The Complete Shoulder and RC Injury Article

**BernieD** · 07-13-2005, 06:45 PM

Here's an article that I've alluded to a few times that I had been working on. It's finally finished. I hope you like the final product. If you have any suggestions or comments, please let me know. I'd be happy to hear constructive criticisms on the article. My goal with this article was to make a single body of text that contained enough information for people to be busy with for awhile. I hope that people like it enough that the next time someone posts a thread asking about a shoulder injury, that they will get linked to this thread. I have tried to cover a lot of material (not just "OK, here's some RC exercises, now go do them" and that's it), and I hope you get something out of it. Thanks in advance for reading this article--I put a lot of time into it, so I hope you like it.

**BernieD** · 07-13-2005, 06:47 PM

Shoulder Rehabilitation: Tips, Exercises and Routines

This article contains the following sections:

1: Introduction to Rotator Cuff

2: Stretches

3: Exercises

4: A sample routine

5: Exercises to be wary of

6: How to do certain exercises better

7: Further Reading

8: Final Thoughts

Section 1: Introduction

First off, let me explain something. I hesitate to call this a �complete� thread on shoulder injuries, as it is virtually impossible to cover everything. My hope is if you have a shoulder injury (or even if you don�t), that you will learn some valuable tips on how to rehab your shoulder and keep it healthy, what exercises to avoid, and how to do certain exercises better to minimize stress on the shoulders. But please keep in mind that you need to be careful doing any of these exercises. If you are in a lot of pain, then you should probably be going to a doctor or chiropractor. I cannot diagnose you. It may be your RC, it may be your AC. But if your shoulder has been a nagging injury (like it was for me) or if you just want to know how to take care of your shoulder better, then look no further.

As for me, I had a nagging RC injury for months and months. I trained through it (stupidly enough) and just went a little lighter on the weights. While my shoulder didn�t really get any worse, it didn�t get any better, either. So finally I decided to take action and really work on rehabbing my shoulder (or shoulders, I should say�I had impingement in both!)

Training the RC is extremely important for lifting. It gets used in most upper body exercises (even in tricep and bicep exercises to a certain extent) and constantly has to handle a lot of stress. If you keep it strong and healthy though, you can lift for a long time with no problems. I will not go into a detailed explanation of shoulder anatomy, as this is not the purpose of this article, but if you want more information on that then look HERE.

An obvious question becomes, how do I know if I even have an injured shoulder? If you have any pain, then there�s obviously something wrong. But there are other telltale signs, such as tenderness in the shoulder when you press on it, pain when lifting it overhead or to the side (i.e. lateral raise) or a limited Range Of Motion (ROM).

Here�s also a quick, easy test to try with which you can evaluate your shoulders. Stand facing a mirror, hands at your sides. If you can only see your thumbs and index fingers, then your posture is fine. If you can see your ring finger or even your whole palm, then your shoulders are out of whack. With the following exercises, your posture and your shoulders-hunched-forward look will improve.

According to a recent article in Men�s Health (yes, I�m referencing that magazine, don�t laugh

) shoulder impingement is the second most common sports injury behind a neck pull, so that will not only tell you how prevalent it is but then also how important it is to not be someone who adds to these statistics.

If you think and/or know that you have an AC injury, I�d recommend searching for posts by �Nainoa� on this board, he knows a lot of information about AC injuries. If it hurts to do overhead presses, then it is more likely an AC injury rather than an RC injury.

Well, that about does it for the intro, now let�s get down to business!

Section 2: Stretches

In case you didn�t already know, stretching is very important in lifting. Without it, you have a higher chance of injury (and who wouldn�t want to avoid that?) If you currently have shoulder problems, do them cautiously. You should feel a stretch when doing this, but not pain. Try holding the stretch for 15 seconds. I�d recommend doing them before and after every workout (even lower body work; squats place some stress on the shoulders as well).

Some great shoulder stretches are explained HERE (Go to the very bottom of the page).

Another great stretch is to bend your elbow so your forearm and upper arm create a 90 degree angle. Keeping this position, put your arm behind your back, palm facing away from you. The higher up you place your hand on your back, the greater the stretch. Experiment and see what position is comfortable for you. This is a great stretch that�s easy to do, and can be done in public without it looking awkward (I do these when I�m talking to someone all the time, although usually just when I�m sitting down).

Section 3: Exercises

Well, here we go. I will make a list of the best RC exercises that I know of, and in the next section I will post a sample routine.

First off, the �Broomstick stretch� from the infamous Dante AKA Doggcrapp over at http://www.intens************

This exercise was extremely vital for rehabbing my shoulder. It increased my ROM, stopped any clicking, and was well, just plain awesome. I highly recommend doing this. (I do it everyday, except for on the same day of my chest workout and my shoulder workout, 40-50 repetitions). As explained in the thread, you will need a long broomstick (about 6-7 feet long) for it to be effective. A towel or anything else just won�t cut it. When starting off, first try 25 repetitions, then slowly work your way up to 50. By the time you get there, your shoulders will feel a lot better and a lot more flexible, whether you had a shoulder problem or not. In case you haven�t already noticed, I absolutely swear by this exercise. Read about it HERE

Internal and External Rotations

These are another must for working the RC. If you don�t have access to a cable pulley machine, you can try them with dumbbells (as explained HERE), but in my personal opinion dumbbells don�t work as well. Why? Doing them on a cable pulley allows you to keep constant tension in your shoulder, and with a cable I feel it is a lot easier to control the motion with strict, strict form (which of course is always important).

