Hitting the ball hard is fun, but staying healthy is key to remaining on the court.

Many young volleyball players are hitting in a way that is not generating maxium power and arm speed, but also is creating shoulder pain and injury for many. In this article we will explain how to move and strengthen the hitting arm and shoulder to maximize arm power and arm speed, while at the same time keeping the shoulder healthy, short-term and long-term.

True Story - Volleyball Athlete's Pain, Injury & Shut Down

Last year a parent contacted me because his daughter had such severe shoulder pain she couldn't lift her hand and arm above her shoulder. An MRI showed no tears in the rotator cuff, labrum or biceps tendon (common in many shoulder injuries), but her shoulder was so inflamed that he shut her down from playing and practice for a minium of three months.

 

 

The player had come to a clinic three years earlier and we had told her and her father that she needed to change her arm swing as the “High Elbow Set-Up” she was using might keep her from hitting her hardest and may cause shoulder problems down-the-road. They later took lessons from another local club and the instructor who told her the same thing. She didn't make a commitment to change her swing away from her High Elbow arm swing...

 

In this article you will see some of the rehabilitation exercises we did to strengthen specific muscles around her shoulder and arm and to change and dramatically improve her arm swing mechanics. She was pain free in a few weeks and in a couple months was able to play her spring highschool season and go to college with a healthy, powerful shoulder and arm swing.

The High Elbow Swing (HES)

This technique is extremely popular right now as it is probably taught by the majority of coaches and hitting instructors across the USA.

HES - Good News

The good part of HES is that it is relatively easy to teach young athletes to perform because it is a simple movement. Additionally, you can hit the ball relatively hard using this technique.

HES - Bad News

This hitting technique:

1. Places the shoulder in a position that is unstable.
2. Can place pressure & potentially strain many tissues around the shoulder joint.
3. Doesn't create maximal power from the hitting shoulder and body.
4. Doesn’t spread the forces across the body.
5. Isn’t tolerated well by many athletes.
6. Creates pain, injury and damages the shoulder long-term for many athletes.

HES Mechanics

In the High Elbow Setup, the athlete lifts the hitting elbow up high above the shoulder joint and then swings the arm to hit the ball.

When the hitting elbow is lifted above the shoulder joint, it places the shoulder joint in an unstable (uncontrollable) position. In this position, the upper arm can move upwards and pinch or place pressure on one of the rotator cuff tendons (the supraspinatus tendon). This action can create pain and can potentially injure this tendon or other soft tissues around the shoulder joint.

 

 

The shoulder is unstable because the shoulder joint itself is like a shallow saucer and since the head of the humerus is round, the head of the humerus can potentially move around the shoudler joint in an uncontrollable fashion.

This can lead to pain, subluxations (dislocations) and other shoulder issues.

 

 

 

HES Muscles

When using the HES, the hitter only uses a few of the muscles around the shoulder joint and arm, mainly probably the rotator cuff and the triceps muscles, to create arm speed. Using a limited number of muscles to power the arm does work but it’s not even close to as powerful as using other hitting techniques that uses many additional muscles, around the shoulder and in the body.

Muscles are engines that stretch, load and then shorten to create the forces to move the arm and shoulder to hit the ball. In general, the greater the number of muscles used in the swing, the greater will be the forces, power and speed to move the arm and hit the ball harder.

Also, the greater the number of muscles used, (that are spread out over the entire body), the less the isolated forces there are around the shoulder joint. This will typically equate to less shoulder pain and shoulder injury risk for the athlete.

Watch the video below to get a feel for how the High Elbow Set-Up creates pain and possibly injury for many volleyball hitters.

Deceleration of the Arm & Shoulder

It’s important to understand that in overhead throwing (or hitting) sports, historically more injuries happen when slowing the arm down rather than when the arm is speeding up. (The slowing down of the arm or is called to the braking or deceleration phase).

 

The most commonly injured tissue, in the deceleration of the arm and shoulder, is the tendon of the supraspinatus muscle. This is one of the four rotator cuff muscles and the tendon connects the muscle to a bone. This muscle that often gets pinched by the top of the arm bone and bottom of the shoulder blade, when using the HES arm swing).

 

When trying to slow the arm & shoulder down after a fast HES arm swing, there are not many muscles on the backside of the shoulder and arm that can help slow the arm down.

This is because of the position the arm and shoulder are positioned in that there aren't many muscles that can help slow the arm down.

Because there are few muscles to help slow the arm down after ball contact, there's more stress on the shoulder joint and the surrounding soft tissues (muscles, tendons and ligaments) that are forced to absorb the stresses of the arm swing. This makes them more prone to pain and injury.

The Neutral Shoulder Setup (NSS)

We teach an arm swing where the head of the humerus moves more safely in the center of the shoulder joint and in anatomical terms we call it a "neutral" shoulder setup.

NSS - Good News

The NSS Hitting Technique:

1. Places the hitting shoulder in a much more stable (controllable) and healthier position.
2. Reduces the likelihood of pinching the supraspinatus tendon.
3. Dramatically improves the number of muscles engaged to speed the arm up and slow it down.
4. Reduces shoulder pain and injury risk and dramatically improves the health of the shoulder long-term.

