If you have shoulder pain, almost any pressing or pulling exercise hurts. Even performing some lower body exercises will be uncomfortable, especially squats that require you to actively stabilize the barbell on your shoulders. Normal chores, even something as simple as carrying groceries to your car, can cause discomfort. Nothing new here, but what can be done about it?
First, consider that some joints are better designed for stability and others for mobility, and with seven basic movements the shoulder joint is definitely made for mobility! But that mobility comes at a cost, as the shoulder can easily be injured. Among the list of possible shoulder injuries are sprains, strains, dislocations, tendinitis, torn rotator cuffs, fractures, and impingements. That’s the bad news. The good news is that many of these issues can be avoided if you follow a workout that is designed to achieve structural balance.
The concept of structural balance suggests that there are ideal strength ratios among muscle groups. If one muscle group is relatively weak, this imbalance can lead to poor biomechanics and increased the stress on the muscles, connective tissues, and joints.
For example, if the strength of muscles that internally rotate your upper arms (such as the subscapularis and latissimus dorsi) are relatively stronger than the muscles that externally rotate the upper arm bones (such as the teres minor and infraspinatus), this may cause a round-shouldered posture that makes you more susceptible to impingement syndromes and dislocations.
To design a structural balance workout for the shoulders to keep them healthy, you should pay special attention on the muscles of the shoulder that tend to be relatively weak. Because most of us spend a considerable amount of time sitting and often focus our workouts on the muscles on the front of the body (such as with bench presses), these are the major muscles to consider strengthening: deep cervical flexors, serratus anterior, rhomboids, mid-trapezius, lower trapezius, teres minor, and infraspinatus. Because the elbow flexors are also involved in shoulder stabilization, it may also be a good idea to perform some biceps exercises if you don’t do these already.
Before sharing with you a healthy shoulder workout, we certainly recommend that if you are in pain, consult with the appropriate health care professional before performing any of these exercises. Also, to accelerate your progress, you should probably back off exercises that often cause discomfort for those with shoulder issues. The main culprits are behind-the-neck pulldowns, close-grip upright rows, bench presses (especially with a wide grip), and dips. We’re not saying to never do these exercises, but that you should strive to achieve structural balance before including them in your workouts.
Of the three major shoulder areas (anterior, posterior, and medial), the anterior shoulder is the one that is usually overdeveloped in relation to the other two. To achieve the fastest results, back off on exercises that work the anterior deltoid (such as bench presses and barbell overhead presses) until the other areas come into balance.
With that background, here are three workouts that build upon the conditioning of the previous one. Perform each workout six times, allowing at least one-day rest between training sessions, before moving on to the next workout. Monday, Wednesday, and Friday is ideal because if you miss a day, you can make it up on Saturday. If you can only train twice a week, that’s fine – it will just take you an extra week to complete each workout.
3x Week for 6 Training Sessions
A. Overhead Squat, Wide Grip, 2 x 10, 4010, rest 60 seconds
B1. Lean away Lateral Raise, 3 x 12-15, 3010, rest 30 seconds
B2. Prone Superman, DB, 3 x 12-15, 1011, rest 30 seconds
C. External Rotation, Seated, DB, 3 x 12-15, 2010, rest 30 seconds
D. External Rotation, Side, DB, 3 x 12-15, 2010, rest 30 seconds
E. Neck Retraction, Foam Roller, 2 x 10, 1310, rest 60 seconds
3x Week for 6 Training Sessions
A. Overhead Squat, Medium Grip, 2 x 10, 4010, rest 60 seconds
B1. Lateral Raise, DB, 3 x 8-10, 3010, rest 30 seconds
B2. Face Pull, Cable, 3 x 8-10, 3010, rest 30 seconds
C. External Rotation, Seated, Cable, 3 x 10-12, 2010, rest 30 seconds
D. External Rotation, Side, Cable, 3 x 10-12, 2010, rest 30 seconds
E. Standing Neck Retraction, 2 x 10, 1310, rest 60 seconds
3x Week for 6 Training Sessions
A. Overhead Squat, Shoulder-Width Grip, 2 x 10, 4010, rest 60 seconds
B1. One-Arm Dumbbell Press, Neutral Grip, 4 x 6-8, 3010, rest 30 seconds
B2. Dumbbell Row, Neutral Grip, 4 x 6-8, 3010, rest 30 seconds
B3. Front Raise, BB, 45-Degree Incline, Medium Grip, 4 x 6-8, 3010, rest 30 seconds
D. Standing Neck Plant, Back Against Wall, 2 x 30 seconds, rest 60 seconds
Descriptions for these exercises can be found in numerous online resources, but here are some notes about the more unique ones.
Overhead Squat. This exercise is included in this workout as a dynamic stretch using just an empty barbell. Often it is difficult for those with tight calves to perform this exercise, but this issue can easily be resolved by placing small weight plates under your heals. Note that the exercise progresses from a wide grip to a more challenging shoulder-width grip.
Lean-Away Lateral Raise. This variation of the lateral raise increases the resistance at the beginning of the movement. Start by holding a dumbbell in your left hand and stand to the side of a sturdy object such as a power rack. Grasp the rack or object with your free hand, put your feet together, and lean away from the object (so that your upper body is at an angle). Turn the dumbbell so it is facing your body. From this starting position, lift the dumbbell until it is parallel to the floor. Repeat for the other side.
Prone Superman, 45-Degree. With this exercise you lie face down on a 45-degree incline bench, lengthwise. Hold two dumbbells, thumbs up, with your arms extended in front of you, slightly wider than shoulder-width (to form a V-shape). Lift the weights as high as possible, then return to the start. This is a very humbling exercise, so don’t be surprised if you have to start with the pink plastic dumbbells.
Neck Retraction. These exercises stretch and strengthen neck muscles that are chronically shortened from prolonged sitting in front of a computer. On a foam roller, you lie lengthwise, face up with your arms forming a 45-degree angle at the elbow (like a goalpost), and flatten your neck against the roller; with the standing variation, you perform the same movement, but with your back against a wall.
Front Raise, BB, 45-Degree Incline, Medium Grip. This back exercise is simply a front raise lying face up on a 45-degree incline bench. Your head and shoulders should be over the end the bench, with your head in line with your torso. Lift the weight until it is in line with the angle of the bench.
Standing Neck Plank. With this exercise you stand with your back against a wall, placing a towel between you and the wall for comfort. Rest your head against the wall, then move your feet several inches away from the wall. Resistance is increased by standing further away from the wall. Warning: if you have a history of neck pain or find this exercise makes you dizzy, do not perform this or any other neck exercise before consulting with the appropriate medical professional.
What about stretching? Yes, one of the central tenets of corrective exercise is to stretch muscles that are tight. Among those muscles that affect shoulder function that often need stretching are the upper trapezius, levator scapulae, sternocleidomastoid, scalenes, latissimus dorsi, teres major, subscapularis, pectoralis major, and pectoralis minor. That’s a bit overwhelming, but the overhead squat is a good start as it works several of these. Also consider spending some time with foam roller exercises, especially those in which you lie lengthwise. As a bonus, many of these exercises also help decompress the spinae.
Despite our best efforts, often adhesions form that can affect natural movements and lead to injury. To deal with these, consider investing in some soft tissue therapy. The “go to” treatment of choice for dealing with adhesions and alterations in muscle tension and texture is Active Release Techniques™ Treatment (ART), developed by Dr. Michael Leahy.
Shoulder issues don’t necessarily have to be a nagging problem that just won’t go away. Try these structural balance workouts so you can enjoy a higher quality of life and once again be able to train with gain and not pain!