View a video of Internal rotations url=http://www.exrx.net/WeightExercises/Subscapularis/CBInternalRotation.html]HERE/url]

Personally, this isn�t my favorite representation of the exercise. I think it is more effective to do it standing up, but to each their own I guess. Your shoulder should act as a hinge. Your elbow should be right on your ribs and should NOT leave your side. The key with internal (and external rotations) is very low weight and very high reps. When I was rehabbing my shoulder (and even now) I never go higher than 10 or 15 pounds (if you�re doing these with dumbbells, try 5 pounds first). The point of training the RC isn�t a lot of weight. The point is to increase blood flow to the area and increase flexibility and ROM. The other important point is high reps. I usually do 2-3 sets of 30-50 reps. Doing that many reps will do wonders for your RC, trust me!

Here are some pics on how to do external rotations (http://www.bullz-eye.com/furci/2004/...l_rotation.htm)

Again, I recommend 10-15 pounds and 30-50 reps. The 2nd exercise shown there is slightly similar to the Cuban Rotation, explained next.

The Cuban Rotation:

View the exercise HERE

This is another great exercise to improve your external rotation. For this one, go very light weight (I cannot stress this enough, working your RC is not about using a lot of weight!). For many a barbell may be too much weight when starting out. I used one of those pre-fitted EZ bars at my gym, only 25 pounds. Again, you don�t need a lot of weight. Make sure your form is strict and controlled. Shoot for about 10-12 reps.

Scapular Retraction:

The Start: http://www.bodybuilding.com/fun/likness22g.jpg
The Finish: http://www.bodybuilding.com/fun/likness22h.jpg

This is a great exercise for your shoulder blades.. This will help you if you have rounded shoulders, as it works in pulling the shoulders back so that they�re in a more natural position. While this does not directly target the RC per se, I still found it to be a great exercise that worked really well. Again, use light weights anywhere between 5-20 pound dumbbells when you first try it. Shoot for about 10-15 reps and concentrate on really squeezing your shoulder blades together. If you go to heavy, you won�t be able to do this and you�ll compromise your form, which is always a no-no.

The Can Opener

I'm not sure of the actual name of this exercise, but I call it "The Can Opener" for lack of a better term. Check it out HERE (Exercise #4).

Make sure to do it with a light weight and slow, controlled reps.

Other exercises:

http://www.ncsf.org/tools/video.aspx#9

This website has a bunch of rotator cuff exercises. I have tried a bunch of them, and personally I don�t feel that they did much for me, but of course I�m not like everybody else, so if you try them and you like them, then by all means use them. I think a better alternative to some of these is doing the rotations lying on your side, rather than on your back.

Note: The exercises I have outlined are by no means the only RC exercises. They are some of the most common ones though (especially the internal and external rotations) and they are what worked best for me (but again, I can�t speak for everyone).

**BernieD** · 07-13-2005, 06:48 PM

Section 4: A Sample Routine

The following is a sample routine for the aforementioned exercises. Ideally you would do them before every upper body workout. But then again, this routine can also be time-consuming, so if you want, you could limit the routine to just internal rotation and then external rotation or Cuban rotation.

Exercise 1: Internal Rotation on a cable pulley machine (do both arms together at the same time) or with dumbbells (but again, cables are best)

2-3 sets, 30-50 reps, 10-15 pounds (20-25 reps and 5-10 pounds for dumbbells)

Exercise 2: External Rotation on a cable pulley machine or with dumbbells

2-3 sets, 30-50 reps, 10-15 pounds (20-25 reps and 5-10 pounds for dumbbells)

Exercise 3: Cuban Rotation

2-3 sets, 10-12 reps, start off somewhere between a 15 pound to 40 pound bar and go from there

Exercise 4: Scapular Retraction

2-3 sets, 10-15 reps, try dumbbells anywhere between 5-20 pounds and go up from there. Remember to really squeeze those shoulder blades

Section 5: Exercises to be wary of

This section of the article will probably be very controversial. I will give a list of exercises that I think should not be done at all (for someone with healthy or bad shoulders) and some that should be avoided if you have shoulder problems (granted, the best thing is to not be lifting at all if you have a bad shoulder, but if it is only minor and nagging, it is still very common to see guys just working through it). Ultimately, you have to be the judge. But remember�just because the exercise doesn�t cause pain, does not mean it can�t cause problems in the long run. Here are some of my suggestions:

1) Upright Rows: I think that these should be avoided entirely. Again, I will emphasize that this isn�t true for everyone, but they have a high probability of causing impingement

2) Pec Deck: If your shoulders are fine, go for it. But if you have any shoulder issues, steer clear.

3) Flyes: Same as above. If your shoulders are fine, go for it. If not, be wary

4) Dips: Same as above. If you have bad shoulders avoid them. Otherwise, go ahead. Just be sure to not go past parallel with your upper arms.

5) Shoulder and Chest Presses (including Bench Press): These will most certainly aggravate your bad shoulder. Try to avoid these if you have shoulder problems.

6) Overhead Tricep Extension (with barbell or dumbbell): These put a lot of stress on your shoulders, so if you have any issues, avoid them.

Realistically, I could go on forever, as almost every upper body exercise involves the shoulders, but I think these are some of the top ones to avoid. You could argue that Any type of lateral or front raise should be in there too, but since you do usually go lighter with them anyway, I�ll leave that for you to decide whether to do them or not if you have a bad shoulder. Only you can judge what your body can handle, not me.

