Shoulder pain reduction using resistance training
Danny O'Dell explains the shoulder anatomy and suggests an appropriate training programme to possibly lower your risk of shoulder injury
Shoulder pain does not have to be the inevitable consequence of exercise, overuse, or old age. Applying a small dose of common sense will go a long way toward the proper care of the shoulder joint. This recommendation needs to be kept in mind for maintaining an injury and pain-free shoulder complex. Constant hammering away at the bench and military press, consistently throwing overhand, and many of the popular swim strokes can slowly eat away at the integrity of the joint. An athlete who is not working on the stabilizing underlying musculature is travelling down a road fraught with dangerous repercussions.
The shoulder anatomy
A quick look at an anatomy and physiology book (Tortora et al. 2002) will reveal an intricate and complex joint which comprises three bones and the tendons of the attaching muscles. The shoulder joint has a tremendous range of motion, but this comes at a price. Damage occurs due to overuse and to the fact that the shoulder is not a true ball and socket joint like the hip. The three bones in the shoulder complex are the Clavicle, Humerus and Scapula (the collarbone, upper arm and the shoulder blade). These three bones are held in place by four relatively small underlying muscles called the rotator cuff muscles. They are the Infraspinatus, Subscapularis, Supraspinatus, and Teres minor. Some literature refers to these as the 'SITS' muscles. These diminutive muscles surround the shoulder joint and hold the Humerus in the shallow socket of the Scapula. They activate at the beginning of every shoulder movement and, as one physical therapist described them, they are the steering wheel of the shoulders. Common injuries to the four relatively small rotator cuff muscles are relatively easy to avoid with a few simple precautions.
The function of the rotator cuff muscles - SITS
The Subscapularis rotates the arm inward, bringing the elbow forward when the arm is held at the side of the body. It also aids in adduction (toward the centerline of the body) when the arm is above the horizontal position.
The Infraspinatus lateral rotates the humerus with the teres minor and stabilizes the head of the humerus within the shoulder joint.
The Teres Minor laterally rotates, and slightly adducts and extends the humerus and stabilizes the humerus in the shoulder socket.
The Supraspinatus abducts the arm with the deltoids and holds the humerus in the shoulder socket.
Preventive measures that may aid in injury resistance
Keep at the forefront of your mind the tendons (like all tendons) of most muscles receive very little in the way of nourishment and oxygen from the circulatory system. A limited supply of blood and oxygen translates to a long recovery period if they become injured. This recovery is even longer if you are an older athlete. Add in the daily living degenerative effects of becoming older plus the constant stresses of the aforementioned exercises and it is no wonder the shoulder fails over time. In some cases, it does not matter if, but when an injury will happen. Setting up and adhering to a properly designed strengthening and stretching (only the strengthening of the rotators is addressed here) program can lead to many years of near injury free living. Some words of advice: if it hurts, stop the exercise or lower the resistance. Listen to what your body is telling you. Pain does not lead to gain, but over time, it will lead to the surgical table. The rotator cuff muscles do not need heavy weights to grow stronger. They are SMALL muscles and can become easily damaged with excessive workout resistance loads.
This article contains a number of exercises that are commonly used to keep the rotators strong and injury resistant. If you are planning to use elastic bands make certain the attachment points are solid and the knots are tied correctly. An elastic band retracts violently from its stretched position back to the relaxed status when it breaks. Imagine how a large rubber band would feel when it breaks and then snaps back at you. NONE of these exercises or movements requires the use of heavy weights e.g. one to five pounds is more than adequate to strengthen them. Begin each exercise at the high end of the repetition ranges to build up muscular endurance. Then do fewer repetitions with a bit more weight to increase their strength.
Arm abduction - arms away from the body
Arm adduction - arms toward the body
Arm circumduction - rotate the arms in a wide circle
Arm extension - arms brought down to the sides from overhead
Arm flexion - arms brought upward from the sides to overhead
Horizontal abduction - moving the arms away from the front to the sides
Arm hyperextension - move the arms backwards from the front
Be conservative in addressing the shoulder complex unless advised otherwise by your doctor or physical therapist. These exercises DO NOT require heavy weights, so set your ego aside and do them the right way.
Reference to "a muscle group" refers to the Infraspinatus, Subscapularis, Supraspinatus, and Teres minor muscles.
For the next three alternating days (17, 19 and 20) choose one exercise for each muscle group and do twenty repetitions for two to three sets. Rest - one minute between sets. After this week is over rest for two days and then gradually build your endurance up over the next two months until you are able to do two exercises from each group for ten to fifteen repetitions for two sets. Once this is an easy task then continue to maintain the endurance by doing at least one exercise every other day. Do this as long as you continue to be involved in a sport or an exercise regimen that includes resistance training.
Exercise can be a beneficial activity, which may be useful in maintaining a healthy lifestyle. Too much of a good thing, however, can lead to injury or chronic pain. Heed your trainer's advice by working out correctly, with the proper intensity, duration, and rest periods built into the schedule.
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About the Author
Danny O`Dell is a NSCA Certified Strength and Conditioning coach from the USA. He is the author of a number of training manuals including The Ultimate Bench Press Manual, Wilderness Basics, Strength training Secrets, Composite training and Power up your Driving Muscles. Danny has published articles in national and international magazines describing the benefits of living the healthy fitness lifestyle.
The following Sports Coach pages provide additional information on this topic: