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20 May

The Importance of Shoulder Mobility and Scapular Stability

shoulderIf you’ve been following my series on joint mobility you’ll know that I’ve already covered how to improve and maintain joint mobility for the hips, thoracic spine, and ankles and wrists. Today and tomorrow I’ll be going over the shoulder. The shoulder is a tricky joint because it has to provide adequate stability while maintaining full mobility to prevent injury and maximize function and performance. If you look at yourself in the mirror and wave your arms around, you’ll see what I mean. If that doesn’t work, watch a swimmer, preferably one doing the IM, and watch the incredible range of motion in those shoulders. That’s what the human body is capable of.

Know what you’re looking for and you should be able to count ten different types of shoulder articulations. Ten! Contrast that with the hips (eight), the ankles (two), the wrists (four), or the spine (five), and the shoulder is clearly the most complicated joint with the greatest range of motion. Because “with great power comes great responsibility,” the shoulder is also perhaps the joint most vulnerable to injury. You can do a whole lot with a well-functioning shoulder joint, but you can also really mess yourself up and curtail your activity level for a long time if you get haphazard with its maintenance. Take it from a guy who messed his shoulder up more than once: shoulder health is absolutely required for an active, enriched life. And if you plan on attaining any sort of athletic competency on any level, you need good shoulders.

Shoulder Structure

A person’s shoulder joint is composed of the clavicle (collar bone), the scapula (shoulder blades), and the humerus (upper arm bone), along with two joints – the acromioclavicular, or AC joint; and the glenohumeral joint. AC joints exist between the clavicle and the scapula, whereas the glenohumeral joint is the classic ball-and-socket joint responsible for basic arm rotations and hinging. All these bones and joints are in turn supported by the surrounding musculature.

Shoulderjoint

The surrounding musculature is extensive. You’ve got the big boys, like the rear, middle, and anterior deltoids or the trapezius, that get all the credit. They’re the ones that pop out and look great in tank tops. Important? Yes. But there are more important ones, I’d argue. Because for all that mobility and all that muscle mass to work correctly, you need stability. You need a base, something to work from.

This concept isn’t new, and it’s certainly not unique to the human shoulder joint. The entire body’s continuum of joints is governed by this “law.” Mobility-centric joints, like the hips, thoracic spine, and ankles, are connected to stability-centric joints, like the knees and lumbar spine. Each requires the next in line to function correctly and smoothly.

For the mobile shoulder joints to stay mobile and healthy, they rely almost entirely on the proper function of the scapula. Yes, the true key to shoulder mobility is scapular stability. You gotta have strong shoulder blades. You need a foundation.

While doing the bench press, that infamous destroyer of rotator cuffs, a trainee must tighten his scapula to create a “shelf” to lay against the bench. A trainee must also maintain that shelf throughout the set, even (especially) when pressing up. This is scapular retraction, and benching without it – with a loose, rounded back on the press up – will eventually kill your shoulders. It certainly knocked mine out for a good couple of months the most recent (and last) time I tried to max out my bench.

Any overhead work, whether it’s pressing a barbell, lifting a growing child, or moving luggage into the overhead bin on an airplane, requires scapular elevation to help the acromion clear the rotator cuff. It moves, ideally, smoothly, but if you’ve got poor scapular function (say, from kyphosis, or poor thoracic mobility), the upward rotation is halted, and impingement syndrome can result.

Back squats work best with a close grip and strong scapular retraction in order to urge the rest of the torso to stiffen and create that “shelf” for the bar to lie on. Try doing back squats with a wide grip and lax shoulder blades to see what I mean. Actually, don’t; it’ll just hurt your shoulders.

Rowing (machine, boat, or barbell) is all about scapular retraction. You’re not just going to yank on a cable or work a paddle by flailing your arms wildly. Well, you could, but you’d injure yourself. Setting your shoulder blades back and keeping them tight creates a safe, linear path for your primary rowing muscles to travel.

Pull-ups and chin-ups are all about scapular stability, very similar to the rows.

The shoulders figure into every upper body exercise. If your arms are moving, that movement is occurring along the joints that comprise the shoulder. Bench presses, dips, overhead presses, and anything else involving your arms depend on healthy shoulders and good scapular function. Tomorrow, I’ll explain more about the scapula, how to target its supporting musculature, and how it all figures into overall shoulder health and mobility.

