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Preventing Shoulder Pain-Installment 1

Shoulder pain is one of the more common reasons patients come to Muscle and Joint Chiropractic. We have excellent results using Integrative Diagnosis™ with MAR™ and IAR™ and ART® to treat the soft tissue surrounding the shoulder, but understanding how the shoulder works is crucial to preventing you from having to visit the Chiropractor’s office. The shoulder (glenohumeral) joint is designed for movement.  This becomes obvious when you look at the structure of the joint.  The amount of support from the bone is minimal.  If you think of a softball sitting on top of a golf tee, then you can imagine how much bony support (the area that the golf tee is in contact with the softball) that the shoulder receives.

Since the support doesn’t come from the bone, the soft tissue surrounding the shoulder plays a huge role.  The group of muscles that cross the shoulder (rotator cuff muscles) contract to stabilize the shoulder.  To get a better understanding of how the rotator cuff muscles work, click the following link (Rotator Cuff ). The tendons of the long head of the bicep and tricep also cross the glenohumeral joint, but their role is outside the scope of this article. There is also a labrum, shoulder capsule, and ligaments to help support the shoulder. All of the above structures can be damaged during improper exercise technique, so learning proper technique is crucial to every exercise you perform.  So if you want to get HUGE or swim in an Ironman triathlon or anything in between, then start taking care of your shoulders.  These installments will cover some common mistakes that occur at the gym.  It is always best to hire a fitness professional to watch your form and correct any technique flaws that you may have.  Time and money spent now will save you a lot of hassle in the future.

The seated horizontal row is a very common exercise performed incorrectly at the gym.

First mistake is pulling the elbows too far back.  The elbows should only go until they hit the side of your torso.  See below:

Wrong-Elbows too far back[/caption]

Correct-Elbows at torso[/caption]

If you pull your elbows too far back, two major problems arise. First, your shoulders roll forward and place stress on the front portion of you shoulder capsule and ligament. This can lead to shoulder instability because these structures become slackened. Second, when your elbows come behind your torso, you are more likely to pinch your shoulder blades together and shrug your shoulders.  This will lead to a strong rhomboid  and upper trapezius contraction without major contributions of the lower trapezius or serratus anterior.  This will be discussed more in a future article but it essentially will lead to muscle imbalances that can lead to shoulder damage.  Instead of pinching your shoulder blades together, you should imagine pulling your shoulder blades down and back. You also have to be careful that you don’t pull your shoulder blades too far down because too much scapular depression can encourage the forward shoulder roll. This is why it is beneficial to have an expert observing you.

Wrong-squeezing shoulder blades together, elbows too close to side and elbows too far back.[/caption]

The picture above also shows the elbows too close to the torso. This will encourage forward rolling shoulders as well.  The elbows should be off your side about 20-40 degrees.

Another common mistake that can occur is neck protraction.  This is where the head moves into the forward head position. See below:

Wrong- Chin is too far forward[/caption]

The neck should be retracted (also called packing the neck in some circles of the strength training world) at all times during the exercise.  Basically you should make a double chin.

There are many variations of the horizontal pull and the above tips should be followed on them as well.  If you want to dive deeper into the row, Eric Cressey, MA, CSCS has an excellent video entitled 8 ways to screw up a row. He focuses on the standing one arm cable row which is a better exercise than the seated horizontal row. Standing one arm cable rows force the core to contract more because your body has to resist the rotational force from the pulling arm.

Hopefully these tips will help you the next time you’re at the gym.