3 quick tips on preventing shoulder pain

Avoid loading the shoulders in suboptimal positions

Are you getting yourself in a good position when lifting? If you don’t know then it’s likely you aren’t. An example of a lift where it is vital that good positioning is the key is the snatch. This lift is a movement which requires good muscle balance of the rotator cuff to allow you to have the correct timing to smash the perfect positioning of internal and external rotation of your shoulder. If your timing is poor or there is an imbalance (overworked and stronger external rotators) then this will hinder your activation of your internal rotator (subscapularis). This will affect shoulder mechanics and the internal rotation movement of the snatch will not be as efficient, causing anterior shearing of the shoulder (Larsen et al) therefore, loading your shoulder in a suboptimal position.

IMPORTANT: to avoid overloading the shoulder, work on the following…
1) Mobility
2) Movement patterns- don’t rush the lift, go through your ques and muscle activation etc.
3) Rotator cuff warm up.
4) Don’t lift in suboptimal positions, scale the exercise such as dropping the weight- maybe just use an empty bar or even change the movement.

Correct imbalances between anterior and posterior rotator cuff

When we talk about our rotator cuff we mean our supraspinatus, subscapularis, teres minor and infraspinatus. These should have the correct balance between strength and length.

What is the correct balance? Our rotator cuff assists our shoulder movement and provides us with shoulder stability. There needs to be a balance between the strength and length of our anterior rotator cuff such as the subscapularis and our posterior, infraspinatus and teres minor to allow a force couple to occur to decrease our risk of injury, such as damage to the shoulder joint (Reuther et al., 2013).

A common muscle imbalance that occurs is our external rotators (Infraspinatus and teres minor) are TURNED UP and our internal rotators (subscapularis) are turned down. This can lead to the shortening of our external rotators which can increase our chances of subacromial impingement (Littlewood et al., 2011).

We can correct these by ensuring you are activating the rotator cuff before beginning exercise. For example simple rotator cuff isometrics, all you need is yourself and a wall, hold them for 15-30 seconds repeat 3-5 times before beginning exercise. Make sure when activating the rotator cuff you activate both. For example, perform the belly press as well as external rotation against the wall (Meakins 2014).

Correct imbalances between the “pushers” and “pullers” of the upper body    

You see our typical gym guy with a pumped up chest and forgetting about training other areas of the upper body. This is someone who trains mainly their “pushers”, a very common imbalance.

For a stable and functional shoulder we need to perform pulling exercises as well as pushing exercises, stressing both anterior and posterior aspects of our upper body. Many people neglect their posterior musculature and neglecting an area of the upper body will affect the joint as movement patterns will be affected. This is due to the anterior and posterior muscles of the upper body not working as a team. Deficits in flexibility and strength of the “pushers” and “pullers” increases other muscular compensations and increases our risks of shoulder injury and dysfunctions (Negrete et al., 2013).

Pushers: Deltoids, pectoralis and triceps

Examples of pushing exercises: Strict press, bench press, push-ups

Pullers: biceps, latissimus dorsi, trapezius

Examples of pulling exercises: Ring rows, Pendley rows, dumbbell rows, pull-ups, banded pull aparts

A good programme should consist of both pulling and pushing exercises to avoid risks of injury and avoid risks muscular imbalances. If you have muscle imbalances these should be addressed to avoid injury.

For any questions or help with your injury or sports performance, please fill out the form below or contact us via email.

Jessica Woodhouse

BSc Sports Therapy MSST