Understanding Your Shoulder Pain
The shoulder is probably the most misunderstood joint in the body, especially among those who don’t have a good foundation in human movement – which, unfortunately, includes the majority of people who work out. This, coupled with its inherently mobile/unstable nature, also makes the shoulder the most commonly injured joint in the body – which is why you see so many people in the gym doing stuff like this:
Granted, rotator cuff exercises have their place. Assuring good external rotation strength at the shoulder can surely help in some instances (e.g., in baseball players – especially pitchers – who regularly take their shoulders through greater than normal ranges of motion in external rotation), but you’re much more likely to get better external rotation at the shoulder with good ol’ fashioned pec stretching and basic rows than you are with standard external rotation exercises.
The fact is, although the rotator cuff is often injured, it’s not a lack of strength in the external rotators (teres minor and infraspinatus) that’s usually the problem. The rotator cuff may take the beating, but it’s typically the victim, not the culprit. The issue usually lies more in one’s ability (or lack thereof) to maintain scapular retraction and depression with the arm overhead, or postural distortions that result in scapular protraction – which means the scapula can’t upwardly rotate properly as the arm moves overhead. Remember: The scapula is supposed to move in response to movement at the glenohumeral joint; we call this “scapulo-humeral rhythm.” For every two degrees of humeral elevation, the scapula is supposed to move one degree and find a stable place to sit on the rib cage, kind of like an anchor.
Here are a couple videos to illustrate the point. The first is someone performing an overhead press with proper scapulo-humeral rhythm:
See that little space between the head of the humerus and the edges of the clavicle and scapula? That’s called the “subacromial space.” We have a lot of structures that run through there – including the supraspinatus (another of the four rotator cuff muscles) tendon, the biceps tendon, a bursa and some nerves.
Now, watch what happens during an overhead press WITHOUT proper scapulo-humeral rhythm:
The scapula doesn’t upwardly rotate (so there is no anchor), the head of the humerus therefore migrates superiorly in the fossa and that little space disappears, which means all the stuff in the middle gets pinched. End result? Irritation, inflammation and PAIN – a condition known as impingement. You can do external rotation exercises all day long but they won’t help the condition much if your scapula doesn’t move properly along the rib cage as you lift your arm. The head of your humerus will keep banging into that scapula and pinching your tissues. And if your posture sucks because your internal rotators are tight, you won’t be able to get into external rotation anyway.
That said, I’d rather train for better posture and proper scapular stability and movement first, and then force the rotator cuff to perform its stability function of pulling the head of the humerus down and into the glenoid fossa (shoulder socket) while maintaining scapular retraction and depression.
Here is a good exercise to get the job done (pay particular attention to how Tony gets in position at the beginning by depressing his scapula):
You can increase the challenge by using a kettlebell, and eventually add a more dynamic movement like the windmill:
Note: Know your progressions and start light! Good posture (including T-spine extension) has to come first and, if you really need to do these exercises, chances are you have a hard time “packing” your shoulder – which means you actually have to learn to do it before adding a lot of load!
P.S. Anyone know if the groundhog saw his shadow? I was up way before the sun… But if winter is 60 degrees like yesterday, I wouldn’t mind another six weeks!
URL to article: http://www.fitnessmash.com/2012/02/understanding-your-shoulder-pain/
As there are risks involved in participating in any exercise program FitnessMASH.com strongly recommends that you not rely upon or
follow the programs, techniques or exercises listed on FitnessMASH.com without obtaining the advice of a physician.
Copyright © 2010 FitnessMASH. All rights reserved.