My Guide To Maintaining Your Shoulders

It’s pretty much inevitable that at some point we’ll suffer from shoulder injuries of some kind so I thought I should write this as a bit of background information on your shoulder and how to keep it healthy. It's my first attempt at writing anything like this so although suggestions and critisism is welcome, please be forgiving ;)

The shoulder joint is formed by the ball of the humerus and the socket of the Scapula (shoulder blade). A group of four tendons stabilize the shoulder joint and form the rotator cuff, they also facilitate the movement of the joint. If you really want to know their names then they are listed below:

The subscapularis muscle, which moves the arm by turning it inward (internal rotation);
The supraspinatus muscle, which is responsible for elevating the arm and moving it away from the body;
The infraspinatus muscle, which assists the lifting of the arm during turning the arm outward (external rotation);
The teres minor muscle, which (like the infraspinatus) helps in the outward turning (external rotation) of the arm

RotatorCufftendons.jpg


On top of the shoulder joint is a bone called the acromion. In the gap between the shoulder joint and the acromion is a space that some of the rotator cuff tendons run through. In this space is a fluid-filled pad called the subacromial bursa, which cushions the tendons
Rotator cuff injuries are usually either an inflammation of the muscles tendons that form the rotator cuff or a tearing of the muscle or tendons.

When the tendons become inflamed they can pinch against the structures that make up the shoulder joint. When a tendon becomes trapped or squeezed, it's known as impingement syndrome. The subacromial bursa can also become swollen and inflamed, and this is called bursitis.

Tendons that make up your rotator cuff can also become completely or partially torn. These can be caused by a sudden impact, such as a fall, or due to tiny tears to the tendon through use and wear over time

Common Causes

-Repetitive overhead lifting
-Lifting or pulling a weight that’s too heavy for you, causing a tear or strain
-Muscle imbalance. When some of the muscles in your rotator cuff are stronger than others, your shoulder may be more prone to injury.
-Age – As you age you are at increased risk of rotator cuff injuries as your tendons start to wear down and become more prone to injury

The risk of sustaining a rotator cuff injury increases if your posture is poor. Rounded shoulders are an indication of weak scapula muscles and may lead to pinching of the rotator cuff
Symptoms of a rotator cuff injury may include pain and tenderness in the shoulder (particularly when raising the arm to the side or moving across the body), a limited range of motion in the shoulder, a feeling of weakness around the area or pain while sleeping.
Tendonitis usually comes on gradually over time and may increase in severity if left untreated but a tear will commonly appear as a sudden twinge of pain. If a tear is present then it may need to be diagnosed by an MRI or ultrasound scan as it will not appear on an Xray.

How to treat rotator cuff injuries

Rest the shoulder and avoid movements which might cause it pain, if you can, try and sleep with your arms by your sides

Applying ice to the area will help reduce swelling and avoid further irritation to the tendons, but always remember not to apply an ice pack directly to the skin, wrap it in cloth first.

Anti-inflammatory medications like Ibroprofen can also help to reduce the pain and swelling allowing the area to heal faster

Strengthening exercises can then be used to build up stability in the area and address any muscle imbalances. If the muscles are not strong enough, or one part of the cuff is working harder than the rest, then the shoulder will be pulled out of alignment and pain will result

Strengthening exercises for rotator cuff rehab

Isometric push

The iso push up hold allows you to build up strength around the joint while avoiding excessive movement that may cause pain. As pain in the area decreases you can return to lifts with an increase range of motion like the bench press. The iso push up is a closed chain movement which makes the shoulder more stable and less likely to inflame the injured area.

