Shouldering Through The Pain by Boris Bachmann - June 27th 2006

[Daniel Clough]

Whether you’re a competitive athlete, an avid strength trainer, or someone involved in a power sport, you can be sure the shoulders will take a beating. Boris takes us through the precautions that should be taken to strengthen the shoulders, and how to fit them into your current program!

http://www.wannabebig.com/article.php?articleid=265

Enjoy!

Daniel

[Sensei]

If you couldn't tell from the pictures, that's me everybody.

Thanks to Daniel and Maki for putting it on the site and, in all modesty, I think they added some much needed introductory and wrap-up text as well.

Hope someone finds it useful!

Boris

edit: btw, here is a great tutorial site on the muscles of the shoulder girdle and their functions http://www.getbodysmart.com/ap/muscularsystem/shouldermuscles/menu/menu.html

[Daniel Clough]

Borris, thanks for the article...

Very informative and great pictures!

[djreef]

Good job Sensei,

This one gets printed for the archive.

DJ

[Buck1115]

Great article, gave me some useful insight.

[Sensei]

Here's a recent article by Mike Robertson about shoulders - a lot of stuff is not new, but it's a quick, easy read and informative: http://www.t-nation.com/readTopic.do?id=1426252&pageNo=0

[Built]

Mike Robertson's awesome - thanks for the link, Sensei.

[Built]

Sensei, I'm just re-reading this excellent summary on the care and feeding of your shoulder.

My rc problem stems from a broken greater tuberosity back when dinosaurs roamed the earth.

I manage the injury with ART and careful lifts, but scapular mobility is a huge concern for me, and something I always fight with.

How often should I be doing scapular rotation work - and on which day(s)? I do two upper and two lower lifting days in my split. Would it be best to do this work on the off-days?

[Sensei]

It's hard to give advice like "Do four sets of 10 reps w. shrugs, overhead shrugs, Kelso, shrugs, dip shrugs, bench press shrugs, and pulldown shrugs 3x/week and call me in a month" because what is reaggravating your shoulder might not be cured by simply doing a few exercises. You might be reaggravating your RC because of exercise selection, form and/or muscle recruitment/tension that has been hampered by trigger points, adhesions, limited range of motion, etc. Hell, you might have some hip issues to deal with that are affecting your RC.

I remember one year, the swimmers were plagued by shoulder issues. Part of it was poor planning on the part of the swim coach, but some of it was that the swimmers had unaddresed form issues in the water that were compounded with knee and hip issues - it's kind of a chicken or the egg thing, but all of them were related and needed to be addressed.

Before you start your "rehab", I would have some objective data that you can measure. Take some measurements of strength, range of motion, static stretch flexibility, distance (in med ball tosses, for example). I'll try to find or take some pictures of assessments you can use, but it might take a few days.

In Gray Cook's words: "You would be amazed at how much basic information is dispensed at the collegiate and professional levels simply because athletes have lost training focus and have gone off on unnecessary tangents caused by information overload or training overanalysis. Find the weak link and fix it. Maintain strength, work on weaknesses, and have a system to assess and reassess progress. " (Ahtletic Body in Balance, pp.210-211)

Anyway, here are some things to start with:
*Have some quantifiable measurements and gauges of progress that you will use every two or three weeks. Understand that some improvement will be from test familiarity.
*Select strengthening exercises, mobility drills, stretches, restorative measures that you think will address the underlying issues
*Do more unilateral movements
*Get off of the bench! Try to do variations where your back or chest isn't pinned to a bench and limiting your RC synergists' range of motion
*Understand that significant improvement is probably going to take, at least 6-8 weeks after you find what works and how to properly program it.

[Built]

Wow - ask and ye shall receive!

Thanks Sensei - I really appreciate this.

I'm very carefully easing back into incline bench - but I keep my elbows in the plane of my back, as per physio's orders - basically an incline floor press. So far, so good.

What chest work do you suggest doing that doesn't involve a bench? (cringes and waits to hear "Swiss Ball" ... )

[Sensei]

If you're serious about getting the issue taken care of, bench press is going to take a back seat for a few weeks at least. Try to maintain your chest strength w. medicine ball work, rings, bands/tubing, and push-up variations. I think dips are ok, but be careful. The point is to relearn how to use your body the way it was intended to - as a unit, rather than a collection of isolated body parts.

When you do go back to bench press, ideally you will bench more naturally and recruit more muscles into the movement, but more likely than not you're going to have to relearn the movement also. BUT, if you've shored up weaknesses, it should be a less painful process...

Hopefully this makes sense.

[Built]

I've already been through this part - I was off all pressing movements for about 6 months a few years ago - remember, this is an OLD injury, one I received about 6 years before I ever touched a weight. As I started lifting it wasn't a problem, but once I started working my bench up past 95 lbs, it flared up. In the last year I've been easing my way back into this lift, and only on an incline. Flat is a no-go for me. What I'm looking for is a way to continue to manage around what is a chronic condition that may ultimately require surgery - but I'd prefer to avoid it.

