In the fitness world, there is a dictionary full of unwritten rules that should be known amongst all gym-goers. Some of the more common ones you should probably know (if you haven’t heard already) are:
- Never do bicep curls in the squat rack.
- Don’t post videos of god-awful deadlift technique unless you want to get ridiculed.
- Don’t skip leg day.
- Don’t be that guy who keeps the weightlifting belt on for his entire one-hour session (warmup included)
- The gym is not a place to pick up/or be picked up. Leave her alone while she works, buddy. And quit trying to flirt with all the guys while they lift, girl with too much makeup wearing only a sports bra.
- Always focus on scapular stability before force production.
Shoulder pain makes up the third most common cause of musculoskeletal consultation in primary care. Studies have shown that 34% of asymptomatic individuals (present with no shoulder pain and normal shoulder function) actually present rotator cuff tears under MRI, and that number almost doubles in clients older than 60 years old (54%). That’s a staggering number that can often times go unnoticed if no symptoms are present, leading to exacerbated damage that will only cause detrimental effects down the road. Building up scapular stability and cuff strength is absolutely imperative in order to prevent injury in everyday situations, and also for eliminating irritations caused by pressing movements. Injuries and conditions such as bicep tendonitis/tendinopathy, rotator cuff tendonitis/tendinopathy, muscle strains, neck/arm pain, overuse injuries, pinched nerves, rotator cuff syndrome, rotator cuff tears, repetitive strain injury, shoulder impingement, and thoracic outlet syndrome can all be controlled and minimized with sufficient scapular stability, positioning and control. I don’t know about you, but that’s enough to convince me to focus on a few exercises to knock off a giant list of potential risks.
The issue with shoulder prehab drills unfortunately, is a lot of individuals think that simply activating the rotator cuff with a myriad of dumbbell, band and bodyweight activities is sufficient enough to warrant “warming up the shoulders”. The concern with this is two-fold. First, the rotator cuff’s main goal and priority is to maintain glenohumeral congruency (or, to keep the “ball” in the “socket”). These types of exercises often don’t take into account the need to maintain glenohumeral congruency while moving the scapula (shoulder blade) (ie. like during overhead and horizontal pressing). Second, these types of exercises (even if they do incorporate scapular movement) are only beneficial if the scapula is properly positioned in the first place. If you are severely rounded over, or have forward head posture, no amount of scapular stability drills will correct your issues. You need to incorporate thoracic extension, inhibit overactive/tight muscles, facilitate underactive/stretched muscles, and work on getting your shoulder blades sitting in a proper position before beginning stability drills. If you struggle with these, don’t even think about overhead pressing until the issue is corrected (or if the training facility you attend doesn’t pay any attention to these issues, and insists on throwing you under a barbell along with everyone else, give your head a shake and get a refund).
There are a lot of factors that go into proper scapular positioning and whether or not you should be able to press overhead. While I understand everyone’s desire to clean and jerk or snatch more than their poker buddies, the reward will never outweigh the risks if it leaves you debilitated two years from now. Ever felt completely useless and suffered through pain beyond measure with EVERYTHING you do (no matter how big or small)? Experience a shoulder injury. You will never take for granted getting your favourite coffee mug from the cupboard ever again.
Overhead pressing is a staple in a lot of people’s exercise programs, and for good reason. Being strong overhead is a great component of strength, in a similar fashion to getting strong with hip dominant/knee dominant/pulling exercises etc. (IF you are able to do so safely). Unfortunately, a vast majority of the population isn’t in a position to press overhead without risking injury. Not only do they not possess enough cuff strength to dynamically stabilize, but their scapula are not positioned properly on their rib cage to warrant proper movement either.
So, HOW DO I FIX THIS SO I CAN START TRAINING OVERHEAD? Ask your trainer for an assessment to determine if your scapula are sitting properly while at rest? Wrong. Studies show it is hard to place an emphasis on resting scapular posture, as they do not correlate to risk of injury, or poor movement patterns. Furthermore, resting posture tests have proven inconclusive at identifying people with or without shoulder injuries. While it may seem like your trainer is adding value and using it as an opportunity to show you they are “educated” better than the next guy, he’s actually feeding you a crock of ****, wasting your time, and stealing your money. He/She can try to cue you into a proper position all they want, but if they haven’t addressed alignment and soft tissue restrictions causing the improper positioning in the first place, they are simply making things much worse for you. For instance, a rounded-over posture might be causing levator scapulae and pec minor shortness, contributing to scapular downward rotation and protraction. Simply attempting to cue the individual into the proper position without focusing on the underlying tissue length restriction will do nothing but crank your client into a distorted Picasso painting.
The key to preventing shoulder injury is maintaining scapular stability while activating the surrounding musculature. No amount of lower trapezius or serratus anterior work will matter if you can’t control the shoulder blades in the presence of the change (ie. while performing the drills). After all, the definition of stability is resistance to change. If you can’t maintain sufficient thoracic extension, lower trapezius and external rotation activation while lifting your hands overhead, what makes you think you will be able to when you have a bar or weights in your hand? If you can’t maintain serratus anterior activation while performing a pushup, what makes you think that shoulder blade will stay tight to your ribcage while performing a bench press? If your lats are too tight and you don’t address their tissue length prior to exercising, what makes you think your lower traps, upper traps and serratus anterior will all fire when you need them most to stabilize overhead? The truth is, there is no simple answer. The shoulder is a super complex entity, and not treating it as one is a fitness sin. Performing overhead pressing movements without being assessed, focusing on scapular stability, positioning and control is a downright crime. At Redline Conditioning, we use a variety of exercises that focus on scapular stability IN THE PRESENCE of proper scapular positioning and control for all of our members. We aren’t scared to tell some of our members that they aren’t allowed to press overhead, or that they aren’t allowed to perform Olympic lifts. Think that stops them from having an amazing workout, setting new strength PR’s, or leaving with a smile on their face? Think again. If you are looking for a change, with coaches who understand how the body works and why it works the way it does, if you are looking for an individualized approach to your fitness program that will allow you to achieve significant results and gains without sacrificing injury management, contact us today! firstname.lastname@example.org