Do you suffer with shoulder pain?
A lot of guys I talk to, both clients and guys on the gym floor, complain to me about shoulder pain or injury.
Shoulder pain is not uncommon, particularly for people who spend hours at a desk or driving. In these cases, strengthening and stretching exercises can usually help to alleviate the problem. The people I am referring to in this article are those that have either had, or currently have, an impingement or problem with their rotator cuff, which not only causes pain but prevents them from performing any kind of pressing movement.
I understand how frustrating this is, particularly when shoulder injury comes partway through a training programme. But my experience has led me to identify a few commonalities which, in my opinion, are a big part of the problem. Most of these guys train regularly and carry a decent amount of muscle tissue. They want a big chest, capped delts and a decent pair of guns, therefore it stands to reason that these are the specific areas that get trained more frequently and with greater intensity.
And herein lies the problem.
In short, a greater emphasis on the anterior (front) delt and chest often causes people to become tight around the pecs, which leads to some degree of internal rotation (or medial rotation, to give it its correct term).
If you’re not sure what this means, a simple test would be to stand upright with your arms by your side. In a neutral and relaxed posture your palms should face inwards. If they face towards the rear, this is an indication being internal rotated.
Image courtesy of backintelligence.com
How Your Shoulder Works
If you suffer from pain in and around the shoulder, such as:
• Pain that is present with activity and at rest
• Pain radiating from the shoulder to the side of the arm
• Sudden pain with lifting and reaching movements
• Pain at night
• Loss of strength and motion
• Difficulty doing activities that place the arm behind the back…
it can help to first understand how your shoulder works.
Your shoulder is made up of three bones: your upper arm bone (humerus), your shoulder blade (scapula), and your collarbone (clavicle).
Your arm is kept in your shoulder socket by your rotator cuff, a group of 4 muscles (supraspinatus, infraspinatus, teres minor and subscapularis). These muscles and tendons form a covering around the head of your upper arm bone and attach it to your shoulder blade.
There are other muscles that help rotate the shoulder in (internal rotation) and out (external rotation) as well as muscles that help lift the arm. The rotator cuff muscles act in conjunction with the chest muscles (pectoralis) and shoulder muscles (deltoid, trapezius, serratus) which is why it has a larger range of motion compared to other joints.
As you can see, the shoulder is a very complex joint and its position and action are influenced by several muscles working together. But there are four other muscles that can cause dysfunction:
Latissimus dorsi (lat, for short) – Along with contributing to excessive internal rotation of the arm or scapular abduction, the latissimus dorsi also contributes to extension problems when tight or when the abdominals are weak.
Pectoralis major (pec) – This muscle can contribute to excessive internal rotation of the arm or scapular abduction.
Teres major – When tight, this muscle contributes to scapular abduction and excessive internal rotation of the arm.
Subscapularis – When tight, this muscle contributes to scapular abduction and excessive internal rotation of the arm.
With such a complex network of muscles working together, shoulder injuries can be complicated. However, most people have issues with the subscapularis.
When you lift your arm, the rotator cuff tendons pass through a narrow space at the top of your shoulder, known as the subacromial space. Shoulder impingement occurs when these tendons rub or catch on the bone at the top of this space. The more internally rotated you are, the smaller the space becomes, which leads to more friction and greater pain and discomfort.
So why does this happen to guys that lift?
Most guys learn to lift either from what they’ve seen in the gym, how their buddy tells them to, or from watching YouTube.
This isn’t always a bad thing, but an important factor that is often neglected is scapula stability – the ability to control and lock down the scapula.
If you want to know how to test your stability, watch this short video here demonstrated by Joe.
The first step to preventing shoulder injury? Pay attention to your scapula. Before any pressing movement, it’s important that the scapula is retracted and depressed. Imagine there’s a pencil behind your shoulder blades and you are trying to hold it into place. This opens up the chest, reducing stress on the shoulder and elbow joints allowing you to press more freely.
By paying proper attention to your scapula while lifting, you can help to prevent shoulder injury without impacting on your progress.
I hope that has clarified things for you, but if you’ve any further questions on this, please feel free to leave a comment.
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