Hi, I'm Dr. Molly with Your Goals Physical Therapy. I've been talking a lot recently about boxing. This time I wanted to do a video on shoulder pain while you're boxing, which I think most people assume is going to cause at least some level of discomfort in their shoulder. When they're boxing, obviously it's an impact sport with your arm and it doesn't shock people when they come back and they're a little bit sore. But what happens when that soreness goes from the sore sensation that you're used to from an exercise to a pain that feels like you might need to see a doctor, or there may be something wrong. And how does that process work? Because for most people, it sort of creeps up on them. They assume that the pain they're having is from the workout so they ignore it until it absolutely can't be ignored anymore. Then they contemplate stopping, doing the thing that they like doing, such as going to these boxing classes, because they don't want to hurt their shoulder.
You become very afraid that you're going to have a rotator cuff tear and who's going to do a sport off they think they're going to need surgery from just doing the sports. I'm here to tell you that there are many, many people boxing or punching in different venues. Between all sorts of MMA fighters, all every martial arts and just everything that’s out there right now, lots of people are throwing punches and not everybody's getting a rotator cuff tear.
So let's talk about how you can make sure that you're on the side that doesn't need the rotator cuff repair versus the side that ends up in surgery.
I think that that starts with a very simple muscle, your Pec.
I know that seems weird because everybody's going to say, “Oh, that's your rotator cuff?” Well, I think it starts before you start having rotator cuff problems…What causes the rotator cuff problems? Typically the rotator cuff is a problem because we're in a society where we spend a lot of time like this and our pec muscle gets very, very short. If you are not sure where your pec muscle actually attaches. It starts at your chest plate, and then it attaches onto your arm. So when it gets tight, it's actually pulling your arm forward. And by pulling your arm bone forward, it's changing the entire mechanism inside your shoulder. One of the first things that I teach people is how to do a really good Pec stretch. Because again, our society, we spend so much time in this bend forward position. Whether you're driving, whether you're on your computer and now when you're boxing and you're in that position, it's just one more thing that's allowing that muscle (pec muscle) to get used to being in this position(pulled forward). Then when you want to throw a punch and your arm is way out here (motion for hook), you're stretching that pec muscle while you're asking it to contract for the punch. This whole process changes the entire mechanism of your shoulder, which over time wears down your rotator cuff. So a really good pec stretch, I'll leave a link in the show in the notes below for a full demonstration of the way that I would do a pec stretch.
But essentially everybody's seen the one where you grab onto something like a wall or a doorway and you lean in. The problem with that is that your shoulders are in front of your feet for most people when they do it. That's how, that's how they think it's supposed to be done but if your head is in front of your feet and your arms are out like this, the only thing keeping you up are your arm and chest muscles. You can’t stretch something that has to tighten to keep you from falling forward. So a better way to do that is keep your elbow and your whole forearm onto a wall, then step forward keeping your hip underneath your shoulder. That way, when you get that stretch or that pull in the front of your chest, it's actually just stretching. You're not getting the sensation of the muscle contracting and confusing those two. That's the first one suggestion to keep your shoulders healthy. Another thing that you should be doing, especially if you're going to be boxing multiple times a week is cross training. Instead of only doing all these pushing motions, you need to find a way to get some pulling exercises into the routine.
For instance adding back exercises and overall shoulder exercises not just the front of the shoulder, not just the side of the shoulder, BUT the whole shoulder joint. (and obviously rotator cuffs exercises should be added to that.)
Finally, I know nobody thinks about it, but stretching your shoulder is very, very important. We don't think about stretching our arms out, but really between your Pec and all of the muscles in your shoulder, things get tight. Just like, if a runner doesn't stretch their hips, if a boxer doesn't stretch their shoulder, you're going to end up with some, uneven tightness that messes up the mechanics in your shoulder.
Now what if you've tried icing? What if you've tried giving it rest? What if you are on an overall balanced exercise program, what could be causing your problem? Or What should you be doing to make sure that you're keeping your shoulders as healthy as possible?
If you've really been problem-solving this and you can't figure it out on your own, there is no shame in asking somebody to help you. That's why professionals like me exist. All we do all day is help people stay in the sport that they want to stay in by finding out what mechanical problem is happening, addressing that specific thing and helping you get back to your sport. So if that's something that you're interested in, I'll leave contact information in the notes below, but overall, I hope that you're able to keep boxing and enjoying that sport.
WE HELP ACTIVE ADULTS OVERCOME THEIR ACHES AND PAINS TO GET THEM BACK TO THEIR FAVORITE ACTIVITIES WITHOUT MEDICATION, INJECTIONS OR SURGERIES.
Dr. Molly McDonald