Solving Shoulder Injuries for Gym Bros

Tom MacCormick

Strength and Conditioning, Personal Training, Sports Science

Solving Shoulder Injuries for Gym Bros - Fitness, injury, mobility, functional movement, lats, upper traps, Scapulae, shoulder health, middle traps

 

The shoulder is one of the most frequently injured joints among gym rats. The shoulder is one of the most complex joints in the human body. Due to its extremely wide range of mobility, it can often be placed in compromised positions which increase risk of injury. A large number of muscles attach to the joint and the space inside the joint is also somewhat limited.

 

 

Modern living tends to place the shoulders in a poor position for excessive periods of time (e.g., driving, on smartphones or laptops, etc.). This poor positioning closes the space in the joint capsule and can contribute to shoulder pain. On top of this, we use our shoulders almost non-stop. Is it any wonder they often get hurt, with all these factors involved with the addition of the beating we give them in and out of the gym?

 

Looking purely at training, the shoulders are involved in practically every upper body exercise. If you perform the Olympic lifts then they get a huge training stimulus from that, too. Even back squats require decent shoulder mobility. Add in all the loading and unloading of weight plates with our regular day to day tasks and it is easy to see why so many people end up with cranky shoulders.

 

The Debilitating Nature of Shoulder Pain

If you have ever suffered from shoulder pain you know how debilitating it can be. All of a sudden, the vast majority of the exercises in your training regime are off limits. This is hugely frustrating. Believe me, I know. Over the years I have encountered shoulder issues a couple of times. Whenever these issues raise their ugly head it is pretty simple for me to trace back to why it happened. When I look back over my training I usually get this “duh” moment where the blindingly obvious suddenly becomes apparent—hindsight is always 20:20 I guess.

 

After making the same mistake more than once I have also fixed it several times. The solution isn’t very complicated or time-consuming. It revolves around some small programming tweaks, fixing a couple of weak links, and improving mobility. Now that might initially sound like a lot, but it really isn’t. A few simple drills will get you back to 100% asap.

 

Bulletproof Your Shoulders

A commonly asked question is, "what causes shoulder pain?" The rotator cuff is the default answer of most physical therapists that I have come across. Now, I am not saying this is wrong, but I don’t believe it is quite this simple. There are multiple factors at play and you should address all of them in order to bulletproof your shoulders.

 

The first is the ratio of pressing to pulling exercises people do. Almost all guys favor the mirror muscles. Incline, flat, decline bench presses, overhead presses, and all sorts of flye variations are all staples in their programs. What about the back? Add in some pull-ups and rows. The back is a far larger, and more complex muscle than the chest so treat it as such and bias your overall volume in favor of the back.

 

Put it this way, it is perfectly fine to say, “I’m training back today,” but you wouldn’t ever say I’m training “front." The muscles of the back make up roughly the same area as the chest, anterior delts, and core, so train them as such. Doing this will go a long way to improve the health of your shoulders.

 

Next up is the ratio of vertical to horizontal pulling. Ask any self-respecting gym junkie what the best back exercise is and they’ll probably tell you it is pull-ups. These are great, no doubt about it. The problem is they primarily train the lats. The lats are internal rotators of the shoulder.

 

Slaving away on the pull-up bar can actually exacerbate the shoulder injuries so many of us suffer from. I suggest that for every set of vertical pulling you do, you do two sets of horizontal rowing. Combined with the above tip of focusing on more overall back work this will build a really solid platform for you to stay injury-free.

 

 

You must improve thoracic mobility. As I mentioned earlier, our modern lives tend to put our shoulders in a crappy position. The whole of the upper back gets hunched forward and our heads end up way out in front of us. This is not good. It ends up with us being flexed over in the thoracic region of our spine. We slowly lose our ability to extend through this region. This has consequences for shoulder mechanics and places you at a greater risk of injury.

 

To fix the lack of thoracic mobility I suggest you use the foam roller. Place it on the ground, and lie down across it with your upper back the point of contact. Place your hands behind your head as if you were sunbathing and chill out for a bit. Let gravity do its thing and gently pull your elbows down.

 

This will give pec minor a nice stretch. Tight pecs are another contributor to poor posture so this kills two birds with one stone. After five slow, deep breaths, move a half inch or so down so the roller is fractionally lower down your spine and repeat the five deep breaths. Do this every day.

 

The Role of the Traps

Scapular (shoulder blade) stability, or lack thereof, is one of the key contributors to shoulder dysfunction in my opinion. The muscles responsible for this are often weak. No surprise really because little thought is given to them in most programs. One of the key muscles involved in this are the traps. Not the upper traps which, when well-developed, make your head disappear into your neck, but the mid, and particularly lower traps.

