Marks Daily Apple
Serving up health and fitness insights (daily, of course) with a side of irreverence.
21 May

How to Maintain Shoulder Mobility and Scapular Stability

muscularshouldersMore than perhaps any other joint in our bodies, the shoulders demand close and careful attention. We use them on a daily basis and they travel a wide-ranging path; it’s in our best interest to assure that the path is the one of least resistance.

The tricky thing about maintaining good shoulder function is that it doesn’t just require strong deltoids or big traps. Those are important for moving big weight and being strong enough to handle anything life throws at you, but real shoulder function – pain-free, unimpeded shoulder function – depends on certain supporting muscles and joints of which most people are simply unaware. I mean, did you realize just how integral the scapular are? And because the shoulders’ function seems relatively straightforward and because we can work out for years without lending serious thought to how our joints move and work, now’s the time to start thinking about proper joint function before it’s too late.

What I’m trying to say is this: you may be neglecting your shoulders and putting them at risk, even if you focus on only the classic multi-joint, compound exercises, like overhead presses and pull-ups, and even if you’re using good form. It’s difficult to admit this to ourselves, but doing the right things the right way may not be enough if we’ve lived regular lives hunched over keyboards, sitting in chairs, wearing shoes, and emulating incorrect posture (masquerading as good posture). Modern nutrition and fitness advice, coupled with the mundane realities of everyday life (chairs, shoes, eight hour workdays, etc) (unwittingly) has the effect of undoing millions of years of evolutionary pressures. It’s true that we’re born with predispositions – toward certain foods, movement patterns, joint articulations – but a few dozen years of doing precisely the opposite sets us on a different path. Deviating from that path is difficult, but it must be done.

I’m of the opinion that everyone should be doing shoulder mobility and stability work, even if you’re otherwise totally healthy and pain-free. Shoulder issues have the nasty tendency to develop gradually due to a deficiency. They don’t always happen immediately (unless we’re talking acute trauma like dislocations or sudden tears); as you read this, shoulder pain could be welling up beneath the surface, growing strength and gearing up to burst through and manifest as a conscious debilitating sidelining injury. Get on the prehab now, not after it happens. You know how it goes: better safe than sorry, an ounce of prevention is worth a pound of cure, and any other bit of folk wisdom elevating careful prudence and preparedness over convenient short sightedness. And if you’re suffering from shoulder pain or poor mobility and stability, by all means, get on the rehab!

Self-evaluation

First, evaluate yourself. Stand up straight and relaxed – just assume your normal stance and posture. Grab two long, straight items to hold in each hand. Pencils, pens, rulers, sticks will all work. It’s got to be straight is all. Hold them in your fists and let your hands drop by your sides. Again, relax.

Your items should be pointing straight ahead. They should form an angle perpendicular to your body. If they’re angling inward, your shoulders are slumping forward, and you probably need to work on your scapular retraction.

Next, raise both arms as if you were waving goodbye. Your hands should be about ear height, and your elbow should be bent around 90 degrees. Maintaining that arm position, push your arms and elbows back by retracting your scapula. Ideally, both arms should go back equal distances. If one arm lags behind, you probably need extra work on that side.

I’m going to do drill recommendations a little differently than I have in past mobility posts. Before, I listed various exercises one could do to help with joint mobility, but there exists a totally free, public domain shoulder rehab program that gets rave reviews from pretty much everyone: the Diesel Crew Shoulder Rehab Protocol (Video).

This is the essential program for anyone currently suffering from, worrying about, or speculating on the development of shoulder issues. It’s free, it’s easy, and it’s all laid out for the user. It follows a seven day schedule. If you’re injured and taking time off, do what you can without causing pain. If you’re otherwise healthy and looking to shore up your shoulders, do the drills after your workouts. Once your shoulders are feeling better, don’t stop the drills altogether. Keep doing them, perhaps on a truncated schedule, but make sure you maintain your shoulder health.

Of course, not everyone requires the DC protocol. I would advise everyone to at least sample the routine, and even go through the full seven day cycle once in awhile to keep things fresh and fluid. I do like some other shoulder drills. The DC protocol can be a bit time-consuming, and I’m pretty pleased with my shoulder function, so I’m okay with basic maintenance. A few good ones:

Basic Maintenance Drills

Scapular Wall Slides (Video)

Stand with your back to the wall and your feet about eight inches away from it. Lean back into the wall and maintain contact between the wall and your head, hips, and back. With your hands over your head, press your forearms against the wall, squeezing your shoulder blades together. Slide your arms up the wall. Maintain contact the entire time.

Scapular Push-Ups (Video)

Get in the “up” push-up position: straight arms, tight core, straight legs. Retract your scapula, then protract it. (Tighten your shoulder blades, then spread them apart.) Keep your arms straight the whole time. Range of motion will be extremely short in this exercise.

Shoulder Dislocates (Video)

Using a flexible band, a broomstick, a piece of rope, a ribbon, a sedate pet snake, or even a dog leash, hold both ends with straight, locked arms. Starting at your hips, bring the band (or whatever you’re using) behind your head until you reach your hips on the other side while keeping those arms straight. At this point, you can go back the way you came, but I find going forward hurts the shoulders, so I just bring it back over with bent arms and go backwards again with straight arms. Your choice. Just avoid pain. Do shoulder dislocates as part of a rehab program or as a dynamic warm-up to loosen up your shoulders.

Tips for Avoiding Shoulder Issues

Scapular Retraction During Bench Press

This is essential. You’ve got to create the shelf when you press. Tighten your shoulder blades, have a buddy help lift the bar off the supports, and maintain the tight shoulder blades for the duration of the set. Too many people neglect this essential portion of the bench press. It helps to arch your lower back a bit (which is why you see the experts arching during the bench).

Scapular Retraction During Rows

Same goes for rows. If you’re doing bent over barbell rows, keep your scapular retraction going during both the concentric and eccentric motions of the lift. Everyone retracts the scapula during the concentric portion, but most protract the scapula at the end of the eccentric. Don’t. Instead, maintain those tight shoulder blades at the bottom. Straighten your arms, but do not let your shoulder blades drift forward, too.

Avoid the Wrong Types of Movements

Avoid upright rows. They are almost universally bad for your rotator cuffs, and they don’t work anything you can’t reach with better lifts. Besides, hoisting heavy weights up to your shoulders while standing by using just your upper body is ridiculous and inefficient; the hips are far better at propelling weights up to the clean position.

Another common mistake is doing lateral raises with your arms directly at the sides. I doubt most of us are even doing lateral raises (I find them unnecessary, but bodybuilding types will find them useful). This is unnatural and can pinch your rotator cuff. Instead, move your arms forward about 30 degrees and lift them that way.

You might also avoid the bench press altogether if you can’t seem to avoid shoulder pain. You could do floor presses or weighted push-ups instead.

Avoid Pain

Soreness is okay. Pain is not. Avoid the movements that cause pain in your shoulders.

Oh, and you’ll want to maintain good thoracic mobility, too.

Eric Cressey has a fantastic series called “Shoulder Savers”. Here are parts 1, 2, and 3. Between his recommendations for avoiding shoulder injury, the DC Rehab Protocol, my advice, and remembering to be conscious of your scapular function, you have everything you need to take care of those relatively minor, nagging, persistent shoulder issues that almost everyone seems to have these days. For more serious, acute injuries, consult with a professional.

You want comments? We got comments:

Imagine you’re George Clooney. Take a moment to admire your grooming and wit. Okay, now imagine someone walks up to you and asks, “What’s your name?” You say, “I’m George Clooney.” Or maybe you say, “I’m the Clooninator!” You don’t say “I’m George of George Clooney Sells Movies Blog” and you certainly don’t say, “I’m Clooney Weight Loss Plan”. So while spam is technically meat, it ain’t anywhere near Primal. Please nickname yourself something your friends would call you.

  1. I did the drill and WOW! The 2 sharpies I used were without a doubt pointing inward – and quite a bit. I am not even close to straight so this post is very enlightening to me! I have bypassed the other mobility posts because I do not have any problems.

    But, after learning from yesterday that our shoulders are so vitally important – more than we realize on a day to day basis – I am ready to improve my shoulder mobility by doing these drills.

    Thanks Mark for such great awareness and providing great action steps to continue to improve our health and life!

    Primal Toad wrote on May 21st, 2010
  2. After recently recovering from my second bout with frozen shoulder (adhesive capsulitis), and still working to regain full mobility, I certainly agree with the importance of paying attention to your shoulders. Next, I hope you’re going to focus on knees, as I’m eagerly awaiting information about how to regain flexibility in my knees.

    SharonLl wrote on May 21st, 2010
  3. Great exercises, I’m going to start on them. Seems like the strength of the shoulder (mobility), is also it’s greatest weakness since it is held in place more by tissue than bone.

    I don’t think any type of exercise is really worth developing chronic pain. I’ve met plenty of people who look great when they are still but look like feeble old men when they start moving around.

    John Solter wrote on May 21st, 2010
  4. Roxanne wrote on May 21st, 2010
  5. Im waiting for surgery to repair an extensive labral tear in my right shoulder. The problem was the laxity in my joints but had I stopped training as soon as it began to hurt Im sure less damage would have been done. Stop when it hurts is the best advice that Im sure all those who weight train have ignored at one time or another.

    Nick wrote on May 21st, 2010
  6. Thanks for the “Avoid the Wrong Types of Movement” section, I needed that! I’ve been doing a circuit workout that includes lateral shoulder raises, and I’ve noticed that I naturally want to pull the weights in about 30 degrees. I thought I should be trying to keep my arms more straight across, but I won’t worry about it anymore!

    Hannah wrote on May 21st, 2010
  7. Love the recent mobility posts. As a desk jockey, my shoulders, hips and wrists all need a good deal of mobility work and stretching.

    Stefan wrote on May 21st, 2010
  8. This post comes at a great time since I’ve been having some right shoulder problems. Particularly when doing shoulder exercises. Good stuff.

    OT: I’m pretty new to PB but I’m wondering if anyone experiences hunger when they get too much protein in one meal? Also, I’m trying to up my fat % but I’m having some problems keeping the protein % lower than the fat. Any suggestions folks? Right now I’m taking over 150 g of protein daily and I’d like to keep it at or slightly below that while getting my fat to that 150 g mark.

    Mountain Dew wrote on May 21st, 2010
    • Mountain Dew, my observation has been that questions such as yours will be mostly ignored when posted as a comment in the blog, but you’ll receive lots of helpful responses if you post your question over in the forum. People will want a little more information about you, such as age, gender, height, weight, and activity level, plus some samples of your daily food intake.

      SharonLl wrote on May 21st, 2010
      • I completely forgot about the forum. Thanks.

        Mountain Dew wrote on May 21st, 2010
  9. i’ve never done it but smart people have recommended to me benching off an exercise/swiss ball. you’ll never get to the same max weight as a flat bench but it’s much easier on the shoulders and adds in lots of support muscle activity.

    greg wrote on May 21st, 2010
  10. Dunno if it’s good or bad, but I noticed something when doing squats. I re-read and watched some Mark Rippetoe instructions, and I realized I was holding the bar across my shoulders all wrong.

    In proper squat form, you retract your scapula by lifting your elbows, creating a shelf on which the bar rests, trapped there by your hands. Your hands aren’t carrying the weight, they’re just to provide rolling friction against the bar that’s resting on your scapula.

    I’ve been concentrating on this proper squat form, lifting my elbows, retracting and flattening my scapula, and I feel very stable in the squat. But my upper back also feels “tired” afterwards, I’m really working the muscles there.

    I wonder if this helps with shoulder support?

    Ed wrote on May 21st, 2010
  11. Um… Shoulder dislocates? Did anybody else watch the video? Can you actually do that? That looks seriously painful…

    Paul wrote on May 21st, 2010
    • Paul, I do dislocates every warm-up with a PVC pipe. Just widen your grip enough so you don’t feel pain. Excellent way to get the shoulders prepped.

      Eric wrote on May 21st, 2010
    • It’s a strange and ironic name for the exercise, but it’s no more dangerous than any other warm-up exercise when done correctly.

