The Bench Press and Shoulder Press are the two exercises most likely to cause shoulder pain. Since they are also two of the most popular exercises, it's no surprise that shoulder pain is common among those who lift weights on a regular basis.
When you ask around, many people in the gym have a theory of why this happens. Some believe a lack of mobility in the shoulder causes the tissue to get stretched like a plastic bag. Others point to a lack of stability in the shoulder, causing the humeral head to bounce around in the joint like a pinball. Still others suggest that lack of back strength causes the shoulders to round forward like a gorilla.
So, who is right? Is it an issue of mobility, stability or strength?
The truth is any one of those things can cause shoulder pain, but the end result is usually the same—impingement of the tissues of the shoulder on the acromion.
The first thing that should be ruled out is any mobility limitations in the shoulder, upper back and chest. It's important to start there, because stability and strength are impossible without mobility. That said, be mindful that stability and strength issues might be disguised as a lack of mobility. This results from the body "guarding" the joint when it senses that the joint is not stable and strong.
If you have a standard 9-to-5 "hunched-over-your computer" lifestyle like most of us in the United States, it is safe to assume you are living with at least some stiffness around the shoulder joint. A few likely suspect areas are:
- Pec Minor
- Levator Scapulae
- Biceps (short head)
Tackle the stiffness with a combination of self-release techniques, massage and stretching.
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The shoulder joint has been described as a seal balancing a ball on its nose. In other words, the shoulder is a shallow joint that allows for a huge amount of motion while also requiring a ton of dynamic stability. To create this stability, the shoulder relies heavily on the rotator cuff muscles. They can create movement, but their real job is to center the humeral head inside the shoulder joint by making quick and precise adjustments during movement.
The stability provided by the rotator cuff muscles is very position-specific. Some people have great stability with their arm at their side, but are very unstable when their arm moves overhead. For this reason, you should train shoulder stability in a variety of positions, with techniques that include rhythmic stabilization exercises, kettlebell work and crawling variations.
The last piece in the shoulder health puzzle is strength. When the body lacks strength in the shoulder muscles, upper back and core, it tends to compensate with less-than-ideal movement patterns. Proper strength in these muscles and the ability to recruit them at the right time allows for better joint positioning.
In a normal functioning shoulder, the rotator cuff muscles pull the humeral head back and down during pressing motions, allowing for more room within the joint. When the rotator cuff muscles are not functioning properly, the humeral head travels forward and upward, placing excessive pressure between the tissues of the shoulder and the point of the shoulder blade (acromion).
Strengthening the muscles of the upper back and core is important as well. A general rule of thumb is to perform twice as many pulling exercise and pushing exercises. When training the core, focus on anti-rotation and anti-extension exercises.
4. Scapulohumeral Rhythm
There is actually a fourth piece of this puzzle—scapulohumeral rhythm. This is the body's natural connection between the shoulder blade (scapula) and the shoulder joint. Ideally, as the arm raises above 30 degrees, the shoulder blade responds by tipping back and rotating up to match the position of the shoulder. This allows for the shoulder to be strong and stable in flexed and abducted positions. When this does not happen—due to inadequate mobility, stability, or strength (or just poor coaching)—the shoulder loses its strength and stability, and becomes more vulnerable.
When doing movements that require flexion and abduction of the shoulder, it is important to feel motion coming from the scapula. If you cannot feel the scapula "crawl" over your rib cage, chances are you do not have good rhythm between your scapula and your shoulder.
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