No pain, no gain! Everybody is familiar with this expression. But if you suffer discomfort during a shoulder workout, it could spell trouble. What starts as a twinge can soon get worse, yet many gymgoers ignore it until the pain becomes intolerable.
It’s a familiar tale. Shoulder injuries are among the most common in the gym and often require lengthy rehabilitation or surgery. Well-intentioned but harmful advice often makes matters worse.
The bottom line is that the shoulder is a complex joint. It’s worth taking time to learn the basics and following the steps necessary to prevent your gains from being compromised by injury.
The shoulder is the most flexible joint in the body, but the flip side is, it’s also one of the less stable.
I say “joint,” but it is not actually a single joint. It is the articulation between the head of the humerus bone on the upper arm and the glenoid fossa socket on the shoulder. It’s often likened to a golf ball resting on a rather large tee. The joint is designed for maximum mobility to allow a broad spectrum of upper-body movement, but this inherent instability is at the root of many problems.
The rotator cuff is crucial because it stabilizes the shoulder. Most shoulder injuries affect the rotator cuff, and the purpose of most rehab work is to strengthen it.
The rotator cuff consists of four muscles that can be remembered by the acronym SITS: supraspinatus, infra-spinatus, teres minor, and subscapularis. These muscles originate from different parts of the scapula (shoulder blade) and insert into the humeral head, converging together into a tendinous “cuff ” around the joint.
Problems usually occur when tight internal shoulder rotators pull the humeral head forward and inward. If the external shoulder rotators are weak, they are unable to counteract this force, and this leads to pain in the rotator cuff.
Although the pain is felt in the shoulder, the root of the problem is usually more widespread. The chest, back, and biceps muscles all traverse the shoulders, so every upper-body workout activates the rotator cuff to some extent. Unfortunately, many of the exercises we do for these body parts cause internal shoulder rotation. There is a mismatch between the internal and external shoulder rotators. Guys who hammer their pecs and lats are potentially storing up problems by overtraining their internal rotators and neglecting their external rotators.
Evidence
1. Studies testing the rotator cuff strength of patients with shoulder impingement syndrome consistently show muscular imbalances between external rotator and internal rotator muscles of the injured shoulder.
2. Significant decreases in electrical activity in the supraspinatus and infra-spinatus rotator cuff muscles were found in subjects with shoulder impingement syndrome compared with uninjured subjects.
3. A number of studies have measured the strength ratio of the external rotators and internal rotators in healthy uninjured subjects. They report that one should be at least 60 to 70% as strong as the corresponding muscle group. So if your internal rotators can lift a weight of 10 pounds, your external rotators should be able to pull a weight of between 6.5 and 7.5 pounds to prevent muscular imbalances.
1. Do not ignore shoulder pain. Training through it will lead to more serious injury, which will require longer and more invasive treatment. If you experience pain, incorporate rest and a modification period into your program to keep the muscles from grating and teach them how to be exercised safely.
2. Be wary of exercises that require excessive internal rotation of the shoulder, such as front raises, lateral raises with thumbs down, and upright rows. These moves put the supraspinatus muscle in a potentially compromised position.
3. Strengthen your middle and lower trapezius and rhomboids to increase shoulder blade stability. Try reverse flyes with straight elbows to hit the middle traps.
4. Keep external rotators strong and internal rotator muscles flexible to avoid a poor internal/external strength ratio, which results in the humeral head pulling forward. Regular stretching after workouts helps.
Try This Workout
If you search for rotator cuff exercises on the Internet, a plethora of generic moves appears. The exercises here don’t cover everything, but they are the most effective moves for guys looking to improve their range of motion and the strength of their rotator cuff and scapula.
The rotator cuff is composed of a similar number of slow and fast-twitch muscle fibers, so your aim should be to increase muscular endurance, and you should vary the tempo. Resist the urge to go heavy: This program is about preventing injury rather than hypertrophy, so it’s a short-term measure that will allow you to gain without pain afterward.
Incorporate the following exercises into your routine for four weeks. They will greatly increase your chances of avoiding injury and allow you to blast your delts safely in the months to follow.
In Weeks 1 and 2, do 3 x 30 reps and adopt a slow tempo of 3 seconds up, 3 seconds hold, 3 seconds down.
In Weeks 3 and 4, do 4 x 20 reps, adopting a fast tempo of 1 second up, 0 second hold, and 2 seconds down.
