With this week's $50 off sale on Sturdy Shoulder Solutions, (using coupon code podcast5), let's cover a question I got a while back. A reader asked whether it was ever useful to train shoulder internal rotation. With the lats and pecs (both internal rotators) always getting blasted in a typical strength training program, is any specific work for internal rotation ever recommended? My response warranted a three-part video, which I've compiled into one here:
To learn more about how I assess, program, and coach at the shoulder girdle, check out Sturdy Shoulder Solutions. It's on sale for $50 off through Sunday at midnight. Just use coupon code podcast50 at checkout.
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Our professional baseball guys are rolling back in to kick off the offseason, so I wanted to offer a sale to celebrate this fun time of year. What better way to celebrate the unofficial start of the baseball offseason than to put my shoulder course, Sturdy Shoulder Solutions, on sale for $50 off through Sunday?
This product includes over six hours of cutting edge assessment, coaching, and programming strategies. You can learn more at the following link (with the discount automatically applied):
How Posture Impacts Pain and Performance (Webinar)
Important Upper Extremity Functional Anatomy Considerations (Webinar)
The Proximal-to-Distal Principle (Webinar)
Nuances of the Neck (Webinar)
Rethinking the Thoracic Spine (Webinar)
Making Sense of Serratus Anterior (Webinar)
Is Upper Trapezius the Devil? (Lab)
The Myth of Normal Range of Motion (Lab)
Rethinking the Thoracic Spine (Lab)
Making Sense of Serratus Anterior (Lab)
Good Exercises Gone Bad (Lab)
The Myth of Balancing Pushes and Pulls (Lab)
It's a great fit for personal trainers, strength and conditioning coaches, sports coaches, and rehabilitation specialists. Additionally, many fitness enthusiasts will appreciate the focus on individualizing programming recommendations and technique coaching strategies.
In particular, it’s a tremendous fit for anyone who has previously been exposed to our Optimal Shoulder Performance and Functional Stability Training products. Sturdy Shoulder Solutions serves as an up-to-date companion to the educational material covered in those previous offerings.
You'll get instant online access to this digital-only product after purchase. Just head to http://www.SturdyShoulders.com to pick it up.
The supine banded shoulder flexion on roller is a new shoulder mobility drill I came up with that is really growing on me quickly. Effectively, it's an alternative to a back to wall shoulder flexion for those who may struggle to "compete against" gravity as they take the arms overhead in the standing position.
In this drill:
1. The foam roller provides feedback for posterior pelvic tilt, thoracic extension, and a more neutral cervical spine posture.
2. Gravity assists the individual into overhead motion to overcome stiffness through the lats, teres major, long head of triceps, inferior capsule, pec minor, etc.
3. The fact that the roller doesn't impede scapular motion (like the wall or floor would) makes it easier to achieve some scapular posterior tilt as the arms go overhead.
4. The supinated grip drives some shoulder external rotation, placing the lats on stretch in the transverse plane so that folks can't "cheat" the movement by letting their hands drift toward the midline.
5. The band creates some posterior rotator cuff recruitment,
I'll take this over a few sets of ugly band pullaparts any day. What's not to like?
Looking for more cutting-edge shoulder strategies like these? Check out my new resource, Sturdy Shoulder Solutions at www.SturdyShoulders.com.
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Sturdy Shoulder Solutions is one of my most popular products of all time, and I want to give you a little sampling of what's included. In this TRX serratus anterior exercise video excerpt, I talk about the importance of getting good scapulothoracic (shoulder blade on rib cage) movement so that you don't have to find extra glenohumeral (ball on socket) motion. Check it out:
This is a key shoulder health principle I cover in great detail in this resource. You can learn more at www.SturdyShoulders.com.
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The shoulder girdle is a complex series of joints unified by subtle movements in perfect timing. If you need proof, just check out this slide from my popular, Sturdy Shoulder Solutions.
This study looked at the difference between the empty can and full can in terms of both muscular recruitment and actual movement in folks with symptomatic impingement vs. healthy controls. Not surprisingly, the empty can exercise hurt more. Just looking at this picture hurts my shoulder (and my shirt is wildly fitting).
To me, though, that's not the most significant takeaway from these study results. Rather, take a look at some of the numbers included in their findings: 1-3 degrees (joint movement) and 1-4% (muscular activation). These are subtle, subtle quantifiable differences between those in pain and those who are pain free - and most of them really can't be perceived "on the fly."
What does this mean for how you assess, program, and coach?
First, from an evaluation standpoint, we have to truly understand what quality movement should look and feel like. If you can't truly define "normal," then how can you ever truly appreciate "abnormal?"
Second, not all exercises are created equal (as we learned from the empty vs. full can discussion).
Third, in coaching, we have to constantly solicit feedback from our athletes on where they feel exercises.
These are all key principles on which I focus in my resource, Sturdy Shoulder Solutions. You can learn more at www.SturdyShoulders.com.
Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!
I'm super excited to announce the release of my new resource, Sturdy Shoulder Solutions, which will be on sale for $50 off through Sunday. This product has been years in the making, and it includes over six hours of cutting edge assessment, coaching, and programming strategies. You can learn more at the following link:
How Posture Impacts Pain and Performance (Webinar)
Important Upper Extremity Functional Anatomy Considerations (Webinar)
The Proximal-to-Distal Principle (Webinar)
Nuances of the Neck (Webinar)
Rethinking the Thoracic Spine (Webinar)
Making Sense of Serratus Anterior (Webinar)
Is Upper Trapezius the Devil? (Lab)
The Myth of Normal Range of Motion (Lab)
Rethinking the Thoracic Spine (Lab)
Making Sense of Serratus Anterior (Lab)
Good Exercises Gone Bad (Lab)
The Myth of Balancing Pushes and Pulls (Lab)
It's a great fit for personal trainers, strength and conditioning coaches, sports coaches, and rehabilitation specialists. Additionally, many fitness enthusiasts will appreciate the focus on individualizing programming recommendations and technique coaching strategies.
In particular, it’s a tremendous fit for anyone who has previously been exposed to our Optimal Shoulder Performance and Functional Stability Training products. Sturdy Shoulder Solutions serves as an up-to-date companion to the educational material covered in those previous offerings.
You'll get instant online access to this digital-only product after purchase. Just head to http://www.SturdyShoulders.com to pick it up.
For today's guest post, I've collaborated with physical therapist Eric Schoenberg, one of my co-presenters at the Elite Baseball Mentorship. Enjoy! -EC
The #1 reason why a player or team does not succeed in baseball is injury. Today, there is a surplus of information, but at the same time a lack of basic understanding of how to keep a baseball player healthy. When in doubt, you can never go wrong by understanding and relying upon anatomy and quality human movement.
One key principle to understand in this regard is that there is a tremendous system of checks and balances working at the shoulder girdle to make sure that we control both the big movements (osteokinematics) and subtle joint movements (arthrokinematics) in a small window for health and performance. If we look to anatomy, we can appreciate a very important concept by looking at the attachment points for the deltoid, latissimus dorsi, and pectoralist major: your three biggest prime movers in the upper extremity. You'll notice that all three attach on the shaft of the humerus, not the humeral head. Take a look at their attachment sites on this anatomical chart, and then compare them to where the rotator cuff (supraspinatus, subscapularis, teres major, and teres minor) attach further up on the humeral head.
You can appreciate that all these big muscles attach on the anterior (front) aspect of the humerus, which means that they have powerful pulls into internal rotation that have to be counteracted by fewer, smaller muscles that attach on the posterior (back) aspect of the shoulder.
Here are three specific implications of these anatomical observations that relate to how you manage your throwing athletes:
1. The Deltoid is strong/active enough!
The deltoid works in conjunction with the supraspinatus to form a “force couple.”
If the strength, recruitment, or timing of the deltoid is greater than the supraspinatus, then the result will be superior migration of the humeral head in the glenoid. This results in superior humeral head stress (chondral defect), undersurface rotator cuff tear, labral pathology, among other structural injuries to the glenohumeral joint.
Tip: Be sure that athletes feel rotator cuff strengthening exercises in the cuff and not the deltoid or biceps.
2. The lat is strong/active enough!
The lat (as it acts on the scapula) is opposed by the serratus anterior, lower trapezius, and upper trapezius to control scapular rotation. Increased relative stiffness of the lat results in excessive scapular depression and downward rotation at rest.
Additionally, if you have decreased activation or muscle performance of the scapular upward rotators and elevators with overhead motion, the outcome will be inferior migration of the glenoid on the humeral head.
This results in superior humeral head stress (chondral defect), undersurface rotator cuff tear, labral pathology, among other structural injuries to the glenohumeral joint.
Tip: Be sure that the athlete’s programs have a good balance of overhead reaching tasks done with proper mechanics and timing of the glenohumeral and scapulothoracic joints.
3. The pecs are strong/active enough!
Pectoralis major's impact on the anterior glenohumeral joint is opposed by the rotator cuff to prevent anterior humeral glide. Effectively, the pec and lats want to pull the ball forward on the socket as the arm goes through gross movements, and the rotator cuff works hard to prevent this gliding at the joint level.
Dominance of pec major over the rotator cuff muscles (namely subscapularis) will play a role in an athlete presenting with anterior humeral glide. We often hear the athlete report “tightness” in the front of the shoulder and their first option is to "stretch it."
This can lead to anterior shoulder pain and potential structural pathology including anterior joint laxity, biceps tendon pathology, and labral pathology – all common injuries in throwing athletes.
Tip: Rather than trying to decrease the “tightness” in the front of the shoulder by aggressively stretching—instead, focus on improving static alignment, proprioceptive awareness, and recruitment of the cuff. If you couple this with some self-massage work, this approach will yield far more favorable results.
In closing, the shoulder joint is happiest when alignment is optimal. Injury will occur if preferred alignment is altered. Examples of altered alignment at rest or with movement are the humeral head is riding too high in the socket, the socket is riding too low on the humeral head, or the humerus is gliding too far forward. The resultant stress to the active or passive restraints of the shoulder leads to injury and loss of playing time. Do yourself (and the players that you work with) a favor and master the basics to help improve success on the field.
Looking to learn more about our unique approach to assessing and managing throwing athletes? Check out the upcoming Elite Baseball Mentorship Upper Extremity Course on January 14-16, 2018. For more information, click here. The early-bird registration discount ends tonight at midnight.
About the Co-Author
Eric Schoenberg (@PTMomentum) is a physical therapist and strength coach located in Milford, MA where he is co-owner of Momentum Physical Therapy. Eric is addicted to baseball and plays a part in the Elite Baseball Mentorship Seminars at Cressey Sports Performance. He can be reached at eric@momentumpt.com.
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I've devoted a lot of my articles to shoulder assessment, training, and programming over the years. Some have been lengthy articles (like my lat strain feature), others have been quick hit posts (like this bear crawl vs. crab walk one), and some have been video technique tutorials and common mistakes, like this:
When you've been at something a long time, the natural tendency is to chase increasing complexity. The more complexity you chase, the more novelty you encounter - and that novelty is what keeps folks engaged when they "specialize" in the same joint over an entire career. One thing I've done well in this regard is to chase complexity in my own education, but kept our application of these principles simple in the way we evaluate and coach athletes. Because, at the end of the day, this is what it comes down to:
[bctt tweet="Shoulder health is about keeping the ball on the socket. Period."]
Keep in mind that we're speaking specifically to the glenohumeral (ball and socket) joint, when in reality the entire shoulder girdle is comprised of many different articulations). As I mentioned, though, the point of this blog is to simplify this discussion.
There are a lot of factors that impact how well one is able to do that. It could be cuff strength, scapular control, ligamentous laxity, previous injury, bony changes, faulty thoracic positioning, tissue density, core control, and a host of other issues. These things all - in one way or another - impact how the ball and socket interact.
As strength and conditioning and rehabilitation specialists, you still need to understand the most common injuries incurred at the shoulder. You must appreciate population specific norms. And, you need to understand the assessments that determine whether static posture and movement quality are where they need to be. However, you should never get away from always bringing these concepts back to the fact that they all have to do with ball-and-socket interaction.
As Einstein once said, "If you can't explain it simply, you don't understand it well enough." That's both the goal of this particular blog, and also in my resource, Sturdy Shoulder Solutions. You can learn more at www.SturdyShoulders.com.
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We often hear that an elbows-tucked bench press technique is more shoulder friendly than an elbows-flared approach. Nobody really ever seems to discuss why this is the case, though - so I thought I'd devote today's video blog to it:
If you're looking to dig deeper into topics like this, be sure to check out my popular resource, Sturdy Shoulder Solutions.
Sign-up Today for our FREE Newsletter and receive a four-part video series on how to deadlift!
The "full can" exercise is a popular shoulder prehabilitation/rehabilitation exercise of which I'm not super fond for a number of reasons. That said, if folks are going to utilize it, I think it's important that they understand exactly how to perform the exercise and where they should feel it. Check out today's video to learn more:
Speaking of shoulder performance, I'm excited to announce that Optimal Shoulder Performance - Mike Reinold and my first collaborative product - is now available for the first time as a digital resource. To sweeten the deal, you can get 20% off by entering the coupon code 20OFF at www.ShoulderPerformance.com through the end of the day Sunday.
Sign-up Today for our FREE Baseball Newsletter and Receive Instant Access to a 47-minute Presentation from Eric Cressey on Individualizing the Management of Overhead Athletes!