Section 6: How to do certain exercises better

Through my training, I found ways to change an exercise a little bit so that if you have shoulder problems, and even if you don�t, you can perform them without putting too much stress on the shoulders. Again, you have to be your own judge. I could do most of these exercises without pain when my RC was bad, but that does not mean that this will be true for everybody. My point is, tread cautiously. Use these suggestions as a guide and hopefully they will help you.

1) Flat, Incline or Decline Dumbbell or Barbell Press: When lowering the barbell or dumbbell, don�t go all the way to your chest. The point of doing these exercises is mainly to work your chest, and if you go too low, your shoulders will start doing all the work. Try it out for yourself to see what�s comfortable for you, but I would stop 3-4 inches above your chest. This will keep the stress on your chest (good) and off your shoulders (also good).
2) Pullups or Chinups: On the negative part of these exercises, don�t quite go down all the way so that your arms are completely straight. This will put a lot of stress on your shoulders.
3) Pushups: Changing your hand positioning will reduce the stress on your shoulders. When my RC was bad, regular pushups caused me pain. But changing the hand position made them pain-free. For example, let�s say your right shoulder is your bad one. When you get into pushup position, move your right hand back a couple inches, but keep your left hand where it was. Although some will decry that this will work your muscles different from the classic pushup, if you have a bad shoulder pushups might be painful, but putting the arm with the bad shoulders a couple inches back will greatly reduce the stress on your shoulders.
4) Skullcrushers or Lying tricep extensions: Instead of doing them on a flat bench, which is the most common way, try doing them on a slight incline. This will greatly reduce the stress on your shoulders. Even now that my shoulders are OK, I still do extensions on a slight incline (the lowest the bench will go without being flat, I think that�s at 15 degrees).

That�s about all I can think of on how to perform certain exercises better to reduce stress on your shoulders. If I come up with anymore ideas I�ll add them, or if anyone else has suggestions I will gladly add them and credit you as the source.

Section 7: Further Reading

Here are some articles on shoulder rehabilitation if you�re interested in further reading:

http://www.findarticles.com/p/articl...18/ai_83343027

http://www.t-nation.com/findArticle....=body_145shldr

http://www.bodybuilding.com/fun/bbin...oulderInjuries

Section 8: Final Thoughts

If you�re reading this, well then thank you for making it this far! This took me a long time to write up, and I hope you have gained some new knowledge, whether you�re a novice or veteran of lifting, whether you have healthy shoulders or you don�t. I would just like to stress again that these exercises aren�t about how much weight you can do. Form and control are paramount. If you have any suggestions or comments or questions, please say something! If there�s something in here you disagree with, tell me why. As long as you give me a good reason, I�ll listen. But if you just say �your article sucks,� it�ll fall on deaf ears. I want to know why it �sucks� and what I can change. I wrote this as a service to everyone out there, healthy shoulders or not, and show you what has worked for me. If you even gain one tip or one exercise or whatever from this, then I�ll be happy. If not, that�s fine too. Good luck!

**maxiw** · 07-13-2005, 07:02 PM

Originally Posted by BernieD

1) Flat, Incline or Decline Dumbbell or Barbell Press: When lowering the barbell or dumbbell, don�t go all the way to your chest. The point of doing these exercises is mainly to work your chest, and if you go too low, your shoulders will start doing all the work. Try it out for yourself to see what�s comfortable for you, but I would stop 3-4 inches above your chest. This will keep the stress on your chest (good) and off your shoulders (also good).

When injured, how high up did you put it?

**BernieD** · 07-13-2005, 07:06 PM

Good question

I didn't quite go up to arms fully locked, I went just high enough so that my elbows were still slightly bent. But I would say that overall I pretty much stayed away from presses. I wouldn't really advocate doing them if you have a bad shoulder. But doing them with a slightly decreased ROM will ease shoulder stress.

Thanks for the question

**maxiw** · 07-13-2005, 07:10 PM

Pressing doesn't give me any direct pain... most lifting activities just seem to intensify a background, dull-like ache in the RC region.

Deadlift is the only lift I go hardcore on.

**maxiw** · 07-13-2005, 07:15 PM

Do/did you have this kind of general ache?

**cwsocr** · 07-13-2005, 07:17 PM

great great great read. im suffering from a shoulder problem now, AGAIN. def gonna start to rehab it as its about that time, ive been waiting just for everyday pain to go away. think im goin to see a chiropractor too, see what he sais about it. well done on the article.

**KKFB140** · 07-13-2005, 07:20 PM

Are shoulder presses bad for you?

According to joe Defrance, they are.

": Timmy, I�ve answered this question before. Basically, when you press overhead, you�re driving the head of the humerus into the acromion. This causes impingement, specifically to the supraspinatus and long head of the biceps tendon. Repetitive impingement can lead to a tearing of these two muscles/tendons. I CAN�T do military presses anymore even if I wanted to. The pain it creates in both of my AC joints is so severe that I can�t lift upper body for at least 3-4 weeks after just a couple of sets of military presses. It�s just not worth it for me. Basically, my shoulder training consists of a ton of rear delt work, external rotator work, shrugs and light cable lateral raises.

It�s also very important for you to know that EVERYONE�S ANATOMY IS DIFFERENT. This is why exercises that hurt me, may not hurt you (for now anyway). For example, I had an appointment with a shoulder specialist last Monday to get cortisone shots in each one of my shoulders. The doctor was nice enough to spend some extra time with me as I asked him a thousand questions. He showed me the x-rays of my shoulders and revealed something to me that no other doctor has ever told me. He told me that the �hook� of my acromion was the largest that he�s ever seen. (This is NOT good, by the way.) Not only has this contributed to the arthritis that I have in my shoulder; I�m destined to have a rotator cuff tear in my supraspinatus down the road. Basically, the �hook� of my acromion comes down so low it�s rubbing against my supraspinatus. Even if I do everything perfect in the weight room, I am destined for this type of tear because of my God-given anatomy. (Just the news that I wanted to hear 1 week before my back surgery!)

**** happens.
Joe D."

http://www.defrancostraining.com/ask...htm#question02 (2nd question down)

**BernieD** · 07-13-2005, 09:13 PM

Originally Posted by maxiw

Do/did you have this kind of general ache?

I wouldn't say that everything gave me an ache. Really only chest and shoulder exercises ached. Back and triceps was fine for me (but I did stay away from doing dips or close grip bench press)

Now, I almost never have any aches in my shoulders..and I attribute that partially to do these exercises prior to almost every workout.

If you get aches like that don't keep ignoring them. I did it for awhile until I realized how ridiculous it was that I wasn't doing anything. Try some of the things I mentioned (along with a little break from lifting) and hopefully it'll get better for you.

Thanks for the comment cwsocr. Good luck with the chiropractor.

And KKF...interesting post from that guy. But when I read that, what pops into my head immediately is something he even mentions: It�s also very important for you to know that EVERYONE�S ANATOMY IS DIFFERENT. This is why exercises that hurt me, may not hurt you (for now anyway)

Just cuz he can't do them cuz he's got real bad shoulders doesn't mean you shouldn't do them. If your shoulders are fine, then go ahead and do them. Just don't go overboard. Remember that bodybuilding isn't a numbers game. Concentrate on doing slow, controlled reps with perfect form with moderate weight. If you don't act all gung-ho and try and military press more than you can handle, you should be fine. Just progress slowly. And doing some of the exercises I've mentioned will certainly help you in the long run. To save time, I usually only do cable rotations, but on my shoulder days and sometimes on my chest days I do the full 4 exercise routine I have listed. Sure, it sucks to have to take the time to do them, but think of it in the long run...those 10 minutes could save you weeks, months or even years of shoulder problems.

**Glyder** · 07-13-2005, 09:32 PM

Tag for later reading. At work now, so will read tomorrow

I have a current problem with my shoulder that I am trying to rectify, so hopefully this information will supplement what i am doing now.

**maxiw** · 07-14-2005, 04:27 AM

Originally Posted by BernieD

I wouldn't say that everything gave me an ache. Really only chest and shoulder exercises ached. Back and triceps was fine for me (but I did stay away from doing dips or close grip bench press)

Now, I almost never have any aches in my shoulders..and I attribute that partially to do these exercises prior to almost every workout.

If you get aches like that don't keep ignoring them. I did it for awhile until I realized how ridiculous it was that I wasn't doing anything. Try some of the things I mentioned (along with a little break from lifting) and hopefully it'll get better for you.

**Boogie** · 07-14-2005, 05:16 AM

I've had a nagging shoulder injury for years in my left shoulder by my armpit close to my chest. I am unable to do flat bench presses. I have never tried to rehabilitate it, so maybe this stuff can work on me.

**KKFB140** · 07-14-2005, 09:09 AM

But what military presses do for EVERYBODY is:

"Basically, when you press overhead, you�re driving the head of the humerus into the acromion. This causes impingement, specifically to the supraspinatus and long head of the biceps tendon."

Shoulders are the most complex body part to workout safely.

**BernieD** · 07-14-2005, 10:47 AM

^I know what you're saying, but then how do you respond to the people who can military press 250+ pounds without problems? Everyone's body is different. Some people are better at handling heavy loads than others...

maxiw...thanks for those links...I'll check em out later.

**xueimelynnad** · 07-14-2005, 11:46 AM

Good post, just about everything there is what my physical therapist told me to do after I had my shoulder cleaned out and rebuilt. Another sign that you might have a bad shoulder is if when you lift, your shoulders both feel fine but move differently and automatically adjust to different angles. Even after lots of therapy and getting them to pretty much the same strength, having no cartiledge or a couple ligaments and tendons makes it move different. The cable extensions are also great for extending your range of motion, let the weight reasonably pull your arm back further than you could pull it in the other direction (I can get to 120 degrees outward pulling the cable, but can pull in from 200, the weight helps pull it backward. Also if you cant quite lift your arm up real high, say, well ok 60 degrees from vertical, but wherever, grab onto a door edge and walk your fingers up, then see how long you can hold it there without holding onto the door, lower as slow as you can.

this thread should be a sticky, shoulders are some of the weakest and most complicated parts on someone, and the most used

**Bad_Vibes** · 07-14-2005, 11:54 AM

Great article, I've worked through shoulder issues on both sides of my body over the years. As soon as I get one cleared up the other side goes. The thing I've learned is making adjustments in movements, constantly trying new things ,and researching will heal them. The lower back can be the same way. That broom stick stretch looks great. One more weapon in the arsenal against impengments. Thanks a lot for the info.

**Gajanga** · 07-14-2005, 12:31 PM

If you feel a twinge while doing db bench, and then pust through it, then a few months later up the weight on your db military press and the shoulder feels like it's "slipping" for lack of better words, which injury do you think this would be? 3 months of rest later, and now in week 3 of workout again, dips don't hurt, but bench does, so it can't be done. Military press is crazy to even consider. Weight was 70lb db's on the military, now is 20lb db's, and a lot of stretching and rehab for the shoulder. I guess what I'm asking is, does this sound like an AC or r/c injury to you? I've had my shoulder x-rayed, and scheduled for an MRI, but not for several months.

