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| Q: I have pain in the front of my shoulder just at the end of my range of motion on rows. I thought rows were the universally safe exercise when it comes to shoulder health?
A: Normally, they’re a very safe bet – but as with any exercise, if performed incorrectly (or not matched to individual tolerances), they can cause problems.
This scenario most commonly occurs when the humerus goes into end-ROM extension, but the scapula stops retracting. Generally, this early end to retraction occurs secondary to a tight pec minor, which gets people stuck in protraction and anterior tilt. When you keep forcing extension on a fixed scapula, the humeral head translates forward in the joint capsule – and you can develop anterior shoulder laxity over time. A strong subscapularis can help to resist this anterior pull.
However, if your pec minor and infraspinatus/teres minor are tight, subscapularis is weak, and you’re forcing end-range a bit too hard, it’ll irritate you sooner than later. This is why it’s so important to ensure that the shoulder blade move back AND down as you row. You’ll be in trouble if the scapula tilts anteriorly as you approach end-range.
Obviously, there are a ton of other factors at work with shoulder function, but this is a good Cliff’s Notes version to what’s going on with you.
Eric Cressey
Click here to purchase the most comprehensive shoulder resource available today: Optimal Shoulder Performance - From Rehabilitation to High Performance. |
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For those of you with testy shoulders, give this levator scapulae stretch a try:
To stretch the right levator scapulae, put your right hand behind your back as if you’re getting handcuffed, then look down toward your left foot while pulling your head in that same direction with the left hand. You’ll feel a stretch along the right side of the back of your neck.
I’ve seen a lot of people who get some immediate short-term relief simply from stretching out the levator scapulae. Regardless of the shoulder problem, scapular upward rotation is almost always limited or occurs with the wrong muscle firing patterns. The serratus anterior, lower traps, and upper traps work together to upwardly rotate the scapula, and when they’re weak and combined with tightness in the downward rotators, we get into trouble. What are the downward rotators? Pec minor, rhomboids, and, you guessed it, levator scapulae.
The only problem is that it’s tough to stretch out rhomboids and pec minor on your own; they actually respond better to soft tissue work. You can get right on levator scapulae, though.
Give it a shot (15s/side) and see for yourself.
Of course, an adequate corrective exercise program is going to address a host of other factors such as thoracic mobility and scapular stability.
Click here to purchase the most comprehensive shoulder resource available today: Optimal Shoulder Performance - From Rehabilitation to High Performance. |
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| Anyone who spends time on a cycle needs to prioritize frontal plane stability (lunge variations), length of the hip flexors and quads (pull-back butt-kicks), and glute activation (supine bridges). These are really just the tip of the iceberg, though. You would also want to work on thoracic extension ROM (check out the Inside-Out DVD/Manual).
Eric Cressey |
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| I get asked quite a bit about what I look for when I see a screwy shoulder. Here you go!
1. Scapular stability
2. Thoracic spine range of motion
3. Cervical spine function
4. Breathing patterns
5. Mobility of the opposite hip
6. Mobility of the opposite ankle
7. Overall soft tissue quality (especially posterior capsule)
8. Glenohumeral (ball-and-socket joint) range of motion
9. Rotator cuff strength
Rotator cuff function is lower down on the ladder simply because the rotator cuff is reflexive and you don't have to worry about firing it in everyday life. Nobody actively tightens up infraspinatus to pick up a suitcase - and you can more easily compensate for a lack of rotator cuff function with added scapular stability (as evidenced by the number of people with internal impingement - a hypermobility problem - who can get by without surgery).
The thing I absolutely love about the Inside-Out DVD from Mike Robertson and Bill Hartman is that it covers the overwhelming majority of these problems. If you have a shoulder problem or want to prevent one, it's a great DVD to have on your shelf.
Eric Cressey |
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| When we're discussing functional anatomy, one thing that a ton of people overlook is the effect of fascia on how we move. Anatomy charts are always nice and neat for us, but anyone who has ever taken gross anatomy or watched a surgery will tell you that there is fascia EVERYWHERE. This connective tissue both facilitates and restricts movement, and as is the case with muscles, fascial restrictions (adhesions) can negatively affect how we perform.
A common example of this phenomenon that might surprise you involves the spiral line, a fascial "train" Thomas Myers brought to light in his fantastic book, Anatomy Trains. Essentially, the spiral line links one shoulder girdle to the opposite leg. If you have restrictions in the spiral line, both "ends" of the train will be negatively affected. This is one reason why I almost always see poor flexibility in the opposite ankle and hip in anyone who has a shoulder problem that involves tightness of some sort in the shoulder girdle.
Additionally, we know that via the "serape effect," the latissimus dorsi works intimately with the opposite gluteus maximus during the sprinting motion. The only way that this "link" is possibly is through the thoracolumbar fascia, a dense section of connective tissue that helps to transfer force.
So what are the take-home points?
1. Don't overlook the importance of soft-tissue work! It's tough to stretch fascia, but modalities like foam rolling, massage, and ART can make a huge difference.
2. Injuries never occur in isolation; as the shoulder-hip-ankle connection verifies, we need to look at the body as a whole.
3. If you spot poor shoulder mobility on one side, as part of your corrective exercise approach, incorporate plenty of mobility exercises and soft-tissue work for the opposite ankle and hip.
Eric Cressey |
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| Q: I was reading your Shoulder Savers: Part I article and noticed your table on balance in training. My main question is concerned with overhead presses. These lifts are categorized as internal rotation of the humeral joint. When we do overhead pressing, the humerus is fixed in an externally rotated position, correct? Why then is this internal rotation?
A: Good question. It's more out of necessity with the population in question than it is true functional anatomy.
You're never really "fixed" in any sort of rotation; your humeral head is always going to be rotating in order to accommodate the degree of flexion/abduction. More external rotation = more subacromial space. This is also going to be affected by the position of the bar (front vs. back vs. dumbbells) and the chosen grip (neutral corresponds to more external rotation). But anyway...
Long story short, if you look at all the other exercises in the "right" categories, they're the ones that - when used in excess - typically contribute to impingement. Overhead pressing is only going to make impingement worse, and a large percentage of the population really can't do it safely. As such, it needed a place to go beyond just scapular elevation.
Additionally, while I can't remember where I saw the data, there was a study that looked at relative EMG of the three heads of the deltoid and found that anterior deltoid (internal rotator) EMG activity was always higher than that of the posterior deltoid (external rotator). Consider that the posterior deltoid also leads to superior migration of the humeral head, and the external rotation contribution that you get with the movement is still going to have a sublte effect on increasing the risk of impingement.
All that said, debating the minutia isn't what is important; what IS important is that lifters, trainers, and coaches start to appreciate who is and isn't suited for overhead pressing. The more people I encounter, the more I realize that the "isn't" crowd is a lot bigger than we previously thought.
Eric Cressey
Click here to purchase the most comprehensive shoulder resource available today: Optimal Shoulder Performance - From Rehabilitation to High Performance. |
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