NSS - Bad News

NSS:

1. It is harder to teach as it’s more complex.
2. An understanding of the shoulder joint anatomy & physiology is requried to really understand why it's better than HES.

Neutral Shoulder Position

In general, the best position for the shoulder joint to work is when the head of the humerus sits and stays in the middle of the saucer (the glenoid fossa) as the arm swings.

Joint Centric - this is a technical term that is used to describe the position of the head of the humerus when it sits in the middle of the shoulder joint. This is the ideal position.

The Rotator Cuff’s Job - The muscles of the rotator cuff main job, is to pull the head of the humerus into the center of the glenoid fossa (the saucer surface on the scapula), and hold it there as the arm rotates to hit or throw a ball.

Keeping the humerus in the center of the joint (saucer) keeps it from moving upwards (to avoid pinching the supraspinatus tendon between the top of the humerus and the bottom of the scapula. (This is a very common area for hitters to feel pain on the top and front of their shoulder after hitting).

 

Watch the video below for a deeper dive and understanding of some of the shoulder anatomy and how the Neutral Shoulder Set-Up is better tolerated than the High Elbow Set-Up.

Scapular Position & Movement

 

The shoulder blade is technically called the scapula (scap). The shoulder blade and the upper arm bone (the humerus) together make up the shoulder joint.

 

 

 

 

 

 

 

 

 

For many young athletes, due to poor strength and flexibility in muscles that attach to the shoulder blade and arm, the shoulder blade is oftentimes not in a good position (on the rib cage). In this less than ideal position, the arm and shoulder don't tolerate the torque created in the swing, espeically when using the HES. The end result is often shoulder pain and it can lead to shoulder injury.

 

 

 

For a right handed hitter, the right shoulder blade or scapula should lay flat on top of the ribs on the backside of the body.

 

 

 

 

 

 

But for many hitters, the right scapula does not lay flat on top of the ribs and many times doesn’t move correctly, either.

This is often the result of weakness in some of the muscles underneath and below the shoulder blade. For many hitters, this ultimately reduces how hard they can hit the ball and it can be the cause of pain and can lead to shoulder injuries as well.

 

 

Really Important Point

When the shoulder blade lays flat on the rib cage and moves correctly, the shoulder blade and upper arm move into a position where the right pectoralis major chest muscle is stretched (loaded) which allows the hitter to use the great strength of this large and powerful chest muscle to hit with greater force, power and arm speed.

Winged, Tipped & Rotated Scaps

So many young developing hitters have shoulder blades that, instead of laying flat down against their ribs, are rotated forwards or inwards on the ribs, and they don’t move over the ribs as they should either.

Look at the position of your hitters scaps and look for these very common issues with the scaps:

 

Winged Scaps - the scapula is rotated inwards so the back of the scapula looks like a little wing coming out of the athlete’s ribs.

 

 

 

 

 

 

 

 

 

 

Tipped Scaps - the scapula is rotated forwards so the bottom of the scap is tipped forwards off of the athlete’s ribs.

 

 

 

 

 

 

 

 

 

 

If you see these winged or tipped scaps, ideally the athlete needs to learn how to use the correct small muscles to make the scapula sit flat down on the rib cage as the athlete throws. This will dramatically improve their throwing mechanics, increase arm speed and allow the athlete to exert a lot less effort to create greater throwing power and speed, and maybe most importantly, reduce the stress on the throwing shoulder and arm.

“Scap Load” - Connecting the Scapula and Rib Cage

We teach athletes to feel how to move the right scap (scapula) and position it where it lies flat down against the rib cage. When this happens correctly, we tell them that the scap is “connected” to their rib cage and want them to learn the FEEL for how to connect it for part of their hitting motion.

We typically see 2-4 mph increases in ball velocity when the athlete learns how to stay connected and the athlete can feel the difference in their ability to hit at higher velocities with much dramatically less effort.

 

 

 

 

 

 

 

 

 

Watch the video below to see how we teach hitters to move their shoulder and arm as they strengthen and train ideal hitting mechanics, with the shoulder in the best position to generate & tolerate shoulder torque.

Connecting & Strengthening the Scap Muscles

We teach & train hitters to connect their scap to their rib cage and then strengthen most of the muscles under and around the scap and shoulder joint using the PC360 Arm & Shoulder Trainer.

 

 

 

The athlete attaches the PC360 Arm Cuff & Resistance Band above the elbow and then we teach them to engage (fire) the muscles underneath the scap to first flatten the scap down on the rib cage.

Next, We teach them to bend the elbow and turn their shoulders to their right.

 

 

 

 

 

 

 

 

 

The athlete is taught to keep the shoulder blade connected to the rib cage as they move the hitting arm slowly through the hitting motion and to ball contact.

 

 

 

 

 

 

 

 

 

 

 

 

Next, we then reposition the resistance bands attached to the PC360 Arm & Shoulder Trainer to work the muscles on the front side of the shoulder.

The same motion is performed to first connect the scap to the rib cage, then bend the elbow and turn the shoulders.

 

 

 

 

 

Next, once again goes through slow hitting motion but now with the bands behind the athlete's body, the bands strengthen the muscles on the front side of the shoulder, chest, arm and body.

This action helps the athlete hit harder because these muscles are responsible for moving the arm forwards with force and speed to contact the ball.