Saturday, January 22, 2011

Injury Limits to Fat Loss: The Shoulder (Part 2)

In Part 1 of this two part series, I discussed what I believe is the most common cause of shoulder pain. So, if the term "scapulohumeral rhythm" is not familiar to you, I suggest checking out that post before reading this one. Anyway, if the scapula does not move freely when you move your arm, something bad is going to happen (ever hear of impingement?)

You see, when your scapula is allowed to move through it's full ROM, then the muscles have ample space to do their work. If the scapula's ROM is limited, then that space gets closed off. I won't go further into all the technical details, but I will let you know some of the major contributors to poor scapular movement.

When it comes down to it, poor postural habits might explain many of the factors in this list. You see, with your typical poor posture, you will get an excessively kyphotic thoracic spine (like a hunchback), forward shoulders, and forward head posture. This can lead to:

1. Lengthening of the upper back muscles and rotator cuff
2. Shortening or stiffening of anterior muscles (such as the pec major and minor)
3. Weakness of all these muscles through their "normal" range of motion (which means they don't contract strongly when they are supposed to)
4. Upper trap dominance as a scapular upward rotator (because the lower traps and serratus anterior will be weak/inhibited)
5. Decreased scapular movement (both due to the kyphosis and the muscle weakness/inhibition)

This is by no means an exhaustive list; however, the take away point is that poor posture is a major contributor to muscle imbalances. A poorly balanced training program will also contribute to these imbalances. Most people spend far too much time training the "mirror muscles" (those that they can see in a mirror) and ignore training their upper back muscles. How many guys training in commercial gyms perform 5000 sets of 50 different exercises for their pecs on Monday (aka international bench day)?

There are a plethora of other muscle imbalances that interfere with scapular movement, but they are beyond the scope of this post as they require individual assessments and specific solutions. Since I don't want to bore you (or myself) with more of that, I'll just tell you what you want to know! That is, how do you prevent shoulder injuries (or fix those minor nagging injuries) in the first place?

In other words, what are the common problems, and how do we fix them? It's simple. We want to restore normal rhythm by reinforcing good posture and ensuring proper muscular recruitment patterns. Of course, sometimes it is a little more complicated than that, but this should be a good starting point for everyone.

The solution here will be very similar in structure to my anterior pelvic tilt fix, so there is nothing new or groundbreaking with my methods... just simple a simple system that will help a great many of you if you follow it.

The Solution:

1. Soft tissue quality, stiffness, mobility

The most common postural problems for the shoulders are forward shoulders and an excessively kyphotic thoracic spine. Regardless of whether improper training, crappy breathing patterns, or activities (or inactivities... to be more accurate) of daily living are the cause, the soft tissue quality should be addressed (of course, so should the causes... but that's another thing altogether). So, grab your lacrosse ball, tennis ball, foam roller, stick, or friend's hand and get to work. First and foremost, you'll want to hit the pec major and minor. Everybody knows where the pecs are, so you don't even need a picture. If a particular area hurts a lot, then you know that's the part you need to hit the most frequently.

Of course, soft tissue quality is good to have in all your muscles/tissues, so you might as well go everything else as well. Rhomboids, posterior capsule, upper traps, etc... Actually, you might as well do your whole body. I don't have a video made, so just watch this one by Eric Cressey instead:

One foam rolling exercise that isn't so much for soft tissue quality (although it does get the rhomboids) as it is for mobility, is the t-spine roll. A thoracic rotation exercise is warranted as well.

If you need help with foam rolling or understanding soft tissue work, check out my foam roller review and then download this free guide:

Immediately after you self-massage, static stretch. A pec stretch is going to be the most important. While you are performing this stretch, focus on actively contracting your back muscles.  Think about pulling your shoulder blades down and back, as if you were trying to put them into your back pockets. The best pec stretches, and the reasons for doing them this way, can be found in this article.

An upper trap stretch is also warranted, as those are usually overactive as a scapular upward rotator (as I mentioned previously).

2. Muscle Activation

After improving soft tissue quality everywhere and then stretching out those excessively stiff muscles, you want to activate the weak/inhibited/lengthened muscles. This will usually include the lower traps, serratus anterior, and external rotators. Of course, it is also a good idea to work on diaphragmatic breathing as well. Anyway, here is what to do:

Lower trap activation
Diaphragmatic breathing

Push-up plus

Side-lying external rotation

3. Strengthening the right muscles

The best exercises to do for your shoulders are the ones you rarely see people in commercial gyms focusing on. These are the rows and the pullups. Of course, I also like heavy deadlifting as a great exercise for shoulder health as well, but that is another story altogether.

If you want more details on rowing and pulling progressions, friend me on my facebook page, and we will talk there.

If you have any questions (this isn't a comprehensive guide by any means, rather a quick starting point), leave a comment.

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