Single Important Thing You Need To Know About shoulder injury
It is probably safe to say that virtually anyone who has worked out for more than two or three years has experienced shoulder pain at one time or another. More than any other joint, the shoulder seems particularly prone to injury, both chronic and acute. Once shoulder pain has set in, even routine daily tasks, such as putting on a shirt overhead or shampooing in the shower, can become burdensome. Training seems beyond the bounds of possibility since nearly all movements involve the shoulder in varying degrees. Even squatting and calf raises involve, and can aggravate, shoulder problems.
The glenohumeral joint (where the head of the humerus attaches to the shoulder complex) is a ball-and-socket type joint. But unlike the hip, the G/H joint is quite shallow—so much so that the bones contribute little to the joint’s stability. That role falls onto the surrounding muscles and their tenuous attachments, as well as the capsular ligaments. Always remember that the shoulder’s forte is mobility, not stability. The second structural factor leading to shoulder dysfunction is the enormous leverage that can be applied to the shallow G/H joint by the arm. Consider that for a person of average arm length, a ten-pound dumbbell in the hand equates to over 45 pounds of force at the shoulder joint when held out at arm’s length, such as in a lateral raise.
Sports-Related Shoulder Injuries
In many sports—including skating, soccer, football, wrestling, and baseball—falling is inevitable. During a fall, the hand instinctively reaches out to break the fall, decelerating the body’s downward movement with the arm outstretched. This instinctive reaction creates a long lever, which results in tremendous mechanical forces on the G/H joint-fulcrum. This often leads to injuries ranging from strains and sprains of the surrounding muscles and ligaments to subluxation (less than a full dislocation) or, in the worst-case scenarios, dislocation of the joint.
Not just in the sense of throwing a ball, but also any hitting or swinging movement (such as a tennis serve or hitting a baseball) is essentially an attempt to separate the G/H joint, in biomechanical terms. During any throwing movement, the rotator cuff muscle group is responsible for decelerating the arm after the object has been released. Since many individuals have very weak rotator cuffs and posterior deltoids as compared to the anterior shoulder muscles, the deceleration aspect of the throw often results in strains and sprains of the shoulder’s soft tissues, especially those of the rotator cuff.
Football, boxing, wrestling, soccer, basketball, and various other sports involve direct, and often violent, impact to the shoulder and arm. Direct blows to the upper arm in particular can “pry” the G/H joint apart, creating injuries ranging from microtraumatic soft tissue injuries to shoulder separations. Additionally, multiple shoulder injuries stemming from years of athletic participation often result in adhesions, loss of range of motion, calcium deposits, and degenerative changes to the joint itself. With each new injury, the shoulder becomes both more prone to, as well as less capable of, withstanding further injuries.
Training-Related Shoulder Injuries
The most popular chest exercise, this movement also results in legions of shoulder injuries. Besides contributing to the imbalance between the anterior and posterior muscles of the shoulders, the bench press has an almost mystical allure for many trainees, making it more of a demonstration event than a training exercise for many. The bench is the vehicle for more forced reps, heavy negatives, missed attempts, and bad training form than any other exercise. Over 90% of all shoulder injuries from bench pressing occur during the transition or amortization phase between the negative and positive portions of the movement. Specifically, a rapid lowering of the bar prior to pressing upward results in large linear momentum forces, which must then be quickly reversed by the shoulder musculature before the bar can be raised. When these forces exceed the strength of the joint mechanism, the shoulder may not be capable of reversing the accumulated momentum, which means that the lifter will miss the lift, suffer a muscle tear, or both. For this reason, always lower the bar with complete control. This does not mean a full pause, however! Unless you are a competitive powerlifter, a controlled “touch-and-go” movement is best.
As noted earlier, most people neglect the posterior shoulder musculature in their training. Most popular gym exercises—bench presses, seated presses, lat pulldowns, and so on—involve external rotation of the humerus at the shoulder joint. The movements that work the internal rotators or rotator cuff (bent laterals, etc.) have little or no cosmetic value. So few people do them, that is, until they suffer a shoulder injury. Eventually, the weaker rotator cuff becomes virtually useless in performing its intended role in stabilizing the shoulder.
Not in the traditional sense (i.e., performing deltoid exercises too frequently), but in the sense that whenever you have a bar or dumbbell in your hand, there is stress on the shoulder joint. So from this perspective, even exercises for the back, biceps, or triceps can significantly aggravate existing chronic shoulder symptoms. Avoiding this type of overuse demands that you take a purposeful, conscious approach to nearly every movement you make—both in and out of the gym! Some of the most common movements, such as getting up off of the floor after doing crunches, opening a car door, or putting on a sweater can add stress to a malfunctioning shoulder.
Strengthen the Arms!
This may seem like odd advice, but the fact remains that your arms are the conduits through which forces are transmitted to the shoulder. If your arms are weak, the shoulders must pick up the slack. If you find that during dumbbell benches or inclines you have a harder time picking the dumbbells up and getting into position than doing the exercise itself, you need to strengthen your arms. Heavy dumbbell curls, hammer curls (i.e., with thumbs up), and dumbbell triceps extensions will go a long way in strengthening your biceps, triceps, and brachioradialis muscles, as well as indirectly fortifying the shoulder girdle itself. Get yourself to the point where you can handle heavy dumbbells with ease. Machines are okay, but they do not challenge the synergistic and stabilizing muscles nearly as well as dumbbells.
Circumvent Problematic Exercises
If military presses (for example) cause you shoulder pain, do not do them, even if every shoulder-training article you have ever read says that military presses are the best shoulder exercise going. For you, they might aggravate prior or existing injuries, or it may simply be that your particular shoulder structure is not well suited to the exercise(s) in question. In either case, make modifications (such as grip, range of motion, or slight deviations from the usual movement pattern) or use another exercise altogether.
Bench Press Technique
As noted earlier, a controlled descent of the bar is essential. Another fine point: most benches are 11” wide. This is necessary to allow proper range of motion during the lift, but it creates a very narrow support for the scapulae. To keep your shoulder blades supported during bench presses, shrug them together as if “pinching a quarter” between them and also tighten the upper back just prior to un-racking the bar. In this way, the scapulae will remain supported by the bench during the lift. Your shoulder joints will thank you! A final note on benching: The authors have observed everything from trainees putting both feet up on the bench (better “isolation,” supposedly) to keeping one foot on the bench and one on the floor, to pinching the knees together during the lift. All of these technique deformities create an unstable base, which can lead to injury. Keep both feet flat on the floor, a bit wider than shoulder width, and keep them there during the lift. Use your feet like the extended pods of a backhoe for support and stability during the lift. If you cannot keep your feet from “fidgeting” during the lift, you are using too much weight!
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