How To Fix Shoulder Pain

shoulder pain picture

Shoulder pain is very common malady among lifters. The shoulder joint is a very shallow ball & socket joint consisting of glenoid cavity of scapula and head of the humerus. It is surrounded by the coracoid process, acromion process and lateral side of the clavicle. The shallowness of the shoulder joint provides it a huge range of motion. It also makes it susceptible to more injuries.

Shoulder Joint Picture
Shoulder Complex

Athletes are often in dire need for recovery from impingement, AC joint sprains, labral tears, dislocations or bicipital tendinitis. Shoulders do take a real beating over the career span of any competitive athlete. Recent studies suggest that chronicity and recurrence are common (Winters JC et al; van der Windt DA et al.).

Mild trauma or overuse before the onset of pain, early presentation, and acute onset have a more favorable prognosis (Van der Windt DA et al; Thomas E at al.). But if you’re in severe and persistent pain, we’ll suggest that you should not try to self-treat yourself. Stop reading and go see a medical practitioner/physical therapist. This type of professional help can’t be delivered online.

But if you want to address minor pains and mild irritations of the shoulder complex, then read on.

Tips To Cure Shoulder Pain
Manage Pressing Work
  • If you’re experiencing shoulder pain, the first and foremost thing you Haevy Shoulder Pressingshould do is to completely stop doing the movements that aggravate pain. No single exercise is mandatory especially if it causes pain and spoils the performance of succeeding training sessions.
  • Experiment with different variations of the exercise, check out if you can perform them pain-free. For example, if you’re unable to do shoulder presses, try doing high incline presses at various angles to see how they feel to you. If barbell pressing is problematic, try dumbell variations or machine presses. You should try your best to keep performing the similar movement pattern instead of ditching it altogether. It may sound contrary to the previous tip, but it’s not. In fact, it is the continuation of the first tip. If you keep performing similar movements in a pain-free range of motion, not only will it help you in a faster recovery but it’ll also help in preserving the joint mobility and prevent the excessive scar tissue build up.
  • Reduce the volume of the pressing work by half. If you’re in the midst of an accumulation phase of your training, keep the volume work for other lifts but reduce the pressing volume. If you’re working through intensification phase, keep the intensity for the pain-free pressing exercises but still reduce the number of sets up to 30-40 percent.
Improve Push-Pull Ratio
  • Compensate for the reduced pressing work by increasing the amount of pulling work (2 or 3 sets of pulling for each pushing set reduced)  like rows and pull-ups. If your shoulders don’t agree with pull -ups (pronated,
    Rope Face Pulls Exercise
    Face Pulls

    knuckles facing you) or chin -ups (supinated, knuckles opposite side), try neutral grip pull ups or pull downs while working aggressively on shoulder mobility drills. Perform rope face pulls from just above eye level, machine rows, chest supported rows, and band pull apart.

  • Retract your scapula (pull shoulder blades together) tightly before initiating every rep of rowing variation. Don’t try to over pull at the end of each rep by bringing your elbows way behind your torso. Just focus on pulling with your back muscles instead of arms. Keeping your eyes closed while performing it improves focus on working muscles. Try similar set-up with the pull-ups and pull-downs with shoulder blades pulled back and down before each rep.
Strengthen Supportive Musculature
  • If vertical pushing like shoulder presses is out of action due to shoulder discomfort, include dips (only if unpainful), push-up plus or scap push ups etc. in your routine to train the serratus anterior muscles which aid in stabilizing the scapula. Also work on strengthening the external rotators and improving the extensibility of internal rotators, elaborated in last two tips. Surgical treatment of rotator cuff syndrome with subacromial impingement is NOT superior to physiotherapy with training (Haahr JP et al.).
  • Improper form/technique on pressing exercises is one of the foremost reason of shoulder pain which worsens during exercise. Learn proper form from an able and experienced coach. Perform soft tissue work over the aggravated musculature, stretching and mobility drills before and after each training session.
Internal Rotators Stretch with Towel
Internal Rotators Stretch
  • If you’re experiencing elbow pain on the inside of the elbow one side or both while locking out during the press, and it gets better with a neutral grip, the cause of this pain lies inside your shoulders. Your shoulders lack flexibility and internal range of motion. You need to work on improving the range of motion of the internal rotator muscles. Stretch out the internal range of motion by holding a towel, rope or band behind your back as shown, and pulling upwards. Also, perform door side lat stretch and pec stretches from different heights.
  • Give your rear deltoids and external rotators some love. These muscles serve an important role in stabilizing the shoulder complex. Best exercises to work these muscles are Hang Cleans and Snatch grip high pulls if you know how to perform them correctly. Face pulls also work very well to improve these muscles. You can also use isolation exercises like rear delt machine flys, rear delt raises and dumbell/cable/band variations of shoulder external rotation.
References
  1. Arthritis Research Campaign. In Practice Series 4. Hazleman B. Shoulder problems in general practice.
  2. Carr AJ, Hamilton WH, eds. Orthopaedics in primary care. 2nd ed. Butterworth Heinemann, 2005
  3. Haahr JP, Ostergaard S, Dalsgaard J, Norup K, Frost P, Lausen S, et al. Exercise versus arthroscopic decompression in patients with subacromial impingement: a randomised, controlled study in 90 cases with a one year follow up. Ann Rheum Dis 2005;64: 760-4.
  4. Thomas E, van der Windt DA, Hay EM, Smidt N, Dziedzic K, Bouter LM, et al. Two pragmatic trials of treatment for shoulder disorders in primary care: generalisability, course, and prognostic indicators. Ann Rheum Dis 2005;64: 1056-61.
  5. Van der Windt DA, Koes BW, Boeke AJ, Deville W, De Jong BA, Bouter LM. Shoulder disorders in general practice: prognostic indicators of outcome. Br J Gen Pract 1996;46: 519-23.
  6. Winters JC, Sobel JS, Groenier KH, Arendzen JH, Meyboom-de Jong B. The long-term course of shoulder complaints: a prospective study in general practice. Rheumatology 1999;38: 160-3.

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