Shoulder pain, particularly pain in the rotator cuff, is a common complaint among athletes and non-athletes alike. Look around the gym and you'll see people getting up from the Bench Press holding their shoulder and moving their arm around in circles. You'll hear others say they stay away from certain exercises because their shoulders hurt when they do them. The sad part is, most individuals think this is normal. Well guess what? It's not! In fact, many shoulder injuries are preventable, and by following this 5-step process you can be on your way to having healthy, strong shoulders in no time at all.
1. Pectoral and Lat Flexibility
Take a good look around the gym. You will see many people with forward-slumped shoulders and extreme internal rotation, indicated by their palms facing backwards instead of the thumbs facing forward. These individuals more than likely have tight pectoral and lat muscles, and you may be on your way to having the same problem. Ultimately tight pecs and tight lats spell disaster for the shoulders, so it's important to take action immediately. Here's how.
Grab a rubber band that you would use for Band Pull-Aparts. Using a shoulder-width grip, lock your arms straight, and raise them overhead and slightly behind your head. Allow your chest and shoulders to relax so you feel the stretch through your front deltoid and chest. Hold that stretch for 2-3 sets of 20-30 seconds each. I also like to do this for 1 set of 20 seconds before I begin my upper-body warm-up to loosen up a bit. Do this stretch daily and you will see noticeable improvements in your shoulder flexibility.
Next, grab something sturdy that is about hip-height. Bend at the waist and push your hips back, feeling a stretch up the side of your torso and into your armpit on the side that you are holding the sturdy object. You are now stretching your lats, which also pull your shoulders forward and into internal rotation. Hold for 2-3 sets of 20-30 seconds each side.
2. Thoracic Mobility
The thoracic spine, or t-spine as it's often called, is the section of your spine between the cervical and lumbar regions, or between the neck and low back. Think of this region as your mid and upper back. The t-spine is where rotation, flexion and extension of the spine mostly occurs, or at least where it is supposed to occur. But, just as with other areas of the body, a limitation in t-spine mobility causes compensations elsewhere.
Limited thoracic mobility will actually wreak havoc on the shoulders. The scapula moves in various directions and is involved in shoulder range of motion. The t-spine plays a direct role in scapular movement and consequently in shoulder range of motion. If t-spine mobility is limited, shoulder motion will be limited as well. The result is eventual pain and injury to the shoulders. This is why thoracic mobility is highly important.
Try this: round your shoulders and upper back as if to "hunch" forward. Now, try to raise one arm overhead. Can't do it can you? Now, straighten your back, push your chest out, and squeeze your shoulders back. Raise your arm overhead again. I bet it was much easier, and your arm moved a lot more. The only difference was the position of your thoracic spine and scapula.
Here's how to improve your t-spine mobility. First, using a foam roller, roll your upper back up and down 15-20 times with your arms crossed over your chest. Then, after you've completed your rolls, place the roller under your shoulder blades, right around the middle of your back. Next, keeping your butt on the ground, reach your arms overhead as far as you can and arch your back over the roller. Hold for 3-5 seconds and return to the starting position. Repeat this 10-15 times. These are called Thoracic Extensions.
Next, lie on your side with your knees up at a 90-degree angle to your torso. Extend both arms out in front of you. Keep the bottom arm on the ground and lift the other arm, rotating it away from you. Keep rotating, trying to touch that shoulder to the ground, but do not let your hips, legs or low back move. You may not be able to rotate all the way around at first. Hold for 3-5 seconds, and rotate back to the starting position. Repeat 10-15 times, switch sides, and repeat. These are called Thoracic Rotations. For a visual demo of how to do them and other great thoracic mobility exercises, check out this video.
3. Rotator Cuff Strength
The rotator cuff is comprised of 4 small muscles that stabilize and support the shoulder and facilitate movements such as internal and external rotation and abduction of the arm. It is highly important to take time at the beginning of each workout to do some strengthening exercises for these small muscles, especially external rotation. This will help to prevent rotator cuff injuries and will keep your shoulders feeling strong and healthy. These are small muscles, so they do not require a lot of weight and will fatigue easily. Here are 3 exercises you can incorporate into your workouts to help improve rotator cuff strength.
1. Standing External Rotation
This exercise may be done with a cable, band, dumbbells or plates. In a standing position, bend your arm at 90 degrees and squeeze your elbow to your side. Rotate your arm away from your body in a controlled manner and then back in toward your body, also in a controlled manner. Perform 2-3 sets of 15-20 reps.
2. Lying External Rotation
For this exercise you will need a light dumbbell or plate. Lie on your side on a flat bench. Hold the plate or dumbbell in the hand of your top arm and bend it at a 90-degree angle. Squeeze your arm to your side. In a controlled manner, rotate your arm upward, pause for a brief second, then slowly lower back to the starting position. Perform 2-3 sets of 15-20 repetitions.
3. Incline Bench I.Y.T.W.'s
Lie face down on an incline bench, holding a light weight (2 to 5 pounds) in each hand. Keeping your arms straight and palms facing each other, raise them both out in front as high as you can in a controlled manner for 10 repetitions. Next, turn your thumbs outward and keeping your arms straight, raise your arms out at a 45-degree angle from your body as high as you can, making a "Y" with your arms. Perform 10 repetitions. Then, face your palms together again, keep your arms straight, and raise them directly out to the side in a "T" for 10 repetitions. Finally, with your palms facing back toward your body, row your arms up, bending your elbows to 90 degrees, then rotate your arms back like an external rotation. This is the "W" portion of the exercise. Perform 10 repetitions. Do 2-3 total sets of this exercise.
4. Upper Back Strength
Believe it or not, upper-back strength is a critical component of shoulder health. Studies have shown that an imbalance of strength between the chest and upper back is a key indicator of shoulder injuries. In other words, if your chest is stronger than your upper back you are far more likely to suffer shoulder injuries such as rotator cuff strains and tears. As a rule of thumb, you should be able to pull just as much weight as you can push. For example, if a 200-pound man can bench press 300 pounds for 1 repetition, he should also be able to do a Pull-Up with an additional 100 pounds on his body, totaling 300 pounds for the Pull-Up.
Another important piece of the puzzle is the push-pull ratio. It's important to remember that you should pull at least twice as many reps as you push in any given week or exercise. For example, if during the week you perform 100 repetitions of push exercises (e.g., Bench Press, Incline Press, Overhead Press, etc.) you should perform a minimum of 200 repetitions of pulling exercises (e.g., various Rows, Chins, Pull-Downs, etc.) This will promote upper-back strength and development and will maintain a balance in the muscles that pull on your shoulders, keeping them strong and healthy.
5. Rear Deltoid Development
The rear deltoids are largely neglected muscles. Some individuals believe that back exercises adequately target the rear deltoids, but that isn't always true. I recommend targeting the rear deltoids at the end of a back workout and also at the end of your shoulder workouts. If you are on a two-day upper/lower split or a three-day full-body split, you can target your rear delts at the end of your upper-body days or at the end of your full-body days. Great exercises include Face Pulls, Bent-Over Rear Delt Flys, and TRX "Y's" and "T's." Perform 3-4 sets of 12-15 repetitions of one of these exercises 2-3 days per week for complete development of the shoulders and to maintain shoulder health.
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