Imagine throwing a right straight, then dropping to the mat in anguish. No, you didn’t get hit, but you’re in pain just the same. It happens, and the culprit is usually the shoulder, a notoriously unstable joint. 

At UFC 103 in late 2009, lightweight fighter Steve Lopez threw a pawing left jab, only to find himself clutching his left shoulder and unable to continue. Lopez found out what so many martial artists have discovered; the shoulder has wonderful mobility, but a lot of instability.

Former UFC lightweight champion Sean Sherk had to pull out of his UFC 104 bout because of a shoulder separation, the likely result of a hard fall from a takedown. Finally, fans of The Ultimate Fighter (TUF) may remember Manny Gamburyan’s scrap with Nate Diaz, which also came to an abrupt end when Gamburyan’s shoulder dislocated during a takedown attempt.

In the Genes
When it comes to shoulder dislocations, Daniel E. Andrews III, M.D., a black belt in karate, and head of the Heart and Health Center, Napa, Calif., says that some people are just genetically predisposed to encounter this particular injury. And if you dislocate it once, the odds of it happening again are much higher.

For those born with a less stable shoulder, Andrews advises specific exercises to strengthen the muscles around the joint. Since kung-fu is filled with dynamic moves, Andrews adds that susceptible people should be aware of their limitations.

“The main protection is to work with your armpit closed,” says Andrews, owner and lead instructor at Pinewood Karate, Napa, Calif. “If you start using your arm away from your body, with your arm extended and your elbow away from the midline of the body—that opens the armpit and makes the shoulder joint more susceptible to injury.”

Pop Goes the Shoulder
As was the case with Lopez, a dislocation often alters the normal contour of the shoulder. Medically speaking, Andrews says the head of the humerus is in an abnormal position, so there is usually a hollow space where there should be fullness. Most dislocations move toward the front, not the back. 

If a medically trained person is present when a dislocation happens, the shoulder can be “popped” back in, but most times a visit to the emergency room is in order.

“The muscles can go into spasm, making it difficult to relocate, so if you wait longer it can be more difficult than if you do it right away,” explains Andrews. “It requires training and knowledge of anatomy, because you don’t want to risk another injury. Fracture dislocations, which are rare, can cut a nerve or artery, and are much more serious.”

Submission fighters routinely exploit the range of motion limitations of the shoulder with familiar jointlocks such as the Americana, which starts with the arm in the same position as a waiter carrying a tray. Conversely, the Kimura begins with the hand down and the elbow out, resembling a man reaching for a comb in his back pocket. The arm bar will tend to do more damage to the elbow, but in certain positions it can also damage the shoulder.

Fighters who get caught in these holds should swallow their egos and tap quickly. According to orthopedic surgeon Randall E. Yee, DO, those who hesitate to tap may end up with doctors’ orders to avoid contact sports for up to four months, with plenty of rest, rehab, and ultimately strengthening for prevention. 

Take it Easy
Veteran instructor Chet Barnett, who holds black belts in lung shou pai kung-fu (4th dan), tae kwon do (4th dan), and krav maga (instructor level), uses kettlebells to strengthen the shoulder muscles, but he cautions that students recovering from shoulder injuries should be sure to take it easy.

“Too often students will want to go too heavy, too hard, and too soon,” says Barnett, owner of Elite Martial Arts and Krav Maga, Fort Collins, Colo. “They should go light and slow at first, and eventually seek to balance strength gains in both shoulders.”

In Yee’s experience, wrestlers and grapplers are more likely to experience shoulder problems than stand-up fighters. However, if any martial artist feels soreness beyond the outside of the muscle, and range of motion is compromised, it is probably time to see a specialist.

Fighters who get injured at the XTreme Couture gym in Las Vegas routinely show up at Las Vegas-based Advanced Orthopedics and Sports Medicine where Yee practices. Yee will perform a physical exam, usually followed by X-Rays or sometimes MRI. Those who end up in Yee’s clinic for shoulder problems usually have some form of ligament laxity, where the shoulders are loose. “For other people with tighter shoulders,” says Yee, “injury is less likely.”

Finally, when it comes to the shoulder, youth is not always an advantage. Like the crafty sifu who outwits a younger opponent with guile, the older shoulder that has never dislocated is likely to stay intact. “The younger you are, the greater the chance of dislocating your shoulder,” confirms Yee. “If you are 16 years old and dislocate your shoulder, there is a 100-percent chance you are going to dislocate it again during your life. If you are 27, it is a probably an 85-percent chance.”

Bionote:
Greg Thompson is a Colorado-based freelance writer and level-4 krav maga student.