Prehabilitation Broscience 101: Shoulder Health

[Turtora]

This series is designed to give an introductory perspective regarding specific techniques used to keep your body injury-free. These short articles will briefly cover anatomy of the given subject, and subsequently detail common injuries or symptoms that one can experience related to the topic at hand. They are not meant to diagnose, treat, or cure anything.

In this initial, super-boring installment of "Prehabilitation Broscience 101", I'll give you a basic, but targeted view of the inner workings of the glenohumeral (shoulder) joint. Additionally, I'll discuss various problems that can arise from sports and training, and explain how to stay injury-free so we can keep making sick gains and slamming weights in the gym. The exercises I've posted at the bottom are ones I do on a regular basis. I used to compete as a tennis player, and have had to figure these things out on my own. Now I would like to share them with you.

Terms you may or may not be familiar with that are kind of relevant to the following passage (note attached pictures for reference):

- Deltoid (shoulder muscles. you have three of them. anterior, medial, and posterior.)
- Scapula (shoulder blade)
- Winging scapula (scapula that sticks out and is not flush with one's rib cage)
- Humerus (upper arm bone)
- Acromion Process (bit of bone that sticks off the top of the scapula and connects via AC joint to distal (further) head of clavicle (collar bone))
- Labrum (ring of cartilage that surrounds the ball/head of humerus (or any other ball/socket joint) within the socket)
- Rotator Cuff (this mass of tissue and muscle serves to provide a downward force angle on the humerus to help increase the space within the glenohumeral joint)
- Subacromial Impingement Syndrome - There's a very small space for things to move within the glenohumeral joint. SAI occurs when the tendons become "impinged", or "pinched", leading to a pinching sensation within the shoulder due to tendon inflammation. This can often occur during pressing movements or when moving the arms above the head.



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First and foremost, go see a doctor if you're actually having problems. You shouldn't dick around with your body. You only get one, so treat it well.

With that said, a lot of my brahs suffer from shoulder problems and pain, especially those that took part in unilateral sports such as baseball, tennis, etc. Even if you did not participate in sports, you're probably at risk if you sit at a desk on a regular basis. One can also observe this happening in swimming, throwing and other such activities. If they're not already experiencing pain, you might see it crop up when they get into lifting and heavy forms of pressing (bench press, overhead press, etc).

People don't often think about it, but sports such as these cause athletes to develop what is called "pattern overload". I'm not arguing that sports are bad, what I'm postulating is that you should be realistic and recognize the various problems that could arise if you don't address specific aspects of your training. In the case of the shoulder and these sport-specific movements, you're constantly strengthening/contracting/shortening the anterior muscles of the glenohumeral joint (pec, anterior deltoid, and other internal rotators) and lengthening/weakening the posterior muscles (traps, rhomboids, rear deltoids, etc). Even sitting at a desk all day with poor posture, constantly in a state of internal rotation, we ingrain these positions into our body. We have to take an active role in correcting these imbalances.

Delving a little deeper into anecdotal reports, one would even notice that, commonly, within those that participated in unilateral sports, the dominant shoulder is often hypermobile (leads to internal impingement). In contrast, the non-dominant shoulder is often hypomobile (external impingement), leading to AC joint problems, humeral anterior glide syndrome, etc. This necessitates slightly different rehab/prehab philosophies for each shoulder, as individual muscle tightness, strength, and range of motion will vary between the two sides. In the dominant shoulder, we want to work on rotator cuff strengthening, as well as scapular stabilization. In the non-dominant shoulder, we want to work on mobilty through the lats, anterior deltoids, bicep, and pectorals.

Putting all of these actions together, this pattern overload can cause winging of the scapula, subsequently putting the acromion process in a disadvantageous position, given that your humerus can now pinch all of those tendons into the top of your scap whenever you do any sort of pressing movement. Even if you don't have a winging scap, this can still become a problem if you're too internally rotated within the shoulder joint. This is surprisingly (heh) really bad, and leads to what is called subacromial impingement syndrome. The tendons become inflamed, and now everything hurts. If left unaddressed, it can even result in labral tears, humeral glide syndrome, and other nasty crap that's not fun to deal with.

Ultimately, however, to deal with these issues, one should always place an emphasis on training, strengthening and activating the rear delts, rhomboids, lats, and lower traps within their training regimen. Rotator cuff strengthening is also pretty great, too. Evaluate your own mobility issues and assess where you should begin and what you need to do to lift pain-free. I recommend training the aforementioned muscles every other day with band work or bodyweight exercises (in addition to devoting a day [two, in my case] strictly to pulling and back development) that take about 5-10 minutes out of your day. It's all pretty simple stuff, but you'll really benefit from it in the long run.

Staying injury-free is one of the most important things when approaching an individual's training. If you haven't done stuff like this before, I highly recommend you check out the following resources I've posted below. I utilize these exercises on a regular basis within my weekly training routine and find them to be very beneficial. I've gone from being unable to shoulder press at all, to setting personal records on a weekly basis. But I have no formal background in kinesiology or physical therapy, so none of this actually constitutes as certified medical advice and you probably shouldn't listen to what I have to say.

Join me next time on History Channel's DragonBall Z, where we'll probably talk about other boring things like hips and stuff.

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Products I recommend:
Lighter miniband (if you think you're weaker): http://www.flexcart.com/members/elit...&m=PD&pid=2729
Stronger miniband (if you think you're stronger):http://www.flexcart.com/members/elit...5&m=PD&pid=246

Exercises for everyone:
1. Lower traps and rhomboid activation/stabilization (2x/week): www.youtube.com/watch?v=pcWUWaooyk8
2. 50 Band Pull Aparts every other day (scap stabilization) (this guy is a genius when it comes to taking care of shoulders): www.youtube.com/watch?v=73Dm-j5wYIc
3. External Rotations (rotator cuff strengthening) (3 sets of 20, 2x/week [these can be done on a cable machine {always use a very, very low weight setting. i use lowest possible.}]): www.youtube.com/watch?v=T3PbNvrhFW4

Stretches if you played a unilateral sport or notice pain strictly in non-dominant shoulder:
- Stretch lat, pec, anterior deltoid, and bicep in non-dominant shoulder for 3 sets of 30 seconds 2x/week.

Stretches if you notice both shoulders are internally rotated (side-effect of having a program based around pressing, with very little pulling):
- Stretch lat, pec, anterior deltoid, and bicep in both shoulders for 3 sets of 30 seconds 2x/week.

[ironripped]

Very good and informative article.

[Raiphr]

Good article. Repped

[FitnessguruBj]

Great article! Been struggling with LOTS of neck, scapula, shoulder and bicep pains that some days make me not even want to train. Cant wait to get it all checked out! I took for granted the days when I could train pain free and now that all I wish for haha one day of pain free lifting!

[Turtora]

Thanks for the positive feedback, guys! I'm currently battling through the end of this semester, but I plan on writing a lot over break. I'd like to add a lot more to the series. Specifically;

- 2 to 3 more installments to shoulders (PBS 202, 350, etc)
- 2 to 4 installments for hips (101, 202, etc)
- 1 to 3 installments for back
- might add an individual installment both for knees and elbows

What would you like to see more of?

[Raiphr]

Thanks for the positive feedback, guys! I'm currently battling through the end of this semester, but I plan on writing a lot over break. I'd like to add a lot more to the series. Specifically;

- 2 to 3 more installments to shoulders (PBS 202, 350, etc)
- 2 to 4 installments for hips (101, 202, etc)
- 1 to 3 installments for back
- might add an individual installment both for knees and elbows

What would you like to see more of?

Dealing with specific rehabilitation and exercises/flexibility for shoulder injuries would be good: I know it's a prehab thread but I feel like shoulder injuries are a big part of lifting. I play rugby and I've had open stabilisations on both shoulders. Pretty used to rehabbing dislocations; aware of what exercises were safe and do able at each part of the rehab etc etc. Then last week I sprained my ACJ. I'm having a helluva time finding exercises I can and can't do outside of legs. Isolateral row machine for example- all good with good form. BB rows, agony.... I could write a book on the disappointments of a shoulder injury! Perhaps dealing with large movement exercises: Squats, deads, bench, and highlighting what injuries can occur and how to prevent them or tell if they're imminent. I know a guy who injured his hip squatting, his form actually looked ok, but the bio mechanics of the lift were off in a really specific way (so said his physio)...

[Turtora]

Dealing with specific rehabilitation and exercises/flexibility for shoulder injuries would be good: I know it's a prehab thread but I feel like shoulder injuries are a big part of lifting. I play rugby and I've had open stabilisations on both shoulders. Pretty used to rehabbing dislocations; aware of what exercises were safe and do able at each part of the rehab etc etc. Then last week I sprained my ACJ. I'm having a helluva time finding exercises I can and can't do outside of legs. Isolateral row machine for example- all good with good form. BB rows, agony.... I could write a book on the disappointments of a shoulder injury! Perhaps dealing with large movement exercises: Squats, deads, bench, and highlighting what injuries can occur and how to prevent them or tell if they're imminent. I know a guy who injured his hip squatting, his form actually looked ok, but the bio mechanics of the lift were off in a really specific way (so said his physio)...