**BernieD** · 07-14-2005, 03:30 PM

^^

I don't know as much about AC injuries, but it sounds as if it could be one. When I was looking up info for this article, I came across posts from this guy "Nainoa" here on BB.com about AC injuries. I tried emailing him once, but got no response. I would search for his posts though, as he seems to have a lot of knowledge about AC injuries...he had simple tests you could do to check pain, ROM etc. My understanding was that if overhead presses etc cause pain, then it could be an AC injury.

And the fact that dips don't hurt leads me to believe that it isn't the RC, but the AC...but this is just what I'm thinking, please DO NOT take this as actual medical advice, just my opinion

Also, to everyone else...in the exercise section of the article I added one more exercise that I'd forgot to put in....

http://www.thetrainingstationinc.com...exercises.html

Exercise 4 there (I did list this link in the article, but thought I'd repost it separately. Just be sure to go light weight.

**JNo20** · 07-14-2005, 03:45 PM

bump for a great thread

**xueimelynnad** · 07-15-2005, 11:10 AM

I tried those over the head broomstick things yesterday and its kicking my ass today, guess I wasnt as equal as I thought. One question with them though, should I keep my entire grip on the stick? I mostly just kept my thumb and index finger ringed around the stick so I could rotate my hands at the bottom of the movement, hope I didnt do it wrong.

**BernieD** · 07-26-2005, 09:24 PM

^oops, should've answered this awhile back, sorry.

Always keep your whole hand gripping the broomstick. Not sure if I understand you right, but you shouldn't be bending at the wrist at all.

Better late than never I guess...

After thinking about it a lot and trying some different things.....I've come to a conclusion: I now DEFINITELY prefer using dumbbell for the different rotations rather than the cables (see links above for the DB examples).

But before you go and reach for those dumbbells now instead, consider this:

If you're gonna do some of the above exercises as a warmup for an upper body workout just to get blood flowing to your shoulders, dumbbells MAY (keyword here) not be the answer for you. Why? DBs will tend to wear out your RC more than the cables will, for obvious reasons (machine vs freeweight). While following such a warmup routine, while your shoulder won't be sore necessarily for your workout, it will be a little more fatigued (but I also found that the more I did rotations with DBs for awhile, the less fatigued I was after). Often though, just waiting a couple minutes before you start your workout will make your shoulder fatigue go away, so even if you were to do a shoulder workout, I don't think it would interfere significantly. That being said though, this DOES deserve a mention (since we're always about safety, right?)

So if you will use DBs as a warmup for the RC before a workout, I'd definitely just try doing only internal and external rotations, 2 sets, around 10 reps (I'm not really a fan of going to failure, this will especially make your shoulders fatigued for the impending workout only minutes away). That should be sufficient.

Otherwise, you could just opt to go for cables.

On the other hand, if you are intent on REHABBING your RC, definitely go with the dumbbells! Not sure why I didn't like using DBs as much before...I think it was just cuz I liked the fact that there was constant tension on the RC with the cables, and that the ROM is somewhat greater/easier. But DBs will work the RC so much better. If you're one of those people that has had clicking/cracking in your shoulder for a longer period of time now, do 2 sets each of internal and external rotations with DBs (lying sideways on a bench) and I can almost guarantee you that your shoulder will feel better immediately after (I could be jinxing myself by saying that, as this is how it is for me, but try it and I think you'll suddenly hear/feel less cracking or noises and increased ROM and flexibility). Granted, this doesn't mean that the loose feeling in your shoulders will be permanent (cuz c'mon, then rehab would always be easy

), but it will definitely tell you you're on the right track.

Just a little update. I will try and edit some of these ideas into the original posts so that people don't miss this info. I'm also going to try and add some new information/observations later this week. The importance of a healthy RC CANNOT be underestimated, so there are always new things to learn and try.

And I'm spent.

**AussieLB** · 08-11-2005, 12:28 PM

Thanks to all for doing the hard work and writing this up - this is really informative.

I just wanted to add that my shoulder problems were caused by me doing poor form on a lot of exercises. Now I make sure I "Lock" my shoulder blades in before doing any shoulder work. This has improved the feel of the exercise, protected my shoulders and isolates my shoulder really well.

Thanks for going to such an effort - I have forwarded this on two three of my friends with similar problems.

**Gajanga** · 08-13-2005, 10:47 AM

Originally Posted by BernieD

do 2 sets each of internal and external rotations with DBs (lying sideways on a bench) and I can almost guarantee you that your shoulder will feel better immediately after

What are internal and external rotations w/db's? Lay sideways, then hold the db out to my front once, and out to my side once? Thanks.

**BernieD** · 08-13-2005, 11:51 AM

^http://www.thetrainingstationinc.com...exercises.html

more pics here: http://www.bodybuilding.com/fun/likness22.htm

exercises 2 and 3 on the first page. You can see animations of them there. For ex. 2, I like to do it so my forearm is vertical, not just up to shoulder level...up to shoulder level didn't really do much for me since the ROM is so small. Your elbow joint has to act like a hinge. Keep the elbow firmly at your side. Try 3 or 5 pound DBs to start, then gradually increase the weight. I get all the benefits I need though from 5 pounds, maybe 7.5 pounds. But of course, if you're a pretty big guy with like 18 inch arms hehe, 5 pounds may seem really light. But again, you don't need a lot of weight at all to strengthen your RC.

