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Shouldering Through The Pain
Death, taxes and shoulder pain; everyone has to deal with these issues at some point in their life. After low back pain, shoulder pain is the second most common complaint in the work force (1). And that’s in a sedentary environment. The risk increases when you place someone in a gym and add hundreds of pounds of force on the shoulder joints. That’s because the shoulder area is the most complex region of the body. It’s also due in part to poorly designed training programs, strength imbalances in and around the shoulder, and improper loading of the shoulder girdle. As a result the price that is paid usually ends up being an injury.
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. The key to ensuring that the risk of injury to the shoulder complex decreases is to have a firm grasp of what precautions should be taken to strengthen the shoulders, and to fit them into your current program.
Under the Surface: Shoulder Anatomy
A basic understanding of what the muscles in and around the shoulder do can be helpful in diagnosing and treating weaknesses and in preventing injury. The shoulder is comprised of several joints that combine muscles and tendons that allow for a wide range of motions to occur. If you’ve heard of the rotator cuff, then you might know what they do. They are four muscles that act to stabilize the glenohumeral joint (which is one of the four joints of the shoulder region that work together to create a controlled movement in the shoulder complex).
The four muscles of the rotator cuff (and their function) are as follows:
- Supraspinatus - inward rotation, arm extension, arm hyperextension, and arm adduction
- Infraspinatus - outward rotation, horizontal abduction, arm adduction, arm abduction
- Teres minor - outward rotation, arm extension, arm hyperextension, arm adduction, arm horizontal abduction
- Subscapularis - arm abduction
The other muscles of the shoulder are the posterior delt, the anterior delt, the side deltoid, the caracobrachialis, the pectoralis major, the latissimus dorsi, and the teres major. Other muscles of the shoulder girdle are the trapezius, the rhomboids, the levator scapulae, and the serratus anterior. Synergist arm muscles include the triceps brachii, and the biceps brachii.
Moving the Shoulder
Perhaps more important than understanding what the muscles of the shoulder do is to know what the movements of the shoulder joint and girdle are. Once this is achieved, an effective program can be designed that addresses specific areas of concern that pertain to the lifter’s situation.
Below are the basic movements that can be performed at the shoulder complex.
Arm abduction - raising the arm up and away from the body, as in a lateral raise.
Arm adduction - pulling the arm down to the body, as in the eccentric phase of a lateral raise.
Arm horizontal abduction - pulling the arms out away from the body, as in a bent-over lateral raise.
Arm horizontal adduction - pulling the arms in front of the body, as in dumbell flyes.
Arm flexion - raising the arms in front of the body, as in a front raise.
Arm extension - pulling the arms down to the sides of the body, as in a straight-arm pull down.
Arm hyperextension - pulling the arms back behind the body, as in the final portion of a swimming stroke before the overwater recovery.
Arm inward rotation - rotation of the arm in towards the body, as in an internal rotation exercise.
Arm outward rotation - rotation of the arm away from the body, as in external rotation exercise.
Scapula adduction - scapula pulling together towards the center of the body, as in a prone shrug.
Scapula abduction - scapula pulling apart, as in a lat spread.
Scapula outward rotation - scapula rotating out and upwards, as in an overhead shrug.
Scapula inward rotation - scapula rotating down and inward, as when doing a pulldown.
Scapula elevation - scapula rising upward, as in a traditional shrug.
Scapula depression - scapula lowering, as in a reverse shrug (hard to see in pic).
Mobility is defined as “the ability and willingness to move or change” which, in the case of the shoulder complex, can be dependant on motor skill. Things such as posture can impair motor skill, which in turn can reduce the movement throughout the shoulder complex. If mobility of the shoulder complex is compromised then mobility training should be incorporated. This allows the joints to be taken through a variety of movements in a controlled yet dynamic motion. Mobility training also increases blood flow to the joints and lubricates them. Below are some mobility exercises that can be performed.
Arm Circles - A simple and great calisthenics movement, this will warm up the shoulder girdle. Start slow with small circles - forward circles and backward circles. Gradually, over time, increase the size and speed of the circles. As with all of these movements, it should be a movement that you will progressively improve upon.
Shoulder Dislocates - This is a great movement for building flexibility and warming up the shoulder girdle. They can be done with a broomstick/dowel, a rope, an elastic band or tubing. It can be performed as a static stretch as well, by holding the movement at a particular point, but most people will do it as a dynamic stretch. Make sure to start with your arms wide and gradually decrease the distance between your hands as you become more flexible.
Broom Shoulder Twist - This movement can be done with or without a broomstick. When done without the broomstick, the swinging of the arm backward will elicit the stretch. With a broomstick however, it is easier to add pressure, as well as do the stretch statically.
The stretches below should be done post-workout when the joints are well- lubricated and blood flow is increased.
Rhomboid Stretch - This is a difficult movement to see but, if done correctly, will hit the middle of your back like nobody’s business. Leaning over, reach over and grasp the opposite leg at the shin and pull yourself toward the leg while rotating your torso away. Be careful not to be overzealous with this stretch as most people will be pretty inflexible in the movement at first.
Trapezius Stretch - This is a great stretch for the trapezius and the subclavical. Begin by placing your right hand behind your back. Then, with the left hand, gently pull the right hand to the left. At the same time, tilt the head slowly to the left. You will feel a stretch throughout the right side of your trapezius. By tilting the head backwards slightly, you will feel a stretch throughout your subclavicular region. Repeat on the opposite side of the body.
Lat & Middle Back Stretch - This can be done on a chair (as pictured), or on a barbell or mantle. It can be done at different heights as well.
Internal-External Rotation Stretch - This exercise can be done with added resistance as in the doorway stretch, but simply contracting the opposing muscle groups will probably provide enough of a stretch.
Lat and Triceps Stretch
Skin the Cat - As we all know, there is more than one way to skin a cat… Seriously, this movement can be done by sitting on the floor and inching the hands backwards, or on a mantle. Gymnasts can do this on the rings apparatus — not recommended unless you have already taken the time and effort necessary to build up the prerequisite strength and flexibility.
Elbows Forward Stretch
Strengthening The Shoulder
The shoulder and arm move efficiently when the coordinated movement of the scapula and humerus, (scapulohumeral rhythm) act together. Scapular and humeral coordination also involves the stabilising muscles of the scapula working in concert with the rotator-cuff stabilising muscles of the gleno-humeral joint. By using various strengthening movements the scapula can hold its position correctly. This is turn allows the rotator cuff to do its job more effectively. Below, are a variety of strengthening movements that will help strengthen and increase the function of the shoulder complex
This is an exercise that seems to have fallen out of favor in gyms in recent years. It is an exercise that can be deceptively easy to pile the weight onto, but if you maintain a full range of motion be careful about doing too much. Pullovers hit a wide range of muscles throughout the shoulder girdle.
Bent-Over Front Raise
The bent-over front raise is another exercise that you rarely see performed in gyms, but it is a wonderful exercise for muscles involved in outward rotation and arm flexion. The targeted range of motion differs from a traditional front raise and would be more comparable to a less ballistic snatch-type of movement.
Flyes are traditionally thought of as a pec builder, however they are a tremendous developer of functional flexibility.
Arm hyperextension is a range of motion that most trainees never develop. The teres minor and subscapularis (two of the four rotator cuff muscles) are involved in this movement, as well as the posterior delts, lats, and synergists that control the movement of the scapulae.
Bent-Over Laterals are one of the best exercises to target the muscles that assist horizontal arm adduction, arm outward rotation, and scapula inward rotation.
External Rotator Exercises
External rotator exercises can be done a variety of ways. Below, are two ways, though there are many more. Other more common methods of performing the exercise include lying on the floor or standing, using stretch cords/bands for resistance.
As with external rotator exercises, internal rotator exercises can be easily performed lying on the ground or standing, using straight weight or stretch cords/bands.
Shrugs of all kinds are indispensable in an exercise arsenal dedicated to strengthening the shoulder girdle. For everything you’ve ever wanted to know about shrugs, I strongly urge you to pick up a copy of Paul Kelso’s book on the subject, aptly titled “Kelso’s Shrug Book”.
Chest Supported Shrug (aka “Kelso Shrugs”)
A “bench press shrug” is a great substitute for this exercise and resistance is more easily added)
Wrapping It Up
Training the shoulders can be a science, however a little bit of knowledge can go a long way. This article has only skimmed the surface of a vast and complex topic. Using the information presented, try to apply some of it to your current workout, or revamp your routine so your shoulders are saved from any further beatings they may be taking at the gym.
Written by Boris Bachmann
Discuss, comment or ask a question
If you have a comment, question or would like to discuss anything raised in this article, please do so in the following discussion thread on the Wannabebig Forums - Shouldering Through the Pain discussion thread.