 

There should be a balance of strength between the upper, middle and lower traps. This is rarely the case. For most muscle chasing folk, the upper traps get plenty of love. The mid and lower traps not so much. I’m sure you have seen the bros shrugging huge weights to target the upper traps. When have you ever seen someone specifically target the mid and lower traps?

 

Probably never. Am I right?

 

It’s true that the middle traps tend to get worked quite hard during back exercises like rows and pulls. The lower traps, however, get no love and if they do get any attention. As a result, the average gym goer has pathetically weak lower traps.

 

The lower traps function to retract and depress the scapulae (think shoulders in back pockets). As I previously mentioned, modern living (and stupid training programs) promote poor thoracic mobility and overactive upper traps. This tends to result in long weak lower traps. Well, here’s the thing, weak lower traps lead to unstable scapulae. Given they are crucial to scapular stability this presents a problem. When loads get heavy they aren’t able to fulfill this function and your risk of getting into awkward positions. While this might not lead to an acute injury it very often adds up over time to cause a nagging pain that soon escalates to a full-blown injury.

 

By now you should have got the point. Lower traps are important to shoulder health. Most of us have weak lower traps. The fix is simple, strengthen your lower traps. This might be where you get stuck. Do you have a repertoire of lower trap exercises in your toolbox?

 

Don’t worry most people don’t. I have got you covered with a few simple exercises for you to put into practice. First up, is my favorite activation drill. This is a combo of three exercises done back to back which will fire up your lower traps and give you a warm, fuzzy, glow of a burn in them. This helps create a mind/muscle connection with the area and sets you up to develop strength in them going forward. I suggest you do this drill before every upper body session.

 

The shoulder saver combo:

 

  • Prone lower trap lifts
  • Prone scapular retraction in external rotation
  • Prone external rotation plus press

 

Do 5 reps of each exercise with a 5-second iso-hold at the top of each.

 

 

The next exercise is done a little heavier and challenges the traps in their scapular retraction function. Given we want to be able to hold this position for the duration of pressing sets it is important to develop some muscular endurance with these.

 

In my experience, if you try and do really high reps with this it tends to get sloppy and the movements are a bit jerky. To remedy this, I have found that performing slow, controlled reps with a 5-count peak contraction work well. Do a few sets of 8 reps every upper body session and you will thank me for it.

 

 

An unrelated element of shoulder health is the imbalance we create between the front, side, and back of the shoulder. Most people get tons of anterior (front) delt training with all their pressing work. The rear delts don’t get quite as much stimulus in general, but they are trained with row variations.

 

Finally, the lateral delts get very little training from compound movements. The upright row is the best at targeting them, however, those with cranky shoulders will likely find upright rows cause more harm than good. Balancing out the strength of the lateral delt then comes down to isolation exercise such as lateral raises.

 

This exercise has several limitations. When done with dumbbells there is almost no tension on the muscle at the bottom. Then, as you perform the lift, the lever arm gets longer and longer until you reach the top of the movement. At this point the exercise it mechanically hardest. Yet the muscle is in a fully shortened position. This is the weakest part of your range. So, the strength curve and exercise resistance profile are opposed. This is not optimal.

 

There is another problem with the dumbbell lateral raise and that is how most people do them. Most lifters go way too heavy, use crappy form, and just end up shrugging the weight up. So, all they do is train their upper traps even more and leave the lateral delts relatively untouched.

 

To balance up the strength ratio of the shoulder muscles you need an exercise you can keep the traps out of, provide stability to the scapulae, and challenge the muscle across its full contractile range to be maximally efficient and effective. To achieve this, I give you the lying, cable cuff lateral raise.

 

 

Because of the set-up on the bench, you can keep the traps out of the movement, you have a really solid base to lift from, the shoulder blades are given artificial stability from the bench, and the cables allow there to be constant tension on the lateral delts. Win, win, win, win!

 

Finally, improving external rotation strength will likely be beneficial to shoulder health. You don’t have to go crazy with intensity or volume on these. Two sets of 8-10 reps done in a slow controlled fashion will do the job. Don’t push these too failure. Leave a couple of reps in the tank and just focus on quality of movement and getting a gentle “burn” type sensation in the muscles.

 

Remember to Care for Your Shoulders

A few of my best tips to fix shoulder pain and correct movement patterns:

 

  • Create a favorable ratio of pulling to pushing
  • Bias the use of horizontal over vertical pulling
  • Improve thoracic mobility
  • Strengthen the mid and lower traps
  • Train the mid and lower traps for strength endurance using isometric holds
  • Strengthen the lateral delts in an intelligent fashion
  • Increase external rotation strength

 

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