The bench press and shoulder press are perhaps the two exercises most likely to cause pain within the shoulder. Being that these are also two of the most popular exercises for the average adult, it is no surprise that shoulder pain is very common among those that lift weights regularly.
When you ask around, most people in the gym will give you their theory of why this is. Some may believe it is a lack of mobility in the shoulder that causes the tissue to get stretched like a plastic bag. Others may point to a lack of stability in the shoulder causing the humeral head to bounce around in the joint like a pinball. Others yet, may suggest a lack of strength of the back causing the shoulders to round forward like a gorilla.
So, who is right? Is it a mobility, stability, or strength issue? Yes.
The truth is any one or more of these three things can cause pain within the shoulder, but the end result is usually the same – impingement of the tissues of the shoulder on the acromion.
The first thing that should be ruled out is any mobility limitations in the shoulder, upper back, and chest. It is important to start here because without mobility, stability and strength are not possible. BUT, you must also be mindful that stability and strength issues can often appear on the surface as a lack of mobility. This results from our bodies “guarding” the joint when they sense that the joint is not stable and strong.
With all this being said, if you live the standard 9-to-5 lifestyle that most of us do in the United States, it is safe to assume you are living with at least some stiffness around the shoulder joint. A few of the likely suspects are:
- Pec Minor
- Levator Scapulae
- Biceps (short head)
To tackle these areas; a combination of self-release techniques, massage, and stretching should be employed.
Some have described the shoulder joint as a seal balancing a ball on its nose. In other words, the shoulder is a shallow joint that allows for a huge amount of motion, but also requires a ton of dynamic stability. To create this stability, the shoulder relies heavily on the rotator cuff muscles. While these muscles can create movement, their real job is to center the humeral head inside of the shoulder joint by making quick and precise adjustments during movement.
The stability that the rotator cuff muscles provide is very position specific, so a person may have great stability with their arm at their side, but be very unstable when they move their arm overhead. For this reason, shoulder stability should be trained in various positions. A few ways to improve shoulder stability include – rhythmic stabilization exercises, kettlebell work, and crawling variations.
The last piece in the shoulder health puzzle is strength. When the body lacks strength in the muscles of the shoulder, upper back, and core; it tends to compensate – usually resulting in less than ideal movement patterns. Having proper strength in these muscles, and being able to recruit them at the right time, allows for better joint positioning.
For example, in a normal functioning shoulder, the rotator cuff muscles pull the humeral head posteriorly and inferiorly during pressing motions, allowing for more room within the joint. When the rotator cuff muscles are not functioning properly, the humeral head travels anteriorly and superiorly, which creates excessive pressure between the tissues of the shoulder and the acromion.
Along with the muscles of the rotator cuff, strengthening the muscles of the upper back and core are very important as well. A general rule of thumb for the average adult is to use a 2-to-1 ratio of pulling exercises to pushing exercises. When training the core, focus should be placed on anti-rotation and anti-extension exercises.
OK, I lied. There is actually a 4th piece of this puzzle and that is scapulohumeral rhythm. This is the body’s natural connection between the scapula and the shoulder joint. Ideally, as the arm raises above 30°, the scapula responds by posteriorly tipping and upwardly rotating, to match the position of the shoulder. This allows for the shoulder to be strong and stable in a flexed and abducted position. When this does not happen – due to inadequate mobility, stability, or strength…or just poor coaching – the shoulder loses its strength and stability, and becomes impinged more easily.
When doing movements that require flexion and abduction of the shoulder, it is important to feel motion coming from the scapula. If you cannot feel the scapula “crawl” over the ribcage, chances are you do not have good rhythm between the scapula and shoulder.
To ensure good scapulohumeral rhythm, it is a good idea to activate the serratus anterior prior to any pressing movements.
Serratus Anterior Activation: