A few days ago I enjoyed a brief conversation with a great friend of mine. He expressed to me some recent shoulder pain issues he has been having and I told him I would post some information that hopefully could assist.
My friend and I share a few things in common; We’re both lifelong Martial Artists, we are both 28 years old (again), and both regularly lift weights (he is a CrossFitter while I am a Strength and Performance guy.)
The fact we are guys, lift heavy things, engage in combat sports and are over 28 years old is enough to cause shoulder issues. Actually any one of those is enough to get us into the club.
My experience working with athletes’ shoulders has proven quite enlightening and it is the joint that I have had the greatest success in delivering the goods for the athletes’ desired outcome. To date, I have helped several men who initially could not lift an arm above head height, two combat athletes, a baseball pitcher, two crossfitters, a shot putter and numerous lifters regain their range of movement and increase their lifting strength.
My method towards achieving the desired outcomes is pretty simple: (1) Screen (2) Refer if needed (3) Mobility/Flexibility Work (4) Passive Work (5) Isolation Work and (6) Integration Work.
The purpose of performing a screen is to detect areas of asymmetry and tightness. The RED FLAG is of course pain. If the client encounters pain you stop the screen and refer the client to their physician.
As a trainer this is neither the time nor place to think “Oh this guy is faking it” or “She’s just being a cry baby.” Yes, I agree the client may very well be either of those two but it is not our place to make that determination.
Clients/Athletes: The only acceptable answers to the question “Are you in pain?” “Does that hurt?” is either YES or NO. The amount of words I could write on this topic would make for a blog in and of itself.
The Wall Shoulder Flexion Test:
How it’s done according to NASM: “The wall shoulder flexion test helps to assess if you have proper range of motion when raising your arms directly above your head. The test is performed with you standing with your heels, buttocks, shoulders and head against a wall. The lumbar should be held in a neutral position with its natural curve. Arms should be hanging at your sides. With the elbows extended and thumbs pointing up, extend your arms straight up toward the wall. The goal is to touch your thumbs against the wall with no compensatory movements such as shrugging your shoulders or arching your back. If any part of your body moves besides your arms, you may have some muscle tightness. “
Eric Cressey of Cressey Performance provides a video example.
Eric allows for a 6-8 inch distance from the wall to the heels. If the NASM screen model proves difficult then try the Cressey modification.
“I’m tight in the flexion test, my arms won’t go that high. What can I do?”
I have instructed clients to procure a sturdy stick and perform the shoulder flexion while holding it. This can be done standing or while lying down.
A CrossFit Mobility WOD Technique with a Foam Roller.
Self-Myofascial Realease / Foam Rolling has become a part of gyms everywhere and many have enjoyed the benefits of its use. What is seldom covered are the warning orders attached to this otherwise innocent looking exercise.
Foam rolling is not advise for clients with osteoporosis/osteopenia, obese/elderly individuals that cannot get off the floor easily, diabetics with reduced circulation in their lower body, the inside portion of pregnant clients thighs, directly over the joints or the spine.
Dr. Jennifer Reiner covers some outstanding thoracic and shoulder mobility/flexibility exercises using the foam roller and other props.
Don’t let me catch you wearing workout gloves or lifting straps during a pendulum exercise.
This is a passive exercise that has proven quite helpful for a number of my clients. When assigning this exercise to clients I have always instructed that the weight be kept very light. 5 lbs is enough for my strong athletes and less than 1 lb is preferred for clients with recovery issues. Progression is measured in the athletes rate of perceived exertion. An athlete with adhesive capsilitus (aka Frozen Shoulder) will not be too tolerant of this exercise until the scar tissue starts to break up.
This exceptionally well spoke gentleman breaks it down for us and I feel smarter just listening to the chap.
Ladies: Doing face pulls will not make your back look like a relief map. I’ve been watching women train for a long time now and I’m really good at it.
While it would appear that face pulls primarily target the rear deltoid, this exercise actually targets the lateral deltoids exceptionally well. Face pulls can be done at either a cable station or with a band.
Coach Nick Tumminello demonstrates his version of the cable face pull exercise.
Coach Brett Contreras demonstrates the band “pull and pull apart” method”
The young lady is doing a great job with her landmine press. I’m going to presuppose the colored dumbbells are for throwing practice and not actual lifting.
Overhead Pressing is not advisable early in a recovery stage. The athlete initially requires mobility and stability before progressing to strength training in either isolated or integrated methods. The landmine is a means of getting the athlete prepped for overhead work, or as a stand-alone exercise that has more available movement patterns. When I first introduce the landmine press I always begin with just the bar.
Aside from the landmines value in building the shoulders, it has proven especially useful for training combat athletes and throwers.
Coach Dean Somerset demonstrates a Landmine Press integrated with rotational movements and force transfer between the lower and upper halves of the body.
Never start with a Kettlebell bigger than the size of your head.
Bottoms Up Kettle bell Press
Starting with a lighter Kettlebell, the Bottoms Up Press is particularly good for developing shoulder stability and has a place in both rehabilitation as well as strength and performance training. I do not believe that a dumbbell version of this exercise elicits the same response due to the balanced load of the weight.
Coach Tumminello demonstrates and gives his tips for a good bottom up press:
(Right) Coach Dan John instructs the fine points of the Get Up.
Kettlebell Get Up
In my opinion first two to three positions of this technique will work wonders in helping stabilize the shoulder. The Get-Up in its entirety is a full body workout that reaps the rewards of mobility, strength and balance…do enough of them consecutively and you have a deceptive cardio exercise.
Gray Cook and Brett Jones detail the perfect get up: