Healthy shoulders’ posture : the RME method – example in rugby.

Introduction

In today’s rugby world many players have a bad shoulders’ posture (shoulder forward in the sagittal plane). Because of the specificity of the practice: the repetition of high-intensity shocks, the player’s willingness to protect himself before contact or to protect the ball from the opposing player. His various actions lead the rugby player to be many times in a situation where the position of the shoulder in the sagittal plane is placed forward.

Posture with shoulder forward vs Posture shoulder back

Moreover in amateur rugby this phenomenon tends to be increased by the sometimes insufficient follow-up given to the rugby player in physical preparation (amateur-level rugby – federal level, problem less present on professional rugby because the tracking of the player is better), indeed at the amateur level, the rugby player tends to strengthen much more his anterior chain of the upper body rather than his posterior chain. Moreover, the sedentary life in which we are constantly sitting, leaning forward, puts us in a bad position and increases this problem. All of these factors lead to an increase in the problem of land encountered.

The sedentary position increases the problem of the field.

For this, many corrections are already possible and proposed to the rugby player. Delay in the posterior muscles is also the major cause of this “shoulders forward” effect. Deltoids, median and lower trapezoids should be targeted. Indeed, it allows us to pull our posture backwards and strengthen the action of our scapular chain in order to improve its control.

This prominent shoulder concerns may have caused an intero-superior conflict of the shoulder “shoulder impingement syndrome” at the level of the coracoid process and at the level under acromial (2). Many other pathologies can emerge. In fact, failure to treat this position can lead to long-term pathologies such as tendonitis of the biceps tendon (the humeral head ahead creating a conflict between the head of the humerus and the proximal insertion of the biceps tendon), or the long-term onset of shoulder blade dyskinesia (8). Other long-term pathologies caused by this position can also be detected, such as rotator cuff tendinopathies or other more serious injuries caused by rugby activity and its repeated shocks on a failing shoulder joint.

The figures support this in fact shoulder injuries account for 9 to 11% of injuries among rugby players according to the study “Epidemiology of shoulder instability among French rugby players – prospective study on 5 sports seasons from 2008 to 2013” by Yoann Bohu, figures for all rugby players with FFR licences between 2008 and 2013. According to this study, during this period, 88044 injuries were reported, of which 1345 were reported, of which shoulder dislocation was due to instability.

Various work is undertaken in the literature on the settlement of intero-superior conflicts, both at the sporting level and also at the level of the more sedentary people. Indeed, the correction of this shoulder position forward can be achieved by strengthening the posterior chain of the upper body and the fixing muscles of the shoulder blade (trapezoids, lift of the scapula, rhomboids and the large dented). Many studies using this principle rely on work to strengthen the posterior chain to fix the position of the shoulder blade in the sagittal plane, inducing a movement of the position of the humeral head in that same plane.

When the public in charge is composed of many athletes, especially rugby players, it is interesting to ask the question of the usefulness of strengthening the external rotator and fixing muscles of the shoulder blade when we work with an audience that has a substantial experience in the practice of bodybuilding and therefore strengthening the posterior chain. In this logic to correct the previously stated field problem one can think about proposing a relaxation of the anterior chain of the upper body and especially of the pectoral muscles. Indeed, in the literature it is argued that a reduced length of the small pectoral would have a direct impact on shoulder pain and especially in the level of acromial conflicts (antero-sup conflicts) as stated in the article (14). Two methods can be used to allow the relaxation of facias (muscle tissues) of the anterior chain and in particular of the pectoral chain: massages and stretching (passive, dynamic, CRAC…). On the other hand, it is difficult to have a real impact on the position of the shoulder positioned too forward.

Nevertheless, another study looked at a combined method between stretching the anterior chain coupled with strengthening of the interscapular and external rotator muscles. This protocol showed significant results on a more erect posture of the upper trunk and an increase in the stability of the shoulder blades (11).

Improve your posture, fix your scapular chain, what to do according to your physical profile?

In the rugby player and good level athlete:

In the reflection carried out, the strengthening of the posterior chain alone does not seem relevant. Using it in conjunction with self massages and stretching will be suitable for an experienced sportsman’s audience. Below is a protocol that can be carried out in addition to appropriate planning. This type of work in the rugby business goes directly into the prophylactic work of the athlete.

Definition of the RME method: the RME method does not represent a conception of physical preparation, this acronym is used here to define a method composed of Muscle Strengthening, Massage and Stretching to deal with a field problem (here the position of the shoulder).

Example of combined work: Protocol RME4

series: max repetitionsRe
st: 1’Te
mpo: 2” eccentric 2” concentric 2” Isometry end of the draw3 s
eries: 30s per sideRes
t: 30s (alternate side D and G)T
empo: Isometry passive stretching

Variation working angles between serie
s2 series: 20s massage in motion on pectoral area – 20s fixation on Trigger pointRe
st: 40s (alternate side D and G)

Reflection on sports:

In addition to the beneficial effects on injury prevention and player health, the interests of improved posture and improved mobility on the ingulent movements of the shoulder joint are numerous.

In the interests of the long-term development of the high-level rugby player, an improvement in the position of the shoulder in the sagittal plane would lead to improved mobility of this joint and facilitate the movements of developed with a position of hands above the head for example: Overhaed Squat, Strict Press, Push Press… improving the kinetics of his movements would facilitate the work undertaken (hypertrophy, strength …) with the player and would develop his physical qualities transposable on the field.

Practical applications:

In terms of the practical applications that can be brought to the field, we can assume that the effectiveness of the RME method will depend on the profile of the player. For example, a player who needs to correct his shoulder position in the sagittal plane but who paradoxically has a posterior face of the upper limb highly developed muscularly (high lean mass rate) should react better to a combined method. This is due to the presence of loosening work on the anterior face. On the other hand, a player who has a lean, undeveloped mass and lacks reinforcement in his shoulder blade-fixing muscles could be more likely to react to exclusive muscle building work. The interest for the physical trainer is to target the needs of the athlete in relation to the problem posed.

Compared to the needs of the field it is interesting to build a routine when problems of mobility and positioning of the humeral head appear in the athlete.

Throughout the rugby player’s curriculum (from his beginnings to his senior career) each experience influences the physical characteristics of the adult player. In this logic, the work of correcting the position of the shoulder in the sagittal plane must be a work to be done in the long term to have significant results on the mobility and stability of the shoulder.

The physical trainer has the opportunity to correct the position of the shoulder by reconsidering the training schedule of the athlete. It should restore the balance of workouts and strength exercises, including reducing the strengthening of the anterior chain of the upper limb and increasing that of the posterior chain of the upper limb.

How to improve your posture and work on your scapular chain?

To go further in improving the above-exposed field problem, I have designed a program to follow to combat the appearance (or correct) this bad scapular position. This protocol contains methods that can be used by the high-level rugby player, but not only. Other athletes experiencing this problem or sedentary people will also find themselves in the small guide of the scapular chain. If you have any further questions about this complex articulation, or if you want more complete planning contact me.

Pierre Mathieu

Bibliography

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