Just thought you all might be interested in checking out a five-part feature Mike Robertson ran with material from Mike Reinold and I. Here's what it included:
In the Trenches Podcast with Eric Cressey and Mike Reinold
The podcast that started it all! Here we discuss how Eric and Mike got into the field, how they evaluate shoulders, and a bunch of baseball training. You'll definitely like this one!
Eric Cressey Q&A #1 - Shoulder Forces in Boxing
Here, I describes the forces you're going to see during a typical punch in boxing, as well as what biomechanical factors might predispose boxers to injury.
Eric Cressey Q&A #2 - Sternoclavicular Joint Dysfunction
In this post, I talk about the potential causes of sternoclavicular joint issues and how to handle them.
Mike Reinold Q&A #1 - Scalene Anatomy
Mike discusses the scalenes, their impact on the shoulder, and why asymmetry may not be bad for baseball players.
Mike Reinold Q&A #2 - Joint Capsule Surgical Techniques
Mike discusses two different surgical techniques for correcting issues with the shoulder capsule, as well as what to expect post-surgery.
I'm thrilled to announce that Mike Reinold and my new project, Optimal Shoulder Performance: From Rehabilitation to High Performance, is now available. This four DVD set blends the world of rehabilitation and strength and conditioning like no other product on the market. For more information on the product and to order, check out www.ShoulderPerformance.com.
The introductory price will not last long, so don't delay!
Q: I've found your articles on T-Nation very informative, and enjoy the format you use to convey your message (with humor!).My specific interest is in the information you provide about your shoulder problems, as you've noticed in the subject line I recently had my shoulder scoped in February to repair a labral tear. I did the required PT, and then when that was finished they pretty much sent me out on my own and said only do internal and external rotations for delts/rotator cuff. Overhead pressing and upright rows will supposedly cause problems according to the therapist (but I question this).I've read in your articles that the shoulders get plenty of work from chest and back/lat exercises, and that external rotation variations may be adequate, with occasional presses and laterals. Can I do dumbbbell presses with palms facing in to reduce shoulder pain, as well as laterals for the middle/posterior heads without causing problems? I seem to be progressing fairly well with higher rep sets on my upper body, but want to make sure I do the correct things to set myself up for a lifetime of healthy lifting and stable shoulders.
A: If I am you, and I have a shoulder surgery, I can the overhead pressing for good. And, I think upright rows are quite possibly the single worst exercise for shoulder health. I wrote about this HERE - but the short version is that you don't want to go through abduction (especially above 90 degrees) with the humeral head maximally internally rotated.
Dumbbell bench pressing (not overhead pressing) is fine - and the lateral raises should be okay as long as you stay in the scapular plane. Check out my Shoulder Savers series at T-Nation for details on that front.
And, above all else, you need to buy the Inside-Out DVD.
It sounds like you are getting way too "rotator cuff-focused" and are ignoring a bunch of other factors that are incredibly important for shoulder health; these include thoracic spine range-of-motion and scapular stability (among other things). Shoulder health is about more than just getting stronger "all over;" it's about optimizing range-of-motion and muscular balance. It would definitely be a good investment - and much cheaper than another shoulder surgery!
I’m of the belief that all stress on our systems is shared by the active restraints and passive restraints. Active restraints include muscles and tendons – the dynamic models of our bodies.
Passive restraints include labrums, menisci, ligaments, and bone; some of them can get a bit stronger (particularly bone), but on the whole, they aren’t as dynamic as muscles and tendons.
Now, if the stress is shared between active and passive restraints, wouldn’t it make sense that strong active restraints with good tissue quality and length would protect ligaments, menisci, and labrums (and do so through a full ROM)?
The conventional medical model – whether it’s because of watered-down physical therapy due to stingy insurance companies or just a desire to do more surgeries – fixes the passive restraints first. In some cases, this is good. For instance, if you have an acromioclavicular joint separation with serious ligament laxity, you’ll likely need surgery to tighten those ligaments up, as the AC joint is an articulation without much help from active restraints.
In other cases, it does a disservice to the dynamic ability of the body to protect itself with adaptation. Consider the lateral release surgery at the knee, where surgeons cut the lateral retinaculum on the outside of the knee, allowing the patella to track more medially. I’ve seen a lot of people avoid the surgeries (and, in turn, the numerous possible complications) with even just 2-3 weeks of very good physical therapy focusing on the active restraints. I’m not saying all these surgeries are contraindicated – just that we need to exhaust other options first.
So, the next time you’ve got an ache or pain, consider whether it’s an active or passive restraint giving you problems – and if it’s the latter, work backward to find out which active restraint you need to bring up to par.
Shoulder dislocations are not something you want to rush. Give them time; trust me.
With shoulder injuries, your goal right should be to do whatever you can to maintain a training effect. Train the uninjured side and your legs as best as you can.
Eric Cressey
