As with most orthopedic conditions, the rehab process involves settling the area down, then building back up. So once symptoms have settled, we need to reintroduce painful movements gradually, being guided by pain response after training. 

With our resistance training, we want to ensure that we have an adequate balance between pushing and pulling exercises. This is essentially to avoid exposing the joint to excessive loading in each direction, and also to maintain strength balance around the joint. Initially we want to avoid exercises crossing the midline of the body, which tend to strain the AC joint. Pressing options such as a single arm floor press with rotation are great for this. Many athletes find that incline pressing (with dumbbells or cables) is more comfortable than flat bench press, due to the direction of the humerus aiming beneath the AC joint. Neutral grip bench using a safety bar, or dumbbells, may also be better tolerated in the early stages. As pain settles we can progress back into more demanding movements.

Scapular stability work focusing on posterior tilt and protraction (see clips) may be effective in optimising the ability of the shoulder muscles to buffer compressive loads.

With our skills training, we gradually reintroduce the previously painful techniques as tolerated, while closely monitoring volume of these strikes. If there were technical factors (e.g. poor elbow position in the hook, flaring elbows in body shot, overextending the jab, poor rotation in the cross) that may have led to the injury, these should be addressed in conjunction with the skills coach. 

Finally, the athlete’s range of motion into hip and thoracic rotation should be assessed, and if there are significant restrictions in these areas which may be increasing the biomechanical load on the shoulder, these should be addressed in their exercise program. 

#thescienceofstriking #boxing #kickboxing #shoulderpain #shoulderinjury #acjoint #rehabiliation #physiotherapy

About the author

Sam Gilbert

Sam Gilbert is a registered physiotherapist with the Australian Physiotherapy Association (APA) and certified strength and conditioning specialist (CSCS) with the National Strength and Conditioning Association (NSCA). He holds a bachelor’s degree in Physiotherapy from Latrobe university (Melbourne, Australia) and a master’s degree in Exercise Science (Strength and Conditioning) from Edith Cowan University (Perth, Australia).

A 3rd Dan black belt in Shinkyokushinkai Karate under the World Karate Organisation (WKO), Sam participated for over 20 years in full contact competition, winning multiple state and national titles, and culminating in a 4th place in the heavyweight division of the Shinkyokushinkai World Cup in 2009.

As the co-founder and clinical director of Club 360, the premier multi-disciplinary health and fitness center in Tokyo, Japan, Sam has combined his practical experience with an in-depth study of sports performance in relation to combat sports, and strives to help other combat athletes reach their full competitive potential, whilst at the same time decreasing injury risk and increasing competition and training potential.

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By Sam Gilbert