Shoulder pain sucks. If you’ve been lifting for any significant amount of time, then you’ve likely felt it. Maybe it was just a little pinch in the front of your shoulder. Or maybe it felt like someone was trying to remove your biceps tendon with a soldering iron every time you went to push or press.
The general “solutions” for this are to rest and avoid these movements for a while. Maybe you were told to do “cuff strengthening” with some fancy rubber bands or a series of questionable stretches that just seemed to piss off your shoulder more. Or maybe you’re one of those no-pain, no-gain individuals and you soldier on despite the crippling pain, completely ignoring the fact you’re doing irreparable damage to your shoulder.
All of these options are terrible. The shoulder is a complex joint, to be sure, but in my experience this fact has been used to justify overly complex courses of treatment that yield lackluster results. Simple interventions deliver better, more reliable outcomes. The following are the five simplest interventions that will give you the largest return on investment.
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1. Stop Half-Repping
An often-overlooked downside of partial reps is that when done to avoid a problematic portion of your range, they tend to reinforce the mechanics responsible for the pain. Partial-repping tells your body you don’t need those parts of the range and it’s perfectly acceptable to become tighter and weaker in those positions.
This is not to say that partial reps don’t have any place anywhere in any path of treatment. They’re actually a rather important part of reclaiming full range of motion post surgery, but that’s not what we’re talking about. If you’re sacrificing range for more reps or higher weight on non-surgical shoulders, you’re doing yourself zero favors. Stop. Now.
“Partial-repping tells your body you don’t need those parts of the range and it’s perfectly acceptable to become tighter and weaker in those positions.”
If your mechanics suck, you need to focus on mechanics, not intensity. Lower the weight to a workload that allows you to perform the movement with proper technique. Once you work your way back up, you’ll likely feel stronger and more stable in every portion of the range, including the part you were already good at.
2. Pull Before You Push
Regarding end range, particularly in the bottom portion of a push up, your shoulder is in an extended position that forces your humerus to angle forward. Passively, this isn’t an issue, but when force is applied many athletes will experience intense anterior shoulder pain.
Sometimes this is caused by actual soft tissue damage or inflammation. More often, I find it’s caused by weakness or poor activation in the muscles of the back that stabilize the shoulder. If your traps and rhomboids aren’t strong enough to hold your shoulders back, your upper arm will pitch forward and compress the tissues on the front of your shoulder. Boom, anterior shoulder pain. This can happen even if you don’t start from extension like you would in a bench press or push up. It can even happen when rowing if you’re upper-trap dominant.
An easy way to address this is to perform some type of resisted row during your warm up. I’m not talking about hopping on the erg or doing band pull-aparts either. Those things have their place, but the best way to activate the oft-neglected muscles of your mid back is to do some type of horizontal pull where your body is stable and the only movement is occurring from the shoulders down.
You want to try to isolate the muscles that help retract your shoulders so less accessory movement is always better. The resistance should be moderate. Enough to feel it in your mid back, but not enough to exhaust those muscles. We’re trying to activate them, not tire them to the point they can’t do their job.
“If your traps and rhomboids aren’t strong enough to hold your shoulders back, your upper arm will pitch forward and compress the tissues on the front of your shoulder.”
3. Row (a Lot)
If the muscles of your mid back are weak, all the activation work in the world won’t magically make them strong enough to stabilize your shoulders. Sometimes you just need to get stronger.
Seated cable rows are ideal for this purpose. Use a handle that allows you to have a neutral, shoulder-width grip. Close-grip handles (the triangle-shaped ones where your hands are inches from each other) actually cause your shoulders to internally rotate, which we don’t want.
Start with a weight that allows you to perform 4-5 sets of 12-15 repetitions with perfect form and shoulders pulled down and back for the duration. I realize that’s a fair amount of volume, but the idea is to establish some muscular endurance in the muscles that hold that position.
In terms of return on investment, you can’t beat the row for overall shoulder stability. If you’ve been plagued by shoulder pain, try doing a few sets of rows two or three times a week for the next month. You’ll be surprised at the results.
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4. Learn How to Pack Your Shoulder
This is one of the most common problems I see and should be the easiest to fix. When your shoulders start in a bad position and have a movement demand placed on them, it’s unlikely they will be able to transition into a good position while doing the work.
Packing your shoulders mostly just means exaggerating your neutral posture. Pull your shoulders down and back and lightly squeeze your scapulae together. Congratulations, you shoulders are now braced and the stabilizers are activated. Doing this before any type of shoulder work, either pulling or pressing, will significantly increase proper muscle activation and joint stability.
It bears mentioning that it’s actually physically impossible to get your arms completely overhead while squeezing your shoulders down and back. Your scapulae need to upwardly rotate to allow the humerus to move into an overhead position. Even so, if you start with your shoulders down and back, it’s more likely that the lower trap, upper trap, and serratus anterior will work together properly to upwardly rotate your scapulae than if you started with your shoulders rounded.
“When your shoulders start in a bad position and have a movement demand placed on them, it’s unlikely they will be able to transition into a good position while doing the work.”
You should also focus on your posture. All the rehab in the world won’t change much if you continue to spend most of your time in a crappy position.
5. Stretch Your Upper Trap
A common issue with anterior shoulder pain is upper trap overuse. An easy way to combat this is to stretch the upper trap before you try to strengthen the muscles of your mid back. Stretching the upper trap will inhibit it a bit, and therefore prevent it from taking over for your mid and lower traps when trying to retract your shoulders.
For the record, I’m not recommending you just stretch your upper trap in the absence of other exercises. I’m saying you can stretch your upper trap immediately prior to some pulling activity to emphasize proper muscle activation. Do this two or three times on each side, for thirty to sixty seconds. The pull should be strong enough that you feel it, but you’re not trying to rip your trap off. Don’t go crazy.
I’ve personally dealt with a lot of shoulder problems and of all the things I tried these were the most useful. Hopefully they can help you too. Now get out there and get to work.
Photo 1 courtesy of Shutterstock.
Photo 1 courtesy of Jorge Huerta Photography.
