7 Reasons Why Your Shoulders Get Hurt in the Gym: Part 3

I’m excited for this part of the article series because we’re finally tying together all of the aspects explored in the previous articles.   At last we get to the practical stuff.  In part 1 we talked about rotator cuff strength, pressing and rotator cuff stress, press to pull balance and spikes in training volume.  Definitely check that article out if you haven’t yet.  In part 2 we spoke about how deficits in strength as well as stability create suboptimal positions during training that lead to injury.  We went over the specific shoulders positions that create this.  This last article series shows the specific technical faults that lead to injury and how to spot and correct them.

Most coaches I’ve met already have a good understanding about what good or bad positions are in the gym but sometimes are lacking some knowledge about why this happens.  On the opposite sign of the coin most therapists I know don’t always understand what good and bad positions are for these movements because we just aren’t used to coaching and teaching the lifts.  The goal of this article was to help bridge the gap some.

We’ll be going over 4 major movement patterns:

  • Overhead Pressing 
  • Pull-ups
  • Dips, Pushups and Bench Press
  • Horizontal rowing

1: Overhead Press

I made a nice little image below to help you understand the dynamics that must occur for a proper press.  We want to adopt enough:

  • Thoracic spine extension
  • Scapular posterior tilt
  • Scapular upward rotation

Remember that people can lack solid technique for mobility, strength or technical issues.  Technical issues can be cued through.  Mobility issues will require a more thorough assessment and mobility intervention before technique cleans up.  Lastly, strength issues usually become apparent when technique starts to break down as the load increases.  Just make sure you have the correct intervention for the technical problem.

2: Pull-ups

This time I made a video describing all of the motions that we want to occur when we hang from a bar for pull-ups.  At the end of the video there are some cues and drills to help your athletes hit these positions.  Again, just keep in mind that these can be strength, mobility or technical issues and need to be treated accordingly.

3: Dips, Bench Press, Push-ups

When it comes to dips I see most men limited by mobility issues where most women are limited by strength.  Now, this does not mean that a man can’t have more strength issues and women more mobility issues but it’s just what I tend to see.  Either way, when these issues exist, this is what the compensation tends to look like:

The infographic above can show you good vs. bad positions and what is actually going on at the shoulder blade level when this happens.

When it comes to the bench press what I see most frequently are individuals who don’t retract enough in their set-up position.  We’re purposely trying to create an arch in the spine to promote an open subacromial space.  The other error I see sometimes in the bench press is the head lifting off the bench when the bar gets to the chest.  I feel this is an attempt to move through the spine and shoulder blades more to create some extra strength for the lift.  This may end up getting you some more weight on the bar but could also irritate the rotator cuff in the process

The push-up is another interesting movement that commonly gets performed incorrectly.  What I tend to see are individuals that anteriorly tilt the shoulder blade and poke their shoulders forward at the bottom of a pushup and then aggressively arch the spine to finish the repetition.  I feel these are mainly people who lack the strength to maintain an optimal push-up posture and are just substituting strength at the shoulder for strength elsewhere (mainly the spine and shoulder blade).

There you have it!  Hopefully the infographics I created help stir you in the right direction to help your clients out.  The goal of this article series was to share why I think athletes are getting shoulder pain in the gym.  Armed with this knowledge it gets much easier to not only rehabilitate athletes but keeping everyone healthy in the future.

Lastly, Dr. Dave Tilley from shiftmovementscience.com and myself have been working on a big new shoulder product for physical therapists, athletes and coaches.  The goal is to help get athletes out of pain, perform optimally and stay healthy in the long run.  Sign up below if you’re interested in being notified when it’s released with a special discount.

Talk soon,

Dan Pope DPT, OCS, CSCS, CF L1

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