I see a lot of shoulder pain in my clinical practice. It probably rivals low back pain with the most common injury I end up treating (Low back pain is more common in the general population). For this reason I think it’s imperative that we take care of our shoulders.
One topic tendon researcher Jill Cook describes in the British Journal of Sports Medicine is “tissue capacity” The concept is simple. Basically all of our tissues (all shoulder parts included) need to be prepared for the demands of whatever they have being thrown at them. We need to build “capacity” in our shoulder to handle the forces of what we want to do in the gym.
Research from Tim Gabbett is clear. Throwing too much, too soon at our bodies without thorough preparation increases injury risk. “Spikes” in training volume can do the same. Lastly, maintaining a high level of chronic workload can help prevent injury.
If you haven’t checked out any of Yann Le Meur’s infographic work yet I highly, HIGHLY recommend it.
Now, most of this research has been done in soccer and rugby players but I think the message can transfer to our work in the gym. We need to prepare our tissues for the demands we’re throwing at it.
When we’re designing a health circuit for the shoulder I take 2 things into consideration:
1: EMG activity is not the be all, end all of deciding which exercises to use in a given program but I think it gives us a start. The supraspinatus rotator cuff tendon is the most commonly injured tendon and I think we should be focusing some of our efforts on it. Keep in mind that reasons for supraspinatus injury are not purely that the muscle is not strong and prepared enough, but when trying to build tissue capacity we should be focusing on it.
2: Specificity – The exercises we choose need to closely mimic the movements we are going to be faced with during training and competition. I’m a huge fan of sidelying dumbbell external rotation but it isn’t the most specific exercise to prepare you for a kipping handstand pushup.
With that being said we’ll need a combination of open chain exercises (where the weight moves and the shoulder stays stationary) which carry over to barbell lifts and we’ll also need closed chain exercises (where the hand stays stationary and the shoulder moves) that have carry over to pushups, handstands and handstand pushups.
With that in mind here’s how I like to put it together:
Super simple, effective and efficient way to improve shoulder internal rotation motion and rotator cuff strength. 1) Having adequate internal rotation ROM is vital to decrease compensation during the snatch (elbows high and outside position). This keeps the subacromial space open and the biceps and rotator cuff happy. Eccentric work going through a full ROM helps increase mobility. 2) This exercise improves shoulder stability with specific emphasis on lowering bars from overhead. Performing high rep sets of touch and go snatches challenges the posterior shoulder, particularly when lowering the barbell from overhead to waist level. This movement mimics the lowering portion of the snatch helping to strengthen the shoulder complex for that specific movement. I use exercises like this once per week at the end of a snatch or upper body dominant day. If you know someone who can benefit from this please share! @powermonkeyfitness #physicaltherapy #fitness #rotatorcuff #olympicweightlifting @themovementfix @suppleperformance @thehybridperspective @edge_mobility_system @mikecerbus @olychad @thebarbellphysio
Keep in mind that shoulder flexion (Bringing your arms overhead) activates the superior (supraspinatus) and posterior (infraspinatus and teres minor) rotator cuff. A tempo overhead press is certainly a specific exercise that will help with tendon health of those muscles when used appropriately.
I like to pick 3 exercises (1 from each category) and perform 3 sets of 8-12 repetitions of each once per week. Also make sure your programming has plenty of pulling exercises to balance out the pressing and posterior cuff work. Also leep in mind that pulling exercises helps work the front side of the rotator cuff. Certainly adding in some extra work consistently will help to build tissue capacity and keep those shoulders healthy! Give some of these exercises a shot and let me know how it goes.
Dan Pope DPT, OCS, CSCS, CF-L1
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