Brah, trust me on this, take time off from upper body. You need to let your ligaments heal, or you'll end up stretching them out even further (more pain and AC joint arthritis down the road). Watch this:



Injuring your hip is quite common for squats, actually. They're not the friendliest of movements for hips, and if you have FAI (femoroacetabular impingement syndrome) you're likely to jank yourself up if you go anywhere past hip flexion of 90 degrees. It's a rough world out there. Be safe, haha.

[Raiphr]

Hope you don't mind me directing another thread to this one brah, there was one on misc questioning prevention of shoulder injuries. Keep up the good work!

[eyesdating]

great share thanks

[myangle]

Thank you so much!I have learned so much.

[Turtora]

Hope you don't mind me directing another thread to this one brah, there was one on misc questioning prevention of shoulder injuries. Keep up the good work!

Stay safe, brah.

great share thanks

Not a problem!

Thank you so much!I have learned so much.

I'm glad I could help!

[NGV22]

This thread is gold. Bump for later read when i go to my computer. Gonna check other installments and maybe post some ques. Repped

Edit:turns out i need to spread reps around first,

[Babygirl95]

Need to show this to my bf who dislocated his shoulder twice last year. :O

[Turtora]

This thread is gold. Bump for later read when i go to my computer. Gonna check other installments and maybe post some ques. Repped

Edit:turns out i need to spread reps around first,

Thanks for the bump, brah. I'm working on a hip post, currently, along with a video to accompany it + the prehab routine. I'm actually over the allotted word count, lol. It's probably a bit much for 101 stuff, so I'm definitely going to need to trim it down into two parts.

Need to show this to my bf who dislocated his shoulder twice last year. :O

He should see a doctor! It sounds serious. Best of luck to him and his shoulder.

[Babygirl95]

Thanks for the bump, brah. I'm working on a hip post, currently, along with a video to accompany it + the prehab routine. I'm actually over the allotted word count, lol. It's probably a bit much for 101 stuff, so I'm definitely going to need to trim it down into two parts.



He should see a doctor! It sounds serious. Best of luck to him and his shoulder.

He's fine now !! He dislocated it once when he fell during snowboarding, but then two months later dislocated it very slightly again by violently splashing water at me in the pool. He's been doing a lot of mobility and stretching and listening to his body.
I think if it ever happens again I'd make him see a doctor, because dislocating something 3 times+ should warrant at least a check up :P

[Turtora]

He's fine now !! He dislocated it once when he fell during snowboarding, but then two months later dislocated it very slightly again by violently splashing water at me in the pool. He's been doing a lot of mobility and stretching and listening to his body.
I think if it ever happens again I'd make him see a doctor, because dislocating something 3 times+ should warrant at least a check up :P

Hmm. In my experience, stretching isn't really the way to go. Shoulder dislocations generally indicate a massive instability within the glenoid due to rotator cuff and deltoid issues. When dislocating, it's also not uncommon to tear your labrum, as well. Repeated dislocations are much more likely to happen. You can read more here: http://orthoinfo.aaos.org/topic.cfm?topic=a00529

[Turtora]

Great article

Thanks!

[WrathfulOne]

I've added External Rotations to Fierce 5 which I am running now. They really get a burn going! Also ordered a resistance band for pull-aparts. Since I will have the resistance band, is there any benefit to do doing shoulder dislocations with them? I've seen them recommended before, but I don't know if they are just for warming up or if I should do them regularly.

[Turtora]

I've added External Rotations to Fierce 5 which I am running now. They really get a burn going! Also ordered a resistance band for pull-aparts. Since I will have the resistance band, is there any benefit to do doing shoulder dislocations with them? I've seen them recommended before, but I don't know if they are just for warming up or if I should do them regularly.

Band dislocations are fine, yep! Just be careful to not get too intense your first go around.

I actually like doing light band overhead squats before I get under the bar to get the shoulder girdle and lats opened up. No need to focus on depth - just keep the core tight and engaged. I.e. - pull the rib cage down, neutral spine, braced core, and get those lats up. Picked that up from Chris Duffin.

[WrathfulOne]

Band dislocations are fine, yep! Just be careful to not get too intense your first go around.

I actually like doing light band overhead squats before I get under the bar to get the shoulder girdle and lats opened up. No need to focus on depth - just keep the core tight and engaged. I.e. - pull the rib cage down, neutral spine, braced core, and get those lats up. Picked that up from Chris Duffin.

Cool thanks for the advice! I saw that stretch too on Chris' 3rd squat vid. Will give that a go too.

[NGV22]

bump