Read on to learn how to maintain shoulder mobility ans scapular stability.

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  1. This is the one I’ve been waiting for. Been dealing with shoulder problems off and on for years. I’m really looking forward to tomorrow’s post, so I can learn how to help it. Thanks Mark!

    anzy wrote on May 20th, 2010
  2. Me too! I just started my physical therapy on Monday for my shoulder. Turns out I had more issues that I thought when it first started hurting back in February. I thought I had just slept funny – well 2 1/2 months later, I’m finally getting it back to where it needs to be so in a few weeks, I can start lifting again!
    Can’t wait for tomorrow’s post!

    Melissa wrote on May 20th, 2010
  3. Really want to hear what you have to say about how to maintain scapular stability. While I love pushups and pullups, just looking at our bodies makes clear that they were not the primary goal of the arms. I’ve been worried about pushing too hard on these exercises, so I’m really enthused that you’re going to explain all about protecting the shoulder.

    John Solter wrote on May 20th, 2010
    • Same here. I do push-ups and pull-ups everytime I lift heavy things… that includes today!

      I never want to overdo while I want to be as strong as possible – ya need healthy shoulders to be doing it effectively!

      Primal Toad wrote on May 20th, 2010
    • You brought up a good point. Many parts of the body aren’t “designed” to do what many of us do in modern times or in gyms. But we do them anyway and for the most part they adapt pretty well.

      But you hit it on the head when you implied a concern with pushing too hard. Pushing too hard with either maximum load, velocity, or volume increases the probability of technical degradation, which is when the shoulder girdle is most at risk.

      I believe this is drawback to the general use of the CrossFit method where an inexperienced, quasi-experienced, or even highly experienced participant pushes him- or herself to beyond “acceptable” degradation of technique. Do this often enough and the trauma rate exceeds the recovery rate, and evolutionary design makes its point clearly with a blown shoulder.

      General advice, for what it’s worth: Be smart, be familiar with technique, know “how much” you can deviate from this technique, and finally know when to stop the set.

      My $0.02 and keep the change.

      Best,
      Johnny

      Johnny wrote on May 20th, 2010
  4. Great one again, Mark. I really like this recent series of articles. Very informative and the stuff you don’t often hear about.

    This one’s off topic (and if it’s out of bounds, please don’t take it personally), but would you share your thoughts on Floyd Landis’ recent admission that he was guilty of doping? No need to comment on the specifics of the allegations (unless you want to) particularly as they relate to Lance and other third parties. I’m mostly interested to hear your perspective on it as a former elite athlete and one who’s taken a leading role against drugs in sport. What do you think about the process? How can (or maybe just “can”) sports and the testing regimes be reformed? What’s do you think is the next step for Floyd both as far as cycling authorities and legal authorities here and in France are concerned? Again if this is too off topic, or if you’d rather just not “go there” in light of the very preliminary, (and, IMO less than totally credible) allegations, no offense. Apologies in advance if this was the wrong place to raise this issue.

    Geoff wrote on May 20th, 2010
  5. My husband has been dealing with Adhesive capsulitis (frozen shoulder) in both of his shoulders for almost a year now. He’s going in today for the ortho to do a manual manipulation under anesthesia. He is young to have this problem, only 38, the Doc says this is usually seen in men and women in their 50′s. But, my husband is also diabetic which seems to play some roll in it but we’re not sure what. I really hope this is the answer, he’s not been able to do any upper body workouts because of the loss of mobility and pain and has to take Advil PM at night to sleep. Do you know anything about this issue Mark? If so please share.

    hcantrall wrote on May 20th, 2010
  6. Very timely post for me. I am seeing a physio on Monday to look at a nagging shoulder injury I have had for about a year. At least I will now have a better understanding of what I am letting myself in for!

    Guy wrote on May 20th, 2010
  7. I just have to share how I accidentally cured my shoulder problem. I had tried everything: chiropractor, PT, OT, acupuncture, NSAIDS… the works. I’d had the pain for over a year.
    Then one day, I had to spray for some weeds. I have a 2 gallon sprayer that when full weighs about 16 lbs. I carried that with the “bad” shoulder, with it’s slowly decreasing weight for 45 minutes of spraying. My shoulder was really burning when I finished.
    The next day I woke up with all my shoulder pain gone. 100% gone. I guess the traction and holding the weight of the sprayer slightly away from my legs to keep it from bumping against me did the trick!

