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I’ve Got 99 Problems but My Shoulder Ain’t One

elitefts™ Sunday Edit ion

Everyone wants big cannonball shoulders, but not all of us are blessed with the perf ect genetics toachieve this f eat. So, you pick up a muscle and f itness magazine and you see a shoulder routine that a pro“uses.” Four sets of barbell presses, f our sets of Arnold presses, Lateral raises, Front raises, etc. It ’s basicallyjust tons of pressing and tons of volume, but the question is: Is this the safest way? Let’s look at the shouldercomplex f irst, and then we will discuss some exercises and precautions.

The shoulder is made up of f our joints: the scpaulothoracic, the sternoclavicular, the acromioclavicular, and theglenohumeral. Aside f rom the joints, we also have host muscles involved. Whether they directly move thehumerus or whether they attach at the scapula or clavicle, they all have their place and purpose to aid in properf unctioning of the shoulder. The shoulder is complex and inherently mobile—in f act, it is the most mobile jointin the body; however, it is not necessarily stable. Even something like the clavicle is of ten overlooked, but itdoes have its place in stabilizing the shoulder against medial displacement and preventing inf erior movement ofthe shoulder. I’m sure most people are f amiliar with the muscles involved, so I’ll discuss the joints a bit as theyare less talked about but yet very of ten injured. The AC joint, or acromioclavicular joint, is important in that itblocks excessive superior movement of the humeral head. This joint helps you raise your arm overhead andincreases range of motion. The scapulothroacic joint, on the other hand, helps move the scapula to maximizethe range of motion of the glenohumeral joint. Finally, the glenohumeral joint allows f or the largest range ofmotion of any joint. This joint receives its stability f rom the surrounding musculature, subscapularis, pec major,teres minor, inf raspinatus, supraspinatus, long head of the biceps, and even the long head of the triceps.These muscles work in coordination to compress the humeral head into the glenoid f ossa.

Let’s take a lateral raise (to 90 degrees), f or example, and describe what happens:

When you begin to abduct (or laterally raise the arm), the force of the deltoid is exertedvertically. This pulls the humeral head superior (or up).

The supraspinatus will aid in abduction, but it will also resist the superior movement of thehumeral head by the deltoid.

Three other players in the rotator cuff—teres minor, subscapularis, and infrapsinatus—applya downward force as well.

So, as you can see, there is a lot going on during dynamic movements. It ’s very easy f or imbalances orimproper tracking to lead to some shoulder dysf unction. Depending on what acromion type you have (Type 1,2, 3), you may have to alter your shoulder movements to make sure your shoulders stay healthy.

The smaller the gap through which the rotator cuf f must slide, the easier it will be f or you to get impinged. AType 3 (or hooked) acromion makes it a very t ight squeeze, so overhead pressing will usually lead to problemsf or someone with this structure. Consequently, this causes the glenohumeral joint to be f airly susceptible toimpingement. Most lif ters have probably experienced this bef ore—when you f eel a pinch in your shoulder oreven down through to your elbow. This is usually the result when the supraspinatus and subacromial bursa (orbicep tendon) gets jammed up or pinched against the acromion. When the arm is abducted and internallyrotated, you are in a prime posit ion f or impingement. The greater tuberosity shif ts over and compressesagainst the acromion. Poor posture, poor technique, and improper movements can make one susceptible tothis injury.

Here are a f ew tips f or how to best avoid developing a shoulder issue:

1. Be smart, you moron

Do you know how many times I hear people say, “Man, overhead pressing really kills my shoulder… hold on, I’mgoing to go do some heavy barbell shoulder presses, bench presses, and dumbbell presses.” Here issomething that Coach X taught me a long time ago, and I think it ’s the best advice I have gotten while lif t ing: Ifsomething irritates an existing problem or causes an injury, THEN DON’T DO IT. There are a ton of exercises outthere—f ind ones that don’t bother you. You can’t improve in the gym if you are always injured. For example, Ican’t overhead press anymore due to the surgery I had on my shoulder. However, here is a pressing exercisethat I can do without causing me any irritation. So, naturally I use this instead. As a matter of f act, I wouldrecommend this even if you don’t have bad shoulders. Your shoulder is in a much f riendlier posit ion, and youget a great pump.