**pepingtom** · 08-13-2005, 03:22 PM

Originally Posted by BernieD

^http://www.thetrainingstationinc.com...exercises.html

more pics here: http://www.bodybuilding.com/fun/likness22.htm

exercises 2 and 3 on the first page. You can see animations of them there. For ex. 2, I like to do it so my forearm is vertical, not just up to shoulder level...up to shoulder level didn't really do much for me since the ROM is so small. Your elbow joint has to act like a hinge. Keep the elbow firmly at your side. Try 3 or 5 pound DBs to start, then gradually increase the weight. I get all the benefits I need though from 5 pounds, maybe 7.5 pounds. But of course, if you're a pretty big guy with like 18 inch arms hehe, 5 pounds may seem really light. But again, you don't need a lot of weight at all to strengthen your RC.

Aren't you suppose to stay at or below 5 pounds to effectively strengthen the rotator cuff and ligaments

**BernieD** · 10-06-2005, 04:25 PM

Shoulder Rehabilitation: Tips, Exercises and Routines

This article contains the following sections:

1: Introduction to Rotator Cuff

2: Stretches

3: Exercises

4: A sample routine

5: Exercises to be wary of

6: How to do certain exercises better

7: Further Reading

8: Final Thoughts

Section 1: Introduction

First off, let me explain something. I hesitate to call this a �complete� thread on shoulder injuries, as it is virtually impossible to cover everything. My hope is if you have a shoulder injury (or even if you don�t), that you will learn some valuable tips on how to rehab your shoulder and keep it healthy, what exercises to avoid, and how to do certain exercises better to minimize stress on the shoulders. But please keep in mind that you need to be careful doing any of these exercises. If you are in a lot of pain, then you should probably be going to a doctor or chiropractor. I cannot diagnose you. It may be your RC, it may be your AC. But if your shoulder has been a nagging injury (like it was for me) or if you just want to know how to take care of your shoulder better, then look no further.

As for me, I had a nagging RC injury for months and months. I trained through it (stupidly enough) and just went a little lighter on the weights. While my shoulder didn�t really get any worse, it didn�t get any better, either. So finally I decided to take action and really work on rehabbing my shoulder (or shoulders, I should say�I had impingement in both!)

Training the RC is extremely important for lifting. It gets used in most upper body exercises (even in tricep and bicep exercises to a certain extent) and constantly has to handle a lot of stress. If you keep it strong and healthy though, you can lift for a long time with no problems. I will not go into a detailed explanation of shoulder anatomy, as this is not the purpose of this article, but if you want more information on that then look HERE.

An obvious question becomes, how do I know if I even have an injured shoulder? If you have any pain, then there�s obviously something wrong. But there are other telltale signs, such as tenderness in the shoulder when you press on it, pain when lifting it overhead or to the side (i.e. lateral raise) or a limited Range Of Motion (ROM).

Here�s also a quick, easy test to try with which you can evaluate your shoulders. Stand facing a mirror, hands at your sides. If you can only see your thumbs and index fingers, then your posture is fine. If you can see your ring finger or even your whole palm, then your shoulders are out of whack. With the following exercises, your posture and your shoulders-hunched-forward look will improve.

According to a recent article in Men�s Health (yes, I�m referencing that magazine, don�t laugh

) shoulder impingement is the second most common sports injury behind a neck pull, so that will not only tell you how prevalent it is but then also how important it is to not be someone who adds to these statistics.

If you think and/or know that you have an AC injury, I�d recommend searching for posts by �Nainoa� on this board, he knows a lot of information about AC injuries. If it hurts to do overhead presses, then it is more likely an AC injury rather than an RC injury.

Well, that about does it for the intro, now let�s get down to business!

Section 2: Stretches

In case you didn�t already know, stretching is very important in lifting. Without it, you have a higher chance of injury (and who wouldn�t want to avoid that?) If you currently have shoulder problems, do them cautiously. You should feel a stretch when doing this, but not pain. Try holding the stretch for 15 seconds. I�d recommend doing them before and after every workout (even lower body work; squats place some stress on the shoulders as well).

Some great shoulder stretches are explained HERE (Go to the very bottom of the page).

Another great stretch is to bend your elbow so your forearm and upper arm create a 90 degree angle. Keeping this position, put your arm behind your back, palm facing away from you. The higher up you place your hand on your back, the greater the stretch. Experiment and see what position is comfortable for you. This is a great stretch that�s easy to do, and can be done in public without it looking awkward (I do these when I�m talking to someone all the time, although usually just when I�m sitting down).

**BernieD** · 10-06-2005, 04:26 PM

Section 3: Exercises

Well, here we go. I will make a list of the best RC exercises that I know of, and in the next section I will post a sample routine.

First off, the �Broomstick stretch� from the infamous Dante AKA Doggcrapp over at http://www.intens************

This exercise was extremely vital for rehabbing my shoulder. It increased my ROM, stopped any clicking, and was well, just plain awesome. I highly recommend doing this. (I do it everyday, except for on the same day of my chest workout and my shoulder workout, 40-50 repetitions). As explained in the thread, you will need a long broomstick (about 6-7 feet long) for it to be effective. A towel or anything else just won�t cut it. When starting off, first try 25 repetitions, then slowly work your way up to 50. By the time you get there, your shoulders will feel a lot better and a lot more flexible, whether you had a shoulder problem or not. In case you haven�t already noticed, I absolutely swear by this exercise. Read about it HERE

updatedInternal and External Rotations

These are another must for working the RC. View examples HERE Exercises 2 and 3

Here are some pics on how to do external rotations (http://www.bullz-eye.com/furci/2004/...l_rotation.htm)

This right here is the biggest change I�ve made to this article. Before I was all about using cables over dumbbells because cables gave you constant tension on the muscle. Now I realize how wrong I was! I started trying dumbbells (begrudgingly) and I was amazed at how much better my shoulders started to feel. So I hate to do it, but ignore what I said about cables and try dumbbells. If you�ve already been doing cables for awhile, then at least give dumbbells a try and see what you think. If you�ve tried neither, go for dumbbells and if that doesn�t seem to work for you then try cables. Again, to each their own, but dumbbells have been much better for me.

That trainingstationinc link above shows how to do DB internal and external rotations, but personally I don�t like their depiction of the exercise. It is common to go anywhere from 15 pound dumbbells on up to do said RC exercises, but I think you can get MUCH better results with trying less than 10 pounds (and increasing from there) by using a greater ROM.

Here�s how (this explains both internal and external rotation, only the grip is different).

Lie on your side on a bench (doing it on the floor won�t allow for the best ROM) or anything elevated. So try lying on your left side first. Hold the dumbbell in your right hand, and lay your forearm across your abs so that your arm is at a 90 degree angle and your elbow is by your waist.. Keep your right elbow FIXED at your side (it should NEVER leave your obliques). Slowly raise the dumbbell (NEVER moving your elbow joint, this is important: If you need to, you can cup your elbow with your other hand so it remains stationary) until your forearm is completely vertical (perpendicular to the ground, in other words). Then slowly come back down (slow negative). As for grip, there�s one for internal rotation and one for external rotation.

For internal rotation: Hold the dumbbell so it is parallel to the floor, palms facing towards you. In other words, you should be holding the dumbbell in the same position as if you were standing up and holding one at your side with a hammer grip (i.e. getting ready to do hammer curls).

For external rotation: Letting your forearm dangle, hold the dumbbell so that the end of it is
The Cuban Rotation:

View the exercise HERE

This is another great exercise to improve your external rotation. For this one, go very light weight (I cannot stress this enough, working your RC is not about using a lot of weight!). For many a barbell may be too much weight when starting out. I used one of those pre-fitted EZ bars at my gym, only 25 pounds. Again, you don�t need a lot of weight. Make sure your form is strict and controlled. Shoot for about 10-12 reps.

Scapular Retraction:

The Start: http://www.bodybuilding.com/fun/likness22g.jpg
The Finish: http://www.bodybuilding.com/fun/likness22h.jpg

This is a great exercise for your shoulder blades.. This will help you if you have rounded shoulders, as it works in pulling the shoulders back so that they�re in a more natural position. While this does not directly target the RC per se, I still found it to be a great exercise that worked really well. Again, use light weights anywhere between 5-20 pound dumbbells when you first try it. Shoot for about 10-15 reps and concentrate on really squeezing your shoulder blades together. If you go to heavy, you won�t be able to do this and you�ll compromise your form, which is always a no-no.

The Can Opener

I'm not sure of the actual name of this exercise, but I call it "The Can Opener" for lack of a better term. Check it out HERE (Exercise #4).

Make sure to do it with a light weight and slow, controlled reps.

New: Dumbbell Swing

These are done with pretty light weights, try under 10 pounds first then take it from there. Hold a dumbbell in one hand and then with the other hand lean down and support it on a bench, table, chair etc. With the dumbbell in hand, do a circular rotation i.e. make a circle by moving your arm from your shoulder, keeping the arm straight. First try making a very small circle, then once it gets easier you can increase the ROM by making very big circles. Aim for 10-20 rotations with each hand.

Other exercises:

http://www.ncsf.org/tools/video.aspx#9

This website has a bunch of rotator cuff exercises. I have tried a bunch of them, and personally I don�t feel that they did much for me, but of course I�m not like everybody else, so if you try them and you like them, then by all means use them. I think a better alternative to some of these is doing the rotations lying on your side, rather than on your back.

Note: The exercises I have outlined are by no means the only RC exercises. They are some of the most common ones though (especially the internal and external rotations) and they are what worked best for me (but again, I can�t speak for everyone).

updatedSection 4: A Sample Routine

The following is a sample routine for the aforementioned exercises. Ideally you would do them before every upper body workout. But then again, this routine can also be time-consuming, so if you want to use the RC exercises as a warmu , you could limit the routine to just internal rotation and then external rotation. [i]A note about poundage: I know I�ve said this earlier, but don�t scoff when I say to try 5 pounds. Sure, most people would be able to do it fine, but when my RC was bad 5 pounds felt like a lot. RC exercises, again, have really no implication for muscle gains, purely for rehab/strength. You don�t need heavy weights (and yes, I realize that strength training is usually associated with heavy weights, but this is different

)

Exercise 1: Internal Rotation with dumbbells

2-3 sets, go to failure or 20 reps, whichever comes first (if you can do 20 reps without feeling much of a �burn� or fatigue in your shoulder, then increase the weight. Try 5 pounds first and see how it feels, then adjust accordingly. Remember, it should not hurt, you should just feel the RC working. Also, don�t forget that I think a full ROM is optimal, so start with your forearm hanging down perpendicular to the floor and then lift up the weight (keeping your elbow fixed at your side) until your forearm is upright and again perpendicular to the floor. Again, PLEASE read Section 3 above on how to do the exercise correctly.

Exercise 2: External Rotation with dumbbells.

2-3 sets, go to failure or 20 reps, whichever comes first (if you can do 20 reps without feeling much of a �burn� or fatigue in your shoulder, then increase the weight. Try 5 pounds first and see how it feels, then adjust accordingly. Remember, it should not hurt, you should just feel the RC working. Also, don�t forget that I think a full ROM is optimal, so start with your forearm hanging down perpendicular to the floor and then lift up the weight (keeping your elbow fixed at your side) until your forearm is upright and again perpendicular to the floor. Again, PLEASE read Section 3 above on how to do the exercise correctly.

Exercise 3: Cuban Rotation

2-3 sets, 10-12 reps, start off somewhere between a 15 pound to 40 pound EZ-bar and go from there

Exercise 4: Scapular Retraction

2-3 sets, 10-15 reps, try dumbbells anywhere between 10-20 pounds and go up from there. Remember to really squeeze those shoulder blades

**BernieD** · 10-06-2005, 04:29 PM

Section 5: Exercises to be wary of

This section of the article will probably be very controversial. I will give a list of exercises that I think should not be done at all (for someone with healthy or bad shoulders) and some that should be avoided if you have shoulder problems (granted, the best thing is to not be lifting at all if you have a bad shoulder, but if it is only minor and nagging, it is still very common to see guys just working through it). Ultimately, you have to be the judge. But remember�just because the exercise doesn�t cause pain, does not mean it can�t cause problems in the long run. Here are some of my suggestions:

1) Upright Rows: I think that these should be avoided entirely. Again, I will emphasize that this isn�t true for everyone, but they have a high probability of causing impingement

2) Pec Deck: If your shoulders are fine, go for it. But if you have any shoulder issues, steer clear.

3) Incline, Decline, Flat Flyes: Same as above. If your shoulders are fine, go for it. If not, be wary

4) Chest/Tricep Dips: Same as above. If you have bad shoulders avoid them. Otherwise, go ahead. Just be sure to not go past parallel to the ground with your upper arms.

5) Shoulder and Chest Presses (including Bench Press): These will most certainly aggravate your bad shoulder. Try to avoid these if you have shoulder problems.

6) Overhead Tricep Extension, seated or lying down (with barbell or dumbbell): These put a lot of stress on your shoulders, so if you have any issues, avoid them.

Realistically, I could go on forever, as almost every upper body exercise involves the shoulders, but I think these are some of the top ones to avoid. You could argue that Any type of lateral or front raise should be in there too, but since you do usually go lighter with them anyway, I�ll leave that for you to decide whether to do them or not if you have a bad shoulder. Only you can judge what your body can handle, not me.

Section 6: How to do certain exercises better

Through my training, I found ways to change an exercise a little bit so that if you have shoulder problems, and even if you don�t, you can perform them without putting too much stress on the shoulders. Again, you have to be your own judge. I could do most of these exercises without pain when my RC was bad, but that does not mean that this will be true for everybody. My point is, tread cautiously. Use these suggestions as a guide and hopefully they will help you.

1) Flat, Incline or Decline Dumbbell or Barbell Press: When lowering the barbell or dumbbell, don�t go all the way to your chest. The point of doing these exercises is mainly to work your chest, and if you go too low, your shoulders will start doing all the work. Try it out for yourself to see what�s comfortable for you, but I would stop 3-4 inches above your chest. This will keep the stress on your chest (good) and off your shoulders (also good).
2) Pullups or Chinups: On the negative part of these exercises, don�t quite go down all the way so that your arms are completely straight. This will put a lot of stress on your shoulders.
3) Pushups: Changing your hand positioning will reduce the stress on your shoulders. When my RC was bad, regular pushups caused me pain. But changing the hand position made them pain-free. For example, let�s say your right shoulder is your bad one. When you get into pushup position, move your right hand back a couple inches, but keep your left hand where it was. Although some will decry that this will work your muscles different from the classic pushup, if you have a bad shoulder pushups might be painful, but putting the arm with the bad shoulders a couple inches back will greatly reduce the stress on your shoulders.
4) Skullcrushers or Lying tricep extensions: Instead of doing them on a flat bench, which is the most common way, try doing them on a slight incline. This will greatly reduce the stress on your shoulders. Even now that my shoulders are OK, I still do extensions on a slight incline (the lowest the bench will go without being flat, I think that�s at 15 degrees).

That�s about all I can think of on how to perform certain exercises better to reduce stress on your shoulders. If I come up with anymore ideas I�ll add them, or if anyone else has suggestions I will gladly add them and credit you as the source.

Section 7: Further Reading

Here are some articles on shoulder rehabilitation if you�re interested in further reading:

http://www.findarticles.com/p/articl...18/ai_83343027

http://www.t-nation.com/findArticle....=body_145shldr

http://www.bodybuilding.com/fun/bbin...oulderInjuries

Section 8: Final Thoughts

If you�re reading this, well then thank you for making it this far! This took me a long time to write up, and I hope you have gained some new knowledge, whether you�re a novice or veteran of lifting, whether you have healthy shoulders or you don�t. I would just like to stress again that these exercises aren�t about how much weight you can do. Form and control are paramount. If you have any suggestions or comments or questions, please say something! If there�s something in here you disagree with, tell me why. As long as you give me a good reason, I�ll listen. But if you just say �your article sucks,� it�ll fall on deaf ears. I want to know why it �sucks� and what I can change. I wrote this as a service to everyone out there, healthy shoulders or not, and show you what has worked for me. If you even gain one tip or one exercise or whatever from this, then I�ll be happy. If not, that�s fine too. Good luck!

**BernieD** · 10-06-2005, 04:30 PM

For some damn reason I can't edit the original posts, so you'll have to scroll all the way down here to read the updated article. The main portions updated are sections 3 and 4.

Thread: The Complete Shoulder and RC Injury Article

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The Complete Shoulder and RC Injury Article

This is an excellent thread!

Updated Article

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