      Best,
      Johnny

      Johnny at The Lean Saloon wrote on May 21st, 2010
  12. I have learned that reaching for something in the backseat of my car while driving is a bad idea. Must be similar to the lateral shoulder raises, but maybe more extreme??

    I also suspect that throwing a ball as hard and far as possible during childhood without any proper form training has caused chronic shoulder issues for me.

    Thanks for the great re-hab tips. I have made great progress on my own, but your advice will surely help even more!

    Rodney wrote on May 21st, 2010
  13. I enjoy doing upside down pushups as one exercise in this area.

    epistemocrat wrote on May 21st, 2010
  14. It seems this test is only partially measuring humeral internal rotation. There could be, and often are, tight forearm rotators that would contribute to the angle of the pen in your hand. Also a humerus can be retroverted, especially if the person has been involved with a lot of throwing sports which would also alter the result. Finally if a scapula is overly abducted, this allows the humerus to internally rotate excessively. Properly assessing the scapular resting and moving dynamics would be a good first place to begin understanding your shoulder function and potential source of pain as they are the keystone of shoulder joint function.
    I enjoy your articles, Mark.
    Thank you.

    Rick Olderman wrote on May 21st, 2010
  15. Thanks for another great post Mark! I did the test and sure enough…my sticks pointed in slightly! I guess I have some work to do back there. Great video resources as well.

    Mike Cheliak wrote on May 22nd, 2010
  16. If you do lateral raises as suggested by Vince Gironda (who also advocated a primal-type diet in the 50’s!) you will avoid any pain and get the full benefit from the movement to build wider shoulders.

    C’mon, Mark! Nothing wrong with a little bodybuilding AND primal living.

    NeoGrok like!

    Farley wrote on May 22nd, 2010
  17. I had some problems with one of my shoulders over the years. It started with a freak dislocated collarbone. Then I fell on the same shoulder when wrestling which resulted in rotator cuff injuries and an unstable distal end of my collarbone that was a pain in the …shoulder! I tried exercises such as some of the above. I found them to be hard to maintain because the workout movements are compartmentalized, boring and physiotherapy. And they just didn’t do the trick. Finally I got sick of it and just started to do pull ups. Lots and lots of pullups. First on an assisted machine but. Then I saw this 70 year old guy hop up on a bar and whip off 15 pullups with no problem. So I resolved to get better at pullups. I started Crossfit and as a result began to do kipping pullups and more whole body upper body exercises as a result. Like cleans and hang cleans and shoulder presses and wall balls. I think that the point I am trying to make is one of the value of REALLY USING YOUR SHOULDERS ALOT. I find rehab oriented exercises almost never rehab me. Instead what really happens is that I wait long enough (the rehab exercises just fill in time until I am ready) and when I am ready I use the exercises that I want to do for a workout as the rehab. I just do less until I can handle it and then start increasing the intensity. I should add that I also do a lot of mobility exercises like rolling shoulders, spinning arms and stretching but I had done those all the time. They did not get rid of shoulder pain or improve my posture. The more intense stuff seems to.

    I think people seriously underestimate what they (Grok) ought to be doing as “normal”. Hanging from your shoulders, hauling yourself around by your arms, picking things up thrusting them over your head… short duration high intensity.

    I think the worst thing I do to my shoulders is sit at the computer at work.

    I am 56.

    Mike Panian wrote on May 22nd, 2010
  18. This is a HUGE issue for any men trying to develop their upper bodies. As we’re prone to do. ;)

    I haven’t been able to bench press in 5 years because of a slight rotator cuff tear from overhead pressing. ….ironically in an effort to strengthen my shoulders! Personally I think if you never lifted heavy things with your upper body, you wouldn’t have to worry about this. The problem is training ONE half of your muscles and creating a strength imbalance. Like most guys I would bench and do shoulder exercises on the BIG muscles. But absolutely NOTHING for the smaller rotator-cuff muscles. Eventually that caught up to me, and I had a debilitating injury. It’s not stopping me from moving in life but I can’t add any upper-body muscle mass. And that sucks. I’m pretty skinny at 5’11” 150 pounds. I used to be able to bench 225 pounds. Now I can’t do over 155 without shoulder pain. Not good muscle soreness, BAD joint pain.