[Sensei]

I wouldn't lay off pressing movements completely - I think that's a mistake if you want to have any hope of maintaining strength. But, IMO, doing your pressing movements standing or prone (i.e. push-ups) will allow you to engage the synergist muscles more easily. Maybe it's just me, but I've always gotten back pump when I do push-ups - bench eventually got there too, but it took time and a lot of practice.

[Built]

I actually work back and chest in antagonist pairs (with rest in between, not as supersets) - perhaps this gets at the same net effect?

[Sensei]

No, I'm not talking about getting the work in for your back - I mean learning to use your back when you do pressing movements. I know that probably sounds counter-productive to a BBer ("Why would I want or need to use my back when I bench press?") who trains body parts, rather than movements, but, IMHO, people with injuries need exactly that.

[Built]

No - it doesn't sound counter-productive at all. For one, the antagonist acts as a brake for the agonist. The stronger the brake, the harder and faster the agonist can fire. That's actually one of the reasons I train this way.

[Sensei]

Pairing antagonistic exercises is great, no doubt - working the antagonist will help the agonist recover between sets too. But when the synergists are potentially a weakness, I'm not sure prefatiguing them is the best idea.

...actually, I'm not really clear on what you're getting at. If scapular function is a problem, you're probably going to need to do some isolation work, at least for a while and then progress to more complex movement patterns, greater range of motion, increased speed, etc.

I just think that foregoing the bench for a while would be in your best interest and allow more freedom of scapular movement while still, hopefully, maintaining strength.

[Built]

Well, I did give up bench a couple of years ago. Are you saying I should give it up again for a while so I can get the scapular mobility up before resuming this press?

[Sensei]

IMHO, yes.

[Built]

Okay. I'll take the rest of this to you directly as I figure out a plan.

Thank you so much Sensei. :)

[Bob]

NO please don't take it to Sensei directly!!!
This is a great conversation.. just look at how many views there have been...
Built-you are asking the hard questions.. (with facts too..)
And Sensei is answering them in a way that can be easily understood...
I know I appreciate it!! thanks..

[Built]

Oh - okay. I'll stay! I just thought I was clogging up the thread with my stupid shoulder tricks.

Alright. <pushes up sleeves>

I'm currently cutting, and had been doing incline bench as 5x5 with 95 lbs, and low incline dumbbell press with 30-35 a side for 3x8-12. For shoulders, I usually do hammerstrength millies with 45-55 a side for the 5x5 work, and arnies ss with lateral raises for the 3x8-12 stuff. The pain is at a very manageable level at the moment, but I know my scapular mobility needs work.

I've been doing scapular mobility stuff on non-chest/shoulder days - currently, prone with dumbbells on a low incline, I think they're called extermal rotations - with light dumbbells, arm at 90 degree abduction, dumbbell start pointing straight down, then up to the plane with my back/head, then back down.

I do a few sets of 15 of these with the pink dumbbells on my non-upper-body days.

They seem to feel good when I get them "right".

What else?

[Sensei]

I haven't had time to get pictures for you of some shoulder assessments you could do, but, IMHO, you really do need to do some first so that you will have some tangible things to compare before and after rather than "it feels better" or "it doesn't hurt as much". I'll try to get some pics, but here are a few off the top of my head (it's ok to practice them a little before taking a measurement). You don't have to do all of them, but you should do a couple:
*lay face down on floor, forehead on the floor, both arms stretched out straight in front of you. Lift left arm as high as possible without lifting chest off the ground - measure distance from floor to fingers. Repeat w. right arm.
*lay face down on floor, forehead on the floor, both arms stretched out to your sides at a 90 degree angle from body. Lift left arm as high as possible without lifting chest off the ground - measure distance from floor to fingers. Repeat w. right arm.
*(I'll need a pic of this one to make it clear) Stand with heels aligned on the cross bar of a "T". The vertical line of the "T" should extend behind you and up a wall. Twist your upper body to the left without bending the knees significantly or lifting your heels off the line as far as possible and touch the wall behind you. Measure the distance from the vertical line of the "T". Repeat, rotating to the right.

There are other more dynamic assessments you could do with a medicine ball or bands, but these could give you a baseline to start from.

Like I said, I would drop any chest or shoulder work that involves a bench or sitting for a while. Do some more unilateral work too.

I'm not really understanding what you're doing for scapular mobility work... When I think of traditional external rotation exercises, I think of this (or some variant):
http://i11.photobucket.com/albums/a178/johnnymnemonic/e516e067.jpg
What you described, sounds like chest-supported bent-over laterals to me. Is that what you're doing? Either way, if you need to work on your scapular mobility, I would start with shrugs and shrug variations. I think I mention in the article that you really don't need to be using much weight for these in the beginning because just abducting, adducting, rotating, elevating and depressing the scapula through a full range of motion is going to be hard enough for a lot of people without any resistance at all.

Kind of related, but not really - when I think of scapular mobility, I remember that scene in "The Chinese Connection" (I think) when Bruce Lee is getting warmed-up to fight a bad dude and he puts his hands in front of him and abducts his scaps and they, literally, pop out of his skin with loud bone cracking sounds... Pretty cool stuff. Edit - here it is:

http://i11.photobucket.com/albums/a178/johnnymnemonic/Picture1.jpg

[Sleepy Guy]

This is a good one for me, snatches seem to be my down fall and I have had to change my work outs to increase arm hyperextension power.

What is a Broom Shoulder Twist? I did not understand with the pic and notes how it is done.

[DARKKNIGHT]

I liked the article by Mike Robertson , I always liked pushups and always work them into my plan.

[Sensei]

Bill Hartman on shoulders (from t-mag article http://www.t-nation.com/readTopic.do?id=1591121 )

Got a problem with your right shoulder? Take a look at your left hip musculature. About 44% of people that have shoulder instability have a hip problem on the opposite side.

I know that this is not revolutionary, but about 5 years ago, as I was coaching swimmers, I realized that a huge key to reducing shoulder issues was not to do endless external/internal rotations, but to hit shrugs, overhead shrugs, Kelso shrugs, dip shrugs, pulldown shrugs etc. It had an almost immediate effect.

Over the past year, with the hip/hamstrings issues I've had, I realized that the hips too could affect your shoulders. Thoracic flexibility was another... I read something very interesting at dragondoor - it was something like the following:

Your musculature is like spokes on a wheel. If one is too tight or too loose it will affect the entire wheel.

Food for thought.

[Sensei]

Another shoulder article that came out a month or two ago - definately worth a read:

A New Component to Rotator Cuff Care by Mark Reifkind
http://www.dragondoor.com/articler/mode3/239/

[Sensei]

Found this at straighttothebar.com
http://www.shoulderdoc.co.uk/

[Sensei]

I made this video a while back with the intention of putting together something better later.... never got around to it, but here it is in all it's raw splendor:

2y949Vl0Y8o

[Built]

This has been such a great thread. Thank you so much, Boris, for taking the time to do all this. Rough or not, the vid was very helpful.

[Sensei]

I appreciate that Built, thanks!

[Sensei]

Kind of wondering if this article made the cut or not and if it's going to be put back up... Anyone?

[samadhi_smiles]

great thread man! thanks for the information! I'm going to defintely try to incorporate some of those mobility stretches.

[tomv]

I was looking for the article just the other day actually and noticed it was taking down. I thought it was one of the better articles available so I hope it gets thrown back up.

[samadhi_smiles]

Sensei, also do you have any comments for foam rolling and shoulders? Does the foam rollers use stop at thoracic and lat rolling or can you do anything more creative to massage the shoulders?

I agree also this article should be up! I remember reading it originally and it was very good.

[Daniel Clough]

it's coming soon guys. Taking a while to get them up but it's next on my hit list - will be up for the weekend.

[Daniel Clough]

the next one that is :)

[Sensei]

Sensei, also do you have any comments for foam rolling and shoulders? Does the foam rollers use stop at thoracic and lat rolling or can you do anything more creative to massage the shoulders?

I agree also this article should be up! I remember reading it originally and it was very good.
Self-massage is good too - you can always kneed your shoulders directly. Foam rolling can hit a lot of things shoulder related. If you have some knowledge of massage/trigger points/shi a tsu/etc. you can get a lot relief using one of these numbers:
http://thumbnail.image.rakuten.co.jp/@0_mall/kagu-club/cabinet/00203989/img15886431.jpg

I've bought several in Japan, but I've never seen these in the U.S. The closest thing is the "theracane" - it's good too, but almost too big and a little unwieldy for hitting some spots.

[Sensei]

Daniel, et. al,

I'm wondering if this article will ever be re-uploaded to the site. It's fine if it's not for whatever reason, but I'd just like to know definitively.

I have my own notes and rough draft, but obviously it's not as nicely formatted as it was here. I've had a number of people ask my thoughts on shoulder mobility and it's nice to be able to send them here when I can.

Let me know. Thanks,
Boris

[Daniel Clough]

Daniel, et. al,

I'm wondering if this article will ever be re-uploaded to the site. It's fine if it's not for whatever reason, but I'd just like to know definitively.

I have my own notes and rough draft, but obviously it's not as nicely formatted as it was here. I've had a number of people ask my thoughts on shoulder mobility and it's nice to be able to send them here when I can.

Let me know. Thanks,
Boris


Sorry Boris, my fault entirely. Putting the old articles back in is very time consuming, particularly the pics hence why I was kinda shying away from this one for a bit.

It;s all live now - http://www.wannabebig.com/training/injury-rehab-and-stretching/shouldering-through-the-pain/

The old url also redirects!

Sorry about the wait Boris!

[Sensei]

Thanks Daniel!