The grip placement is neutral, limiting the internal rotation associated with regular presses. (Exercises with apronated grip, like the bench or regular barbell shoulder press, promote more internal rotation whichsignif icantly shortens the acromion gap). Also, because the bar is going on an angle and not directly overhead,you allow the humeral head to clear the acromion smoothly and without issue. The closer in your elbows are,the more you will recruit the triceps, so you can f lare them out a bit if you desire.

2. Be cognizant of your posture

As the late Mel Sif f said, “Just because posture is poor does not mean it is pathological.” I agree with him, f orthe most part. However, poor upper body posture, in my opinion, does leave you more susceptible to injury. Forexample, the next t ime you’re at the gym, look at the posture of the typical bro in his wif e beater and f resh tanwho benches every single day. It ’s normal f or his shoulders to be rounded anteriorly (f orward) and thekyphosis of his thoracic spine to look like the Hunchback of Notre Dame. This means that he most likelysuf f ers f rom tight pectoralis muscles and weak rhomboids (amongst other things). There’s also a good chancethat his scapula is protracted, thus leading to some dysf unction of the scapulothoracic joint complex… again,amongst other things. So what does this mean? Well, he may be lucky and never get hurt, but he’s surelyputting himself in a disadvantageous environment. Poor thoracic mobility is another way to set yourself up f orshoulder problems. Yet, it also must be noted that most of our day is spent outside of the gym—sitt ing at thecomputer, sitt ing at work, sitt ing on your couch, sitt ing on the toilet, etc. I don’t personally believe that we weremeant to sit all day long, and I sure as hell don’t believe that we were meant to sit with our heads f orward,shoulders slumped, and backs hunched. Add simple postural exercises like chin tucks, brueggers, or somedirect work of postural muscles.

3. Prehab, rehab, and activation work

It ’s better to be proactive rather than reactive. I hate nothing more than starting my workouts with f oam rolling,prehab, and activation work, but unf ortunately I have to. It allows me to stay healthy and train as of ten as I like.Some examples of these types of exercises include f oam rolling, scapular f loor slides, thoracic mobility drills,shoulder mobility drills, etc. Take the extra t ime to warm up properly and you will thank yourself f or years tocome. Here’s an example of a two- in-one exercise that you can use: a plank with scapular retraction. I hatethese boring exercises, so if I can f ind ways to work two things at a t ime, I will.

This next video is a band pull apart shoulder warm up.

4. Have an intelligent program design

Most readers of this site are probably intelligent enough to know that you should have a well thought-out andbalanced routine. You can’t just train your f avorite muscle groups all the time. If you have a weakness, don’talways avoid it; work on it! If your rotator cuf f is weak, then try to make it stronger. Things like weak externalrotators can be a huge limiting f actor f or your bench. Don’t always train the individual rotator cuf f muscles inisolation, either. (Although there is a place f or this). One of the main actions of the rotator cuf f is to stabilizethe humeral head. The muscles work in conjunction, so you need to train them this way, too. Also, if all you dof or your traps are shrugs, then once again you are likely an idiot. If you only work scapular elevation, then youare neglecting scapula depression and abduction. The trapezius runs f rom the base of the skull down toalmost the mid thoracic or mid back area—not just those things that sit near your clavicle and shoulder. Ingeneral, most people neglect their mid to lower trapezius. However, an imbalance between the upper and lowerf ibers of your trapezius could actually lead to sub-acromial impingement. This imbalance can also lead to uppercrossed syndrome, as it consequently sets of f a chain of events inhibit ing and shortening muscles. A greatunconventional way to hit the lower/mid traps is to do some pull-ups on gymnastic rings.

Here’s an exercise to change up your shoulder routine and work those external rotators a bit:

5. Utilize some soft tissue work

Whether it ’s Graston, massage, or ART, try to f ind a way to work it in every once in a while. Any serious lif ter isgoing to be in a prime posit ion to develop myof ascial trigger points and simple aches and pains due to denseand f ibrous tissue. This sof t t issue work can help with pain and circulation (recovery), and it can also improverange of motion and prevent injury.

Shoulder issues are common, and as your years under the bar accumulate, they can get worse if you don’ttake simple precautions. Lif t ing heavy is f un, but being able to lif t your arm more than 30 degrees when you’reolder is also something to consider. Take the extra t ime to warm up and correct any imbalances that you mayhave. You will thank yourself in the f uture.

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