    About 18 months ago I finally decided to STOP trying to bench altogether and work on my rotators. The first day in I could do 5 pounds for about 12 reps. FIVE pounds. F-I-V-E, five. And I was benching 225 at my peak. Is there any wonder I injured myself?? Now 18 months later I can do 25 pounds. I still won’t bench. I figure when I get the rotator exercise up to 40 pounds for 20 reps, I will allow myself to embark on a bench press/upper body size routine. I don’t aspire to be huge, but I would like to weigh more than 150 pounds at some point in my life. If I could get back to benching 225 I’d be happy and not try to go beyond that. But I’m not willing to even attempt it until my rotators are the STRONG point in the chain not the weak point.

    …I don’t know if this has anything to do with the rotator exercises I’ve been doing for the past 18 months, but my 2 pens pointed straight ahead. …interesting.

    fixed gear wrote on May 25th, 2010
    • I gummed up my shoulder pretty good a few months ago, as a weight training newbie trying to press with poor form. I ordered the “Secrets of the Shoulder” DVD from DragonDoor. In their 80 minutes of instruction, they don’t prescribe a single rotator cuff strengthening excercise. Instead the emphasize scapular stability, and the ability to pack the shoulder through good grip strength. They walk you through a functional movement screen, then progressively harder excercises (level 1,2 and 3 – generally things like kettlebell turkish get-ups, clapping push-ups, military press). I can recommned this, as my shoulders can now easily find a position of strength and stability and I didn’t need to spend
      any time on rotator cuff strengthening excercises, which arguably don’t do anything for shoulder stability (but who knows, maybe they do – I’m hardly enough of a shoulder expert to determine if Gray Cook and Brett Jones are right or wrong or now, just that what they proscribed worked well for me).

      Kevin Teague wrote on May 27th, 2010
  19. Im not sure if i understand this correctly. I should have my shoulder blades squeezed together. When extending the arms overhead, should the scapula elevate or stay in position the entire time. Should they move. i thought any overhead pressing required scapula elevation.

    Ruari wrote on September 7th, 2010
  20. Hi, my both shoulders dislocated. Left shoulder for 1 time, Right shoulder for 5 times. Recently, my left shoulder dislocated after a check up with doctor after weighing a luggage for a trip. Just popped out by normally walking after having a back pack on my back for 1okm on bike. Its in weak state not getting strength, feeling of impingement syndrome. I went to physiotherapy. That guy created Neck Pain after testing by hitting on my head whether my Neck disks are in good health? I request you Please tell me how to deal with Shoulders at this point of time. No Strength for both shoulder shouldn’t weigh any things other than max 3 kg.

    Ram wrote on August 18th, 2011
  21. So I have a bad left shoulder and it feels like it will come out of the socket when i am sitting or standing. It also just feels awkward all of the time. I am a pretty constant gym goer but i am trying to figure out things to do with it to strengthen it but it just seems to feel the same. Do you suggest the DC protocol?

    Nate wrote on January 26th, 2012
  22. Would you be eager about exchanging links?

    online backup storage wrote on February 15th, 2012
  23. I have trouble understanding how to execute the lateral raises correctly according to this article, “move your arms forward about 30 degrees” can anyone send a link to a video demonstrating this? Thanks!

    Mina wrote on August 1st, 2012
  24. hello, are you too lazy to put pictures in this article? you are just confusing readers. too bad you are on 1st page of Google, but not illustrative at all.

    legg wrote on August 31st, 2012
    • He posted videos, and that ALOT better than just pictures

      Karly Warsing wrote on October 4th, 2012
  25. These excercises are awesome! I retired from horse training very early because of a horrible accident and was left with a messed up shoulder that doctors just couldn’t figure out. I went through all the tests but no one knew why my scapula muscles on one side wouldn’t work together so I always had one very weak shoulder. After going through physical therapy, I discovered I had normal use of my arm if I kept it strong. These excercises are great!

    Karly Warsing wrote on October 4th, 2012

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