I’ve Got 99 Problems but My Shoulder Ain’t One
Everyone wants big cannonball shoulders, but not all of us are blessed with the perfect genetics to achieve this feat. So, you pick up a muscle and fitness magazine and you see a shoulder routine that a pro “uses.” Four sets of barbell presses, four sets of Arnold presses, Lateral raises, Front raises, etc. It’s basically just tons of pressing and tons of volume, but the question is: Is this the safest way? Let’s look at the shoulder complex first, and then we will discuss some exercises and precautions.
The shoulder is made up of four joints: the scpaulothoracic, the sternoclavicular, the acromioclavicular, and the glenohumeral. Aside from the joints, we also have host muscles involved. Whether they directly move the humerus or whether they attach at the scapula or clavicle, they all have their place and purpose to aid in proper functioning of the shoulder.
The shoulder is complex and inherently mobile—in fact, it is the most mobile joint in the body; however, it is not necessarily stable. Even something like the clavicle is often overlooked, but it does have its place in stabilizing the shoulder against medial displacement and preventing inferior movement of the shoulder. I’m sure most people are familiar with the muscles involved, so I’ll discuss the joints a bit as they are less talked about but yet very often injured.
The AC joint, or acromioclavicular joint, is important in that it blocks excessive superior movement of the humeral head. This joint helps you raise your arm overhead and increases range of motion. The scapulothroacic joint, on the other hand, helps move the scapula to maximize the range of motion of the glenohumeral joint. Finally, the glenohumeral joint allows for the largest range of motion of any joint. This joint receives its stability from the surrounding musculature, subscapularis, pec major, teres minor, infraspinatus, 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 fossa.
Let’s take a lateral raise (to 90 degrees), for example, and describe what happens:
- When you begin to abduct (or laterally raise the arm), the force of the deltoid is exerted vertically. This pulls the humeral head superior (or up).
- The supraspinatus will aid in abduction, but it will also resist the superior movement of the humeral head by the deltoid.
- Three other players in the rotator cuff—teres minor, subscapularis, and infrapsinatus—apply a downward force as well.
So, as you can see, there is a lot going on during dynamic movements. It’s very easy for imbalances or improper tracking to lead to some shoulder dysfunction. 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 cuff must slide, the easier it will be for you to get impinged. A Type 3 (or hooked) acromion makes it a very tight squeeze, so overhead pressing will usually lead to problems for someone with this structure. Consequently, this causes the glenohumeral joint to be fairly susceptible to impingement. Most lifters have probably experienced this before—when you feel a pinch in your shoulder or even down through to your elbow. This is usually the result when the supraspinatus and subacromial bursa (or bicep tendon) gets jammed up or pinched against the acromion. When the arm is abducted and internally rotated, you are in a prime position for impingement. The greater tuberosity shifts over and compresses against the acromion. Poor posture, poor technique, and improper movements can make one susceptible to this injury.
Here are a few tips for 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’m going to go do some heavy barbell shoulder presses, bench presses, and dumbbell presses.” Here is something that Coach X taught me a long time ago, and I think it’s the best advice I have gotten while lifting: If something irritates an existing problem or causes an injury, THEN DON’T DO IT. There are a ton of exercises out there—find ones that don’t bother you. You can’t improve in the gym if you are always injured. For example, I can’t overhead press anymore due to the surgery I had on my shoulder. However, here is a pressing exercise that I can do without causing me any irritation. So, naturally I use this instead. As a matter of fact, I would recommend this even if you don’t have bad shoulders. Your shoulder is in a much friendlier position, and you get a great pump.
The grip placement is neutral, limiting the internal rotation associated with regular presses. (Exercises with a pronated grip, like the bench or regular barbell shoulder press, promote more internal rotation which significantly 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 flare them out a bit if you desire.
2. Be cognizant of your posture
As the late Mel Siff said, “Just because posture is poor does not mean it is pathological.” I agree with him, for the most part. However, poor upper body posture, in my opinion, does leave you more susceptible to injury. For example, the next time you’re at the gym, look at the posture of the typical bro in his wife beater and fresh tan who benches every single day. It’s normal for his shoulders to be rounded anteriorly (forward) and the kyphosis of his thoracic spine to look like the Hunchback of Notre Dame. This means that he most likely suffers from tight pectoralis muscles and weak rhomboids (amongst other things). There’s also a good chance that his scapula is protracted, thus leading to some dysfunction 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 surely putting himself in a disadvantageous environment. Poor thoracic mobility is another way to set yourself up for shoulder problems. Yet, it also must be noted that most of our day is spent outside of the gym—sitting at the computer, sitting at work, sitting on your couch, sitting on the toilet, etc. I don’t personally believe that we were meant to sit all day long, and I sure as hell don’t believe that we were meant to sit with our heads forward, shoulders slumped, and backs hunched. Add simple postural exercises like chin tucks, brueggers, or some direct 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 foam rolling, prehab, and activation work, but unfortunately I have to. It allows me to stay healthy and train as often as I like. Some examples of these types of exercises include foam rolling, scapular floor slides, thoracic mobility drills, shoulder mobility drills, etc. Take the extra time to warm up properly and you will thank yourself for years to come. Here’s an example of a two-in-one exercise that you can use: a plank with scapular retraction. I hate these boring exercises, so if I can find ways to work two things at a time, 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 and balanced routine. You can’t just train your favorite muscle groups all the time. If you have a weakness, don’t always avoid it; work on it! If your rotator cuff is weak, then try to make it stronger. Things like weak external rotators can be a huge limiting factor for your bench. Don’t always train the individual rotator cuff muscles in isolation, either. (Although there is a place for this). One of the main actions of the rotator cuff is to stabilize the humeral head. The muscles work in conjunction, so you need to train them this way, too.
Also, if all you do for your traps are shrugs, then once again you are likely an idiot. If you only work scapular elevation, then you are neglecting scapula depression and abduction. The trapezius runs from the base of the skull down to almost the mid thoracic or mid back area—not just those things that sit near your clavicle and shoulder. In general, most people neglect their mid to lower trapezius. However, an imbalance between the upper and lower fibers of your trapezius could actually lead to sub-acromial impingement. This imbalance can also lead to upper crossed syndrome, as it consequently sets off a chain of events inhibiting and shortening muscles. A great unconventional 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 find a way to work it in every once in a while. Any serious lifter is going to be in a prime position to develop myofascial trigger points and simple aches and pains due to dense and fibrous tissue. This soft tissue work can help with pain and circulation (recovery), and it can also improve range of motion and prevent injury.
Shoulder issues are common, and as your years under the bar accumulate, they can get worse if you don’t take simple precautions. Lifting heavy is fun, but being able to lift your arm more than 30 degrees when you’re older is also something to consider. Take the extra time to warm up and correct any imbalances that you may have. You will thank yourself in the future.