This is a guest article from Ben, a highly knowledgeable member on the PropaneFitness Forum:

Ben, "Quadzilla"

Shoulder Problems

I’m going to talk about my shoulder problems, and what I did to fix them, rather than post specific advice for other people. I’m doing this because:
1) I’m not qualified to diagnose your problem (least of all over the internet);
2) the shoulder joint is incredibly complex and there are many treatments that may be beneficial for some problems but completely inappropriate for others.

I think that the only general advice I can give is to strengthen and balance your upper back and rotator cuff muscles. That means training the lower/mid traps as well as the upper traps, and balancing internal rotation with external rotation to give two concrete examples.

The first step is to admit you have a problem. If you hear your shoulders clicking and popping, don’t be a fool and ignore it. Get a proper diagnosis. If your GP tells you to that it’s a rotator cuff injury and you should stop training, then tell them that isn’t good enough. You need to know exactly what is wrong; for example, is there subacromial impingement? Are any of the rotator cuff tendons or muscles, like the infraspinatus, torn? There are simple physical tests that can be carried out to check for impingement and rotator cuff injuries: http://www.shoulderdoc.co.uk/article.asp?section=497

When I first started training I had no idea how to bench properly, I would use a wide grip and bring the bar down to my neck. This is a great chest exercise and an efficient shoulder destroyer. I combined this with no rear delt and upper back work, and poor posture. Slