Shoulder Health: Don’t Get Trapped by Faulty a Force Couple

August 21, 2015 4:23 pm Published by Leave your thoughts

by Joe Giandonato, MBA, MS, CSCS

Manager of Health Promotion

Drexel University

 

Aside from Katy Perry reverberating from the speakers hovering above the fitness floors, few things are more prohibitive to a lifter’s progress than having a wonky shoulder or two.

 

And unless one of her annoying catchy tunes morphs into an earworm of apocalyptic proportions will it then become as problematic as a chronic shoulder issue.

 

Anatomy Briefer

 

The shoulder girdle consists of four key components – the glenohumeral, acromioclavicular, sternoclavicular, and scapulothoracic joints which are webbed together by a confluence of musculotendinous, ligamentous, and capsular structures which communally produce and resist forces. The scapulothoracic joint possesses the least amount of ligamentous and capsular restraint, meaning that it relies more heavily on the musculature anchored to the scapulae for movement and stabilization. The interaction of all of the scapulothoracic muscles must be seamless enough to ensure glenohumeral congruency (think overhead movements and such) while maintaining the subacromial space below the collarbone. Both are critical in pressing big weight and keeping impingement at bay.

 

Many lifters, ranging from fitness magazine toting novices to elite level strength athletes, fall prey to imbalances within the shoulder girdle, which are largely attributed to seemingly innocuous training gaffes.

 

  • Training presses (bench, shoulder, incline) entirely while supported on benches impedes natural shoulder abduction and scapular upward rotation
  • Performing a greater ratio of open kinetic chain pressing exercises to closed kinetic chain pushing exercises
  • Training upward rotation of the scapulae almost exclusively with shrugs bearing considerable loads

 

These maligned strategies fall palpably short in accounting for the function of the scapulae.

 

Scapular Rotator Force Couple

 

The scapulae is encircled by 17 muscles which govern its movement. Of the greatest relevance, are the trapezius and serratus anterior muscles which upwardly rotate and stabilize the scapulae. Both muscle groups initiate scapular upward rotation and collectively, both groups stabilize the scapulae, thus permitting the necessary length-tension relationship of the deltoid to produce shoulder abduction.

 

The lower fibers of the trapezius muscle stabilize each scapulae to prevent unwanted protraction caused by the serratus anterior and pectoralis minor.

 

During overhead movements, the lower trapezius relaxes, but EMG data revealed notable activation during shoulder abduction – precisely why many good coaches advise incorporating lower trap training for lifters whose elbows flare on the bench. A sluggish lower trapezius disrupts the length-tension relationship of the deltoid, which may tax the infraspinatus, a muscle which is intimately involved in stabilizing the rotator cuff and is tied to another important shoulder force-couple.

 

Coactivation of the muscles encasing the scapulae reduces superior migration of the scapulae and helps establish neutral scapular tilt, thus widening the space below the acromion and clavicle, an area that commonly becomes enflamed among lifters.

 

Practical Considerations

 

So what is a well-intentioned lifter to do?

 

Provided that they demonstrate sufficient thoracic mobility and core control, a large component of shoulder work should be performed overhead. If thoracic mobility, or lack thereof, is a concern, performing a number of drills to “gain extension” through the t-spine should be incorporated.

 

Here is one that I personally like:

 

Kneeling Slide Out

 

  • Assume a quadruped position
  • Affix sliders beneath your hands
  • Keeping a neutral neck, while maintaining the knees atop the floor, push out and attempt to “reach overhead” as the arms slide forward
  • Pick up the sliders and return to starting position
  • Repeat for 10-15 repetitions for 2-3 sets

 

Individuals lacking requisite core stability who want to go overhead should ascribe to the 4×4 matrix, popularized by Gray Cook, which entails a progression transitioning from half and tall kneeling variations to standing movements.

 

A crowd favorite among those suffering from constant low back pain, including myself, find a half kneeling press, performed either with a dumbbell, landmine, or kettlebell (perform bottoms up to engage the musculature of the rotator cuff).

 

Half Kneeling Shoulder Press

 

  • Assume a half kneeling position with the shin of the front leg running parallel with the thigh of the rear leg
  • Achieve a long spine with a tight core
  • Keep the shoulders stacked atop the hips
  • Firmly grasp the dumbbell, barbell sleeve, or kettlebell handle
  • Inhale to drive negative pressure throughout the thorax
  • Exhale during the ascent, making sure that the core remains braced throughout the movement
  • Repeat for 10-15 repetitions for 2-3 sets

 

 

For those wanting to dispatch those absent scapular stabilizers to the scene of a big bench, prone raises are simple to execute and require little equipment.

 

Prone I, Y, T Raises

 

  • Grasp object (tennis ball featured in video) in hands with thumb side of hand facing up
  • Squeeze the shoulder blades together and drive hands rearward
  • Extend arms straight to sides in line with shoulders
  • Hold briefly at the top
  • Relax shoulder blades and lower to starting position

 

Research has demonstrated that during shoulder external rotation and flexion (occurring during the “T” portion), elicits significant EMG activity in the middle and lower trapezius. Also, having the thumb facing up, as in holding a full can, acutely increases subacromial space thus reducing sensations associated with shoulder impingement.

 

 

As it pertains to addressing their training, I would suggest paring back the amount of pressing movements performed while supported on a bench.

 

Benches apply an added compressive force to the scapulae which provides “synthetic stability”.

 

Do you think for a moment that the serratus anterior and lower trapezius are working their hardest when benching?

 

This false sense of stability interferes with scapular functioning during movements and over time, can insidiously brew imbalances within the shoulder girdle.

 

Imbalances may also be exacerbated by the lack of scapular upward rotation occurring as this capacity is limited during supported pressing movements.

 

  • Substitute supported pressing movements with unsupported pressing movements
  • Incorporate pushups, which permit more natural scapular tracking as the shoulder blades are “more free” than when doing pressing exercises on a bench

 

Lastly, the incorporation and subsequent execution of shrug exercises should be reconsidered. Overactive upper trapezius muscles can interfere with the motor patterning involved in scapular upward rotation, offering scapular elevation instead. Over time, aside from becoming a literal pain in the neck, overactive upper trapezius muscles can interrupt muscle sequencing and glenohumeral congruency which may possibly contribute to shoulder impingement.

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