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Tip 133: Protect Your Shoulders - Shoulder Injury Prevention and Rehabilitation

Thursday, July 21, 2011 9:30 AM
Get a bigger and stronger upper body physique through shoulder training. No, I don’t mean shoulder shrugs or overhead pressing with heavy dumbbells. While these lifts are part of the ideal shoulder program, working the smaller shoulder muscles that you can’t even see are just as important for optimal development and overall health. Your best bet to prevent injury and pain is a combination of structural balance and flexibility work, with strategic overhead press training.  

Shoulder injuries and chronic pain are rampant among the resistance-trained population at large. In fact, research suggests that 36 percent of injuries and disorders from strength training occur at the shoulder complex. Also, in recent years there has been a dramatic increase in the incidence of shoulder injuries, which researchers suggest is due to the shift away from machine-based to free weight training. Of course, this doesn’t mean you should ditch free weight training for machines, rather be aware of injury risk factors and train smart by regularly including injury prevention exercises in your routine.

The primary risk factor for shoulder injury is imbalanced muscles. There is a trend among body builders and recreational trainees alike to overemphasize the large muscle groups of the shoulder (pectoralis major, upper trapezius, deltoids), resulting in imbalances between the internal and external rotator cuff, and the scapula muscles. Plus, researchers note that many training motions require end-range external rotation, but not internal, resulting in weaker internal rotator muscles and posterior shoulder tightness. Such imbalances put you at even greater injury risk if you play a sport that includes overhead motions because they overload the front of the shoulder joint, intensifying any instability or impingement.

Researchers suggest adding flexibility exercises for the posterior shoulder tissue (when lying on your side, stretch the lower arm by crossing it across the chest and putting pressure on the elbow) to improve mobility. Muscle imbalances should be targeted with prone and standing shoulder abduction and eccentric external rotation. Specifically, training four times a week for five weeks with the following exercises was shown to significantly decrease shoulder muscle imbalances in tennis players: Standing external rotation with elbow at 90°, seated row, scapula retraction, chest press, and external shoulder rotation with the elbow at the side. 

For everything you need to know about overhead pressing, read The Case for the Overhead Press.

Kolber, M., Beekhuizen, K., Cheng, M., Hellman, M. Shoulder Injuries Attributed to Resistance Training: A Brief Review. Journal of Strength and Conditioning. 2010. 24(6), 1696-1704.

Niederbracht, Y., Shim, A., Sloniger, M., Paternostro-Bayles, M., Short, T.  Effects of Shoulder Injury Prevention Strength Training Program on Eccentric External Rotator Muscle Strength and Glenohumeral Joint Imbalance in Female Overhead Activity Athletes.   Journal of Strength and Conditioning.  2008. 22(1), 140-145.

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