Return to kipping pull-ups after shoulder injury: part 1
Returning to Kipping Pull-Ups after Shoulder Injury: Part 1
When returning from shoulder injury or pain, kipping from a pull-up bar often takes athletes longer to return to than other movements. Have you ever tried to jump right back into it, hoping the shoulder would just hold up? Maybe this caused the pain to come back, or it didn’t feel as strong and stable as it should? Returning to this can instill fear in athletes; but we wish to rewrite this narrative. Here’s the deal: the shoulder may not react appropriately to returning to kip swings and kipping pull-ups because the tissue loading threshold has significantly decreased since injury. But like all injuries, this CAN and WILL improve; that’s why a progressive, intentional plan is necessary for your return.
We need a plan that begins with appropriate loading of the shoulder, strengthening through full ranges applicable to the kip swing and pull up, retrain velocity changes (most specifically, the amortization phase between the concentric and eccentric motions of the kip swing), in order to re-train the tissues for stress under volume and speed. With that said, many don’t know where to start! Let’s get away from ring rows and banded pull-ups, and start making some real progress!
Physical Therapy is pivotal to address shoulder pain related to kipping movements. Physical Therapy can help drive a progressive care plan that is very specific to kipping and pull-ups. Our goal is to not only to help you return to your baseline level of skill participation… but return STRONGER than that! This will both prevent injury going forward, while strengthening the foundation to PROGRESS toward higher level skill development! We don’t want your shoulder to simply “feel better”, we want you doing the things you love!
This is a guide to outline what to focus on, where to start, and how to progress, for safe return to kipping.
First and foremost… There are THREE major boxes to check before ensuring you are ready to progress back to kipping movements on the pull-up bar:
Full Shoulder Flexion Overhead: To test shoulder flexion, lay on a medicine ball, with the ball under your upper back. Hold a PVC pipe in your hands, and take it over your head as far as possible. If this is full, and not painful, on both sides, then you’ve checked the first box.
The ability to pull your arm down from overhead against resistance: To test resisted pull down, this can be done in more than one way. A cable lat pull down, banded pull down with long arms, etc. If you’re able to work against this resistance without pain, you’re ready to move forward!
Adequate Hollow and Arch control: this can be assessed on the floor. For a hollow body, you should be able to have your thighs together, knees and ankles straight, shoulders off the floor with arms overhead. For the arch, lay on your stomach, and lift thighs off the floor with your knees and ankles straight. Raise the chest off the floor with arms overhead. Think about “elongating” your body through the arms and the feet. These should be able to be held for at least 10 seconds.
If these criteria are not met, continue working with your provider to restore these areas before advancing!
From here, there are 3 Phases to work through. In Part 1, we will touch on the first 2 Phases, which will involve progressive loading in accordance with the demands of the movement pattern. You may start at any phase depending on symptom severity. Provided are a few exercises in each phase to help get you started!
Phase 1: Loading
Due to the dependent nature of the kip swing, we want to make sure your shoulder can tolerate loading in this full overhead position. This includes the anterior shoulder structures, such as the biceps tendon, pec tendon, and subscapularis rotator cuff insertions. These can be addressed isometrically, in positions that replicate the movement (full overhead, at the top of the pull, etc).
Additionally, initiating Lat recruitment is necessary to begin the transition from the arch into the hollow. We begin training this through isometric muscle recruitment initially before progressing.
Finally, addressing core control in relation to the kipping positions, hollow and arch, is vital to advancing movement control.
Here are some exercises that challenge these areas, but the intensity is graded to what you can tolerate.
Med Ball Wall Presses Overhead: with your arm overhead, hold a wall ball on the wall between your hand and the wall. Push into the ball with your hand. This will load the shoulder similarly to where we kip on a pull up bar. Hold for 5-10 seconds depending on what you can tolerate.
Hollow Hold with Med Ball: perform a hollow hold with a light med ball overhead. Can be done with a light dumbbell if a med ball is not available. Hold the hollow for 3-5 seconds and repeat. Should be done for multiple reps. This is to replicate the shoulder activation necessary through the biceps and lats when moving into the hollow part of the kip swing.
Med Ball ABC’s: with your arm and elbow at a 90deg angle out to the side, place your hand on a med ball against the wall. Make sure the hand is in FRONT of the ball, not under it. Push into the ball and spell out the ABC’s in small letters. When done correctly, this loads the front of the shoulder, including bicep and pec tendons.
Pull-up Bar Push Down: stand under a pull up bar; you may need to stand on a box or a plate so that your feet can touch the ground. Don’t stand directly under the bar, but slightly behind it. Hold the bar, with arms straight, and pull down on the bar. This will begin to activate the lats in the dependent position. Hold 5-10 seconds at a time.
W Ring Hold: find a pair of rings that are at about waist height. Crouch down on the ground while holding them, where your feet are on the floor. Pull on the rings until you make a “W” shape with your arms and head. Your feet are there to support you and offload bodyweight as much as needed. Hold this for 5-10 sec at a time.
These are definitely not the only ones you should/can do, but some ideas for a starting point!
Phase 2: Greater Ranges and Speed
Here, we are advancing the loading phase, but through greater ranges of motion, and varying the speed. Moving away from isometrics, and into eccentrics, and strengthening through the pulling motion. Isometrics can still be performed in this stage on off-days. These will simulate the same demands of kipping and pull-ups on the shoulder through these ranges.
Furthermore, we want to strengthen the Lats and through FULL RANGES of shoulder flexion. This is necessary, because when you transition from full arch back into the hollow, this is predominantly driven by the lats! Strong lats are a huge foundation of all kipping and higher level skill progression. So, we want to strengthen these muscles through the full range from full overhead.
Finally, it’s important to prep for HIGHER VELOCITY. Outside of the full range strengthening, it’s important to prep tendon loading for transitions through the eccentric and concentric phases. This is where we address the force output of the muscle activation to address tendon tissues for stress under higher speeds. The mechanical component of the bicep tendon/anterior shoulder (which was strengthening in the Loading phase described above), is now connected to the neural component, including muscle spindles that sense tissue stress. When training this under control, we can grade the force output that these tissues can tolerate.
Med Ball Circles: holding a med ball at chest level, raise it up above the head, then out in front of you with arms long, then down by the hips. Pull back to the chest and repeat these circles.
Open Chain Kipping Pull Up with Band: band around a rig, stand inside the band. hold the band over your head, while leaning backwards, as if in the arch portion of the kip swing. Then, generate your hollow transition, while pulling the band around and to your chest. Return by pushing the band away and back up over your head, while transitioning back to the arch position.
Reverse Pull Up: perform a jumping pull up, and slowly lower yourself back down into a dead hang. The speed of the eccentric is dependent on your tolerance and ability to control. This can be done to-assisted initially, if needed!
Long Arm Lat Pull Down: find a band or a cable machine. Bend over, in a hinge position, where your back is at a 45deg angle from the floor. Hold the band or cable overhead, in full shoulder flexion. Pull down to your side, and slowly return back to the top, all the way into full shoulder flexion.
Med Ball Chest Passes: as described, perform a chest pass with the med ball to the wall, or a buddy. The goal is speed through the press. This is to allow the front of the shoulder muscles to train the tendon loading through higher velocity movement, similar to the transition from arch and hollow, and connecting the pull-ups.
There are many more exercises here; Reach out with questions on this phase!
In Part 2, we will discuss PHASE 3: MOVEMENT PATTERN RESTORATION. Here, we will discuss how Physical Therapy can help with progressive drills with graded assistance, specific to the kipping movement on the pull-up bar. We will also touch on safe parameters to progress with these drills in accordance with your workouts. Our goal is to help you find the safest, pain-free modification while also progressing back toward baseline volume with skill training. Even more importantly… our goal is to help you return STRONGER than you were at baseline!
Questions? Happy to help! Reach out to me at jparrish@loonstatephysicaltherapy.com, or 612-200-2962!
We would be happy to discuss further how Loon State Physical Therapy can be a teammate in getting you back to moving and feeling your best! Our convenient Minneapolis physical therapy, Edina physical therapy, and Stillwater physical therapy locations will happily welcome you to get you back to moving at your best. Call us at (612) 200-2962 or book with us online at www.loonstatephysicaltherapy.com for an in-person or virtual appointment.
We look forward to being your teammate through this journey!
