Shoulder trouble – Can our workout routine make that big of a difference?
Our shoulders are a part of virtually every movement we make during the course of a day from typing and driving to eating and opening doors. Add in regular workouts and our shoulders are always in motion. It’s no surprise then that shoulders are at a high-risk for injury. In fact, shoulders have an injury prevalence of more than 65% during a lifetime (Luime et al., 2004). This is second to only the lower back.
The shoulder, unlike other joints in the body, relies primarily on muscles for its stability (Norkin and Levangie, 1992). Therefore, the exercise choices made in the gym have a particularly large influence on the health of our shoulders.
Shoulder impingement is a very common syndrome among those who lift weights or perform overhead sports. Key prevention techniques include a proper warm-up, specific strengthening exercises and education on the warning signs of impingement (Chang 2004).
Let’s examine the mechanics of the shoulder first. The rotator cuff stabilizes the shoulder while the deltoid is a main contributor in moving the arm away from the body. When we exercise, we often strengthen the deltoid by performing deltoid raises and overhead presses. If the rotator cuff is not doing its share of the work, the deltoid can take over and create an upward shearing force (Wilk et al, 1997). This can pinch part of the rotator cuff and bursa against the acromion of the scapula, creating a painful shoulder impingement (Chang 2004).
Creating a balanced shoulder workout program and strengthening the stabilizing muscles of the shoulder complex are key to preventing injury.
Gaining stability in the shoulder requires muscular endurance, so the client should progress sets and reps before progressing load. If the client experiences any pain or restriction in range of motion, please refer him/her to a medical provider for evaluation.
Chang WK. (2004). Shoulder impingement syndrome. Physical Medicine and Rehabilitation Clinics of North America. 15: 493-510.
Guildford Orthopedics (2010). Shoulder impingement image. Retrieved from: http://www.guildfordupperlimb.co.uk/shoulder/shoulder-impingement
Luime JJ, et al. (2004). Prevalence and incidence of shoulder pain in the general population; a systematic review. Scandinavian Journal of Rheumatology. 33 (2): 73-81.
Norkin, C, Levangie P. (1992). Joint Structure & Function. 2nd Ed. F.A. Davis: Philadelphia
Reinold M, et al. (2009). Current concepts in the scientific and clinical rationale behind exercises for glenohumeral and scapulothoracic musculature. Journal of Orthopadeic and Sports Physical Therapy. 39 (2): 105-117.
Wilk K, et al. (1997). Current concepts: The stabilizing structures of the glenohumeral joint. Journal of Orthopeadic and Sports Physical Therapy. 25(6): 364-379.