The Shoulders
Shoulders
In bodybuilding, shoulders mean deltoids, but that’s not the case in sports nor when thinking of healthy joint stabilization. The shoulder is an extremely complex joint. It is by design the most mobile and least stable joint in the body. Very small changes can change the mechanical function and can cause problems.
The muscles that stabilize and support the joint are primarily the rotator cuff muscles and the scapular stabilizers, the rhomboids, traps and serratus. Let’s talk a little about these elements of what’s commonly called the shoulder girdle, but what’s more like a yoke that includes the clavicles that attach at the sternum, the glenohumeral joint, which is the ball-and-socket shoulder joint, and the scapulae, otherwise known as the shoulder blades.
The Rotator Cuff
The introduction most gym trainees get about shoulder health are instructions to do internal and external tubing exercises for the rotator cuff. Strengthening the rotator cuff muscles is often a good idea, but by no means is it a guarantee of optimal shoulder mechanics. You’ll never have proper shoulder mechanics with a weak rotator cuff—rotator cuff work is necessary, but it’s not sufficient.
Often you’ll see the rotator cuff referred to as tendons, but don’t rule out a rotator cuff muscle as the root cause of a problem. In fact, most of the damage that gets done by the bones fraying the tendon is originally because of a muscle problem.
Regarding the rotator cuff, the current thinking in physical therapy involves several steps to get back to good function. The first steps involve healing the individual muscles, restoring strength and range of motion, and getting them to neurologically fire well. The little isolation exercises do this, and physical therapy is where we learned those tubing exercises.
The next step is to relearn the motor patterns that cause these muscles work in concert with the whole body. Compound exercises are good, and exercises that make extra demands on stabilization may help a lot.
How Rotator Cuff Structures Get Injured
The rotator cuff muscles get beat up for two reasons. First, they’re little muscles with a big job, and second, they’re in a position where the joint will literally grind them up if the shoulder isn’t functioning properly. This grinding is called impingement. If you hear a click or pop every time you hit a certain point in a movement, it might be impingement and you’re wise to address it because over time that little abrasion can cause big trouble.
Strong rotator cuff muscles will be better able to do their jobs without getting injured from the strain, and will help keep the shoulder moving properly. But strong external rotators alone do not insure healthy shoulder movement.
If you’re not flexible in the pectorals, you’re going to have trouble. And the muscles that control the scapulae have to be sufficiently strong—meaning the rhomboids, mid and lower traps and serratus. And finally, even if everything is strong and sufficiently loose, if your coordinating motor patterns aren’t sequencing well, you still might have trouble.
First, consider this: If your rotator cuff is injured, you may need to wait before you strengthen it. See a doctor; make sure there’s nothing torn that needs repair. You may get sent to a physical therapist if passive movement is in order.
How We Strengthen the Rotator Cuff
Ultimately, most people will have to do direct work to maintain adequate strength in the stabilizers. For one thing, if you aren’t doing elbows-out rows, you might not be hitting the rotator cuff much. Even if you are, there’s an excellent chance the big prime movers will get ahead of the stabilizers and wind up doing more than their share of the work, leaving the rotator cuff muscles lacking. The odds that all four of the rotator cuff muscles will be strengthened enough to adequately support the shoulder just by doing row are small.
There are two ways to go. One is to periodically test the rotator cuff for strength, making sure adequate strength and range of motion is there in all the various positions. Then do exercises to bring up the weak points as necessary. The other is to just do some rotator cuff work. Since we’re talking about 10 minutes a week, just doing a bit of it is easy enough.
Rotator cuff strength is normally tested by seeing how much weight can be handled in direct rotator cuff exercises. Ideally, rather than look at that number in a vacuum, it would be compared to strength in compound upper-body exercises, which we’ll cover in another segment.
The rotator cuff external rotation exercises are just a small part of keeping a healthy shoulder, and are not the be-all answer you might expect as you see your gym mates grabbing the tubing to warm up before every training session.
Next: Basic Shoulder Health