    Dave, RN wrote on May 20th, 2010
    • and it hasn’t returned at all? so happy for you, wow.

      Josephine wrote on May 20th, 2010
  8. how about everytime u do a pull up or sit up and one of your shoulders makes a popping sound over and over like something in my socket is moving? it doesnt hurt at all, but it feels weird and puts me off doing more reps than i want to.

    norcalgal wrote on May 20th, 2010
    • i get a popping sound in my right hip on the down movement of a sit-up! same thing. it doesn’t hurt but i really don’t think that it could possibly be good for me.

      t.rock wrote on May 20th, 2010
      • i get popping in my right hip too!
        ahh. our poor achy popping joints. and im only 28 =/

        norcalgal wrote on May 21st, 2010
        • and i, a mere 29!

          t.rock wrote on May 21st, 2010
  9. I have trouble with my arm going numb when my arm is forward. I have front shoulder pain and know that I have a pinched nerve between my 5th & 6th verebrae. I personal train 3 times a week & other strenuous exercises the rest of the week. This shoulder pain is inhibiting me from my full potential as an athlete. looking forward to your articles

    dedra wrote on May 20th, 2010
  10. Mark, thank you! I have messed up my right shoulder twice now and have sort of become gun shy with weights. I stopped wide angle pull ups and military press because my rhomboid section closest to my spine locks up and twitches. I have been doing a bunch more power yoga to try to losen it, but even that hurts sometimes. I can’t figure out if it’s my AC joint or rotator cuff that clicks. Do you have any suggestions as to what exercises I could do to help losen it up?

    Looking forward to your post maniana! Thanks Jo

    Josephine wrote on May 20th, 2010
  11. I have a calcification in a ligament that can’t be corrected via surgical means. Stopping dumbbell flys has kept it somewhat under control, but when it flares up it is 6 weeks of heavy ibuprofen and therapy and no lifting.

    randalland wrote on May 20th, 2010
  12. Some really new stuff (at least for me) here. I wouldn’t imagine scapulas where that important (just like one year ago I wouldn’t imagine carbs where so bad), so I’ll trust you on this one too.

    Looking forward to part too.
    Cheers,
    Iván.

    Iván Pérez wrote on May 20th, 2010
  13. I swim laps for exercise and couldn’t swim for almost a year when I developed a shoulder impingement. PT finally cured it, but it was a long, slow process, and I had to keep up the exercises until the shoulder was finally pain free and strong. I now do the PT program periodically to keep my shoulders strong.

    Anita Gandolfo wrote on May 20th, 2010
    • Hi,

      I have a shoulder impingement caused by an ice-skating fall. Could you post a link to the PT program that finally cured it. I keep telling my doctor that my shoulder is killing me and he just says, “Oh, oh. Well, exercise.” My five-year old can now throw a ball farther than I can.

      Mark wrote on May 26th, 2010
  14. Actually, push-ups are a great exercise to stabilize the scapulae by strengthening the serratus anterior. After 10 years in the industry, I’ve come to the realization that unless you desire to be a competitive powerlifter, the bench press is a utterly useless exercise that only serves to feed some adolescent fantasy. Push-ups are superior in just about every aspect, and can be loaded in a variety of ways.

    For those wanting to get a head start on shoulder health check out the following article -

    http://www.tmuscle.com/free_online_article/sports_body_training_performance_repair/pushups_face_pulls_and_shrugs;jsessionid=FED2712851D03231EA5D8FFB76DE51CF-hh.hydra

    And for more on push-ups and how to do them CORRECTLY – not with your elbows flared like a squawking chicken’s wings…

    http://www.tmuscle.com/free_online_article/sports_body_training_performance/everything_pushups

    Russ wrote on May 20th, 2010
    • Thanks for those two links =)

      Franek wrote on May 22nd, 2010
  15. Great post Mark. A couple years ago I jumped feet first into a swimming pool and dislocated my shoulder. (Still have no idea how that’s even possible!)

    I’m going to be more cognizant of retracting my scapula during squats, bench presses, and pull ups in the future after reading this.

    Darrin wrote on May 20th, 2010
  16. Thanks for a great post Mark. I have been enjoyed this whole series of posts on our different body parts. Very helpful!

    Willow wrote on May 20th, 2010
  17. Thanks for a fantastic explanation of the shoulder joint and it’s inherent blessings / curses.

    I wonder how much of our shoulder problems can be traced to improper exercise form and or too much testosterone?

    Keep em coming.

    Chris Melton wrote on May 20th, 2010
    • How would too much testosterone affect shoulder health?

      Matt wrote on May 21st, 2010
  18. After injuring my shoulder in yoga many years ago, I found Pilates exercises regarding scapular stabilization to be simple but effective. More than anything the movement work on the mat as well as on the Reformer and other typical Pilates equipment heightens awareness regarding what each individual’s range is, and how to articulate it with ease. But again, that’s been my experience with investigating what works best for me.

    Jenny wrote on May 21st, 2010
  19. Hmm.. I really should do perform more shoulder dislocations.

    Matt wrote on May 21st, 2010
  20. Great post Mark especially considering so that many of us are spending more and more in seated flexed-forward positions. We need to loosen up the pecs, strengthen the upper back, and keep our shoulder girdle in good health each day!

    Yuri Elkaim wrote on May 21st, 2010
  21. Great article. However, regarding the shoulder joint having 10 articulations, I think you mean movements of the shoulder. In anatomy, articulation refers to the actual joint which joins two bones together. There are only 3 articulations in the shoulder: The acromion of the scapula articluates with the clavical to form the acromioclavicular joint, the clavicle articulates with the manubriam of the sternum to form the sternoclavicular join, and the glenoid fossa of the scapula acticulates with the humerus to form the glenohumeral (shoulder) joint. There are 11 movements of the shoulder: arm flexion, arm extention, arm adduction, arm abduction, medial rotation of the arm, external rotation of the arm, circumduction of the arm, and scapular elevation, depression, retrataction and protraction.

    Kristen wrote on May 21st, 2010
    • Don’t forget about the scapulothoracic articulation, making a total of four.

      Brian wrote on May 21st, 2010
  22. This post couldn’t come in a more timely fashion….

    I have been dealing with shoulder problems for going on 8-9 months. I tore my supraspinatus tendon I am not sure how I did it, but one day I went Crossfit and I couldn’t even bench. I have basically been forced to get cortizone injections to see if it will heal before they opt for surgery.
    I have been reading up on these injections and I heard they destroy connective tissue. Anyone have any thoughts on these Injections? Also, I found out yesterday my left and right scapula are uneven. This is contributing to the tingling sensation I have had for years. So now I have to get an EMG…
    I am 23 years old I never thought I could have so many muscloskeletal issues.
    I just want to get back into my Crossfit gym…all I can do with now are squats and the spin classes…
    Any thoughts or input on this situaion would be awesome!

    Alissa wrote on May 21st, 2010
  23. I am a big row machine fan. I do 3-5 sets of sprints with good posture to warm up lots of times at the gym. Quite enjoyable.

    epistemocrat wrote on May 21st, 2010
  24. Great article. I listened to my coaches in High School and completely tore apart my right shoulder. I tore all but one of the rotator muscles and had a posterior dislocation of the shoulder which onyl accounts for about 5% of all dislocations. these are the ones that the only way you know it’s out is if your arm goes numb. Not great when you play third base or are the QB. I had to have the entire thing rebuilt and it took 4 years of rehab to get it back. Needless to say I take very good care of the shoulders now.

    Matt wrote on May 26th, 2010
  25. It always flies over my head how it is recommended to contract your shoulder blades together when doing bench presses or rows. I can understand do that when your arms are retracted. But how is that even possible when your arms are extended??

    Mo wrote on October 2nd, 2011
  26. I have ligament laxity and ive been doing PT programmes for years and years now. They refuse to opperate on me. My shoulder pops out everytime i raise my arm. NOTHING works, tried it all, press ups, rotator cuff training. I have a chronic subluxation. I AM FED UP

    John wrote on December 15th, 2012

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