Wednesday, September 16, 2015

How to Protect you Shoulders when Lifting


The shoulder is the most mobile and flexible joint in the human body. It is also the area most prone to injury.

Compared to the stability of the hip joint, (another ball and socket joint) where the head of the femur (thigh bone) sits deep in the socket of the pelvis, the shoulder joint is much less contained, with the head of the upper arm bone sitting in a very shallow indentation in the scapula (shoulder blade). Think of a golf ball sitting on a tee. The muscles around the hip joint are some of the largest and strongest in the body. Whereas the muscles of the shoulder joint are generally thin and much weaker.

Even minor shoulder injuries can be painful and take an inordinate amount of time to heal. A major shoulder injury (such as a rotator cuff tear) can take up to a year or more to heal.

Causes and Prevention

The flat bench press seems to be most people’s favorite exercise and a universal measure of strength.
As soon as anyone knows you lift the most common question is “How much do you bench?” Bench presses are, or course, a pushing exercise.

Most people do way more pushing than pulling, focusing on chest exercises (they show in the mirror!) much more than back movements. This causes an imbalance between the chest and back, pulling your shoulders forward and out of position. Something as simple as reaching overhead can cause pain in the shoulder.

You should be doing approximately twice as many pulling exercises as pushing. Use seated rows, dumbbell rows, T-bar rows, pull-downs, pull-ups and, of course, dead lifts. On all pulling exercises concentrate on pulling your scapula (shoulder blades) back and down for maximum benefit. Work on strengthening both the upper and middle traps (Trapezius), Rhomboids and Lats (Latissimus Dorsi).

 Do fewer flat bench presses, which pin your scapula (shoulder blades) in a fixed and unnatural position and limit the ability of the shoulder to move properly. Instead use more incline presses and dumbbell presses and dumbbell or cable flyes and weighted pushups. 

If the shoulder press or military press causes pain, declining the back of the bench from fully upright (90 degrees) to a smaller angle (say 70 to 80 degrees) can often eliminate the discomfort.

Any exercise that moves the shoulder joint in an unnatural or awkward way should be avoided at any sign of pain. Upright rows and machine shoulder push downs come to mind.

Exercises to strengthen the shoulders must be performed with relatively light loads due to the smaller muscle fibers that make up the shoulder complex. As a result of the necessary lighter loads many lifters will extend the number of reps which can eventually lead to damage from friction and over use of the small muscles. To prevent overuse you are better advised to work the shoulder complex (primarily anterior, medial, and posterior deltoids) for shorter sets but on multiple training days. Use slow steady reps and don’t try to extend the range of motion higher than the tip of the collar bone. (The comfortable range of motion will vary by individual) And avoid “cheating”. The shoulders do not respond well to the unnatural stress of trying to force the larger range of motion. Stop the range of motion at any sign of pain.

If you experience shoulder pain that last more than a few days after a few days rest and much lower loads consult a medical or rehab professional. There are causes of shoulder pain not discussed here that need to be eliminated before beginning any type of self rehabilitation.  (Bone spurs, severe impingement, nerve damage, etc)

A serious tear of the rotator cuff can land you in the operating room. At best, a rotator cuff injury can require months to rehabilitate. I’ve had two. One required fourteen months of rehab. The other eight months. Almost any type of rotator cuff tear should be handled by rehabilitation professionals.

More minor shoulder injuries (over use or impingement) can still limit your use for several months. Rest the affected area for several days or until the pain subsides. Then very slowly with very light loads and a less than maximum range of motion test the affected area. Rushing this process will usually only cause set- backs. So take your time.

If you, or your medical professional, are satisfied that the condition is relatively minor and won’t cause further damage, move slowly back into limited pushing movements. One effective way is to use unilateral sets using a lower load on the affected side either using machines, cables or dumbbells until the affected side gets back up to normal strength. This will also minimize atrophy (muscle loss).

The takeaway:
·         Don’t neglect training you shoulders from the very beginning. They are the weakest link so don’t let your shoulders lag behind.
·         Plan your programming to avoid all imbalances but pay particular attention to push vs. pull balances. Always try do as many pulling as pushing (or more-some coaches say 3 times as much pulling as pushing)
·         Avoid exercises that put the shoulder in an unnatural position or extended range of motion or limit the free motion of supporting muscles.
·         Don’t try to work through shoulder pain. In most cases you’ll simply make the problem worse
·         Take any shoulder rehab efforts very seriously and very slow.

Shoulder Conditions

  • Frozen shoulder: Inflammation develops in the shoulder that causes pain and stiffness. As a frozen shoulder progresses, movement in the shoulder can be severely limited.
  • Osteoarthritis: The common "wear-and-tear" arthritis that occurs with aging. The shoulder is less often affected by osteoarthritis than the knee.
  • Rheumatoid arthritis: A form of arthritis in which the immune system attacks the joints, causing inflammation and pain. Rheumatoid arthritis can affect any joint, including the shoulder.
  • Gout: A form of arthritis in which crystals form in the joints, causing inflammation and pain. The shoulder is an uncommon location for gout.
  • Rotator cuff tear: A tear in one of the muscles or tendons surrounding the top of the humerus. A rotator cuff tear may be a sudden injury, or result from steady overuse.
  • Shoulder impingement: The acromion (edge of the scapula) presses on the rotator cuff as the arm is lifted. If inflammation or an injury in the rotator cuff is present, this impingement causes pain.
  • Shoulder dislocation: The humerus or one of the other bones in the shoulder slips out of position. Raising the arm causes pain and a "popping" sensation if the shoulder is dislocated.
  • Shoulder tendonitis: Inflammation of one of the tendons in the shoulder's rotator cuff. 
  • Shoulder bursitis: Inflammation of the bursa, the small sac of fluid that rests over the rotator cuff tendons. Pain with overhead activities or pressure on the upper, outer arm are symptoms.
  • Labral tear: An accident or overuse can cause a tear in the labrum, the cuff of cartilage that overlies the head of the humerus. Most labral tears heal without requiring surgery.

Send your questions or comments to If I don’t have an answer I’ll find someone who does.

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