motion, but you can talk about keeping your shoulder blades “packed” (dropped down your back and stabilized) when you’re in a ready position or throwing a forehand. Encourage players to keep the disc “right-side up” when they’re in a ready position — this will encourage their shoulders not to round forward. You can also talk about the shoulder as a unit and give them movements in a warm up that prepare them to throw. Point them to resources and encourage them to take responsibility not just for their play and skill, but for their health.

In short, you don’t need to sacrifice practice in order to protect your body and think long-term about your ultimate career, and encourage others to do the same. Alex Snyder’s “World Class Throwing” is a great example of an ultimate mentality that I love: “everyone should always be throwing more than they ever thought they could or would want to.” I agree wholeheartedly. But you also gotta balance all that throwing out with a little bit of focus on your body before, during, and after letting the disc fly.

My pipe dream is to see more upper body movements in warm ups, more lacrosse balls on the sidelines, and better-looking shoulder movement on backhands because I know that when I see more of those things, I’ll see fewer injuries and less pain in my athletes. :) Send any questions or thoughts my way– I’m always gathering info and learning from my clients and colleagues!