The iso hold can also help to reinforce correct benching technique with arms tucked in so once you return to open chain movements you will be less likely to get injured again. This was given to me by Tony McClellan to help sort out my tendonitis a few years back and it’s probably the movement that’s had the most dramatic effect on my performance ever. When I returned to open chain movements I was pressing more than ever.

http://www.tmuscle.com/free_online_...sionid=DA56E87D54A5F985A133B47FD12FC3D0.hydra

Turkish Get-ups
This is an exercise that will get you funny looks, but works very well, it was originally suggested to me by Goergen on the fitness forum and it’ll amaze you with how difficult it can be at first (especially if you are riddled with imbalances like I was).
You just hold a weight vertically and stand up from a supine position. This forces your shoulder to stabilize the weight through a very broad range of motion.

http://www.exrx.net/WeightExercises/Other/DBTurkishGetUp.html

Face Pulls

Face pulls simultaneously train scapular depression and retraction which strengthens the muscles that pull the shoulder blades down and back.

http://robertsontrainingsystems.com/blog/Exercise+of+the+Week:++Face+Pulls/

So there you go, my first attempt at writing something long and meaningful about anything, ever, apart from about myself of course. There are a ton of other exercises I could list but those three are the ones that I do consistently regardless of training programme or goals and since I have incorporated them into my training I have been completely pain free in my shoulders despite the heavy abuse I put them through with my shocking form and OH lifting fetish.
 
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Isn't the bench press more dangerous in terms of causing of shoulder problems than overhead presses? Or does it just seem that way because so many more people do bench press than overhead press and/or do bench press with poor form?

I hurt my shoulders doing bench presses and wish I had learned how to do them correctly before I hurt my shoulders!
 
Isn't the bench press more dangerous in terms of causing of shoulder problems than overhead presses? Or does it just seem that way because so many more people do bench press than overhead press and/or do bench press with poor form?

I hurt my shoulders doing bench presses and wish I had learned how to do them correctly before I hurt my shoulders!

I agree here. The majority of the rotator cuff is usually far more active as a stabilizer during bench press than it is on a military press, which involves the supraspinatus as a synergist to the abduction movement. Because of the limitations of ROM during a military press when compared to a bench press, the rotator cuff is usually more active during a brench press than a mil press
 
I think the overhead lifting is referring to impingements, which are more likely to be aggravated with overhead lifting than horizontal pushing.

Do you have any data on RC being more active in a bench press than in a military press?
Also, what do you mean by reduction in ROM.. reduction where? I'd say the shoulders typically go through a higher ROM in military pressing than bench pressing. When bench pressing you go from being extended to the arms being flexed in a position where they align with the transverse plane. While in the military press you go from an extended position to a completely flexed position where the arms are in alignment with the frontal plane. granted the starting position involves less extension than the bench press, but I don't think it makes up for the extra ROM into flexion.
But I'm not quite sure what you mean by ROM being limited.
 
I think what *4 is trying to say is that during a bench press, depending on your grip, body mechanics, etc. your elbow can go below your torso, which, as I understand it, is a very unstable position for the shoulder, and the cause of a lot of shoulder injuries (including mine). During an overhead press the elbow never goes behind the torso, but obviously goes a lot father in the other direction where impingement is the danger, more so for some individuals than others depending on their body mechanics. If you watch people bench press you notice individuals with deep rib cages and/or short arms never reach the position where the elbow is below the torso. I assume something similar happens with overhead presses where one individual might reach impingement at the full extension of an overhead press while another may not depending on their individual body mechanics, so for one individual the overhead press could be very dangerous and for another completely safe?
 
Oh yeah, like that, now I get it. In a position like that the humeral head will be pushed forward in the joint capsule. I don't know the RC muscles are at such a high risk here, I think it's more that the humeral head can irritate the joint capsule and cause an inflammation. But I'm not sure, continuing to extend the arm when the shoulder blade stops would lead to changes in the muscles since the muscles originate from the shoulder blade. Maybe the rotation could cause one of the tendons that otherwise wouldn't, to move under the acromion. I think that's possible.
 
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Thanks for the great article, Ty! Very timely as well, as I am currently navigating my way through some, ahem, shoulder issues. :-\
 
melantotan 1

Wow, it seems that you had a great post. I've never read this kind of post before. Thanks for the information!! I like your post, really!!!
 
Karky is right, overhead pressing is much more problematic because of possible impingement.

Good article OP. The video to the face pull doesn't work, which is too bad, because I think this is probably one of the best Rehab/prehab exercises for shoulder health.
 
Good article. I get shoulder pain when I run - anywhere between the 2-4km mark and then it goes away after that. It affects either the left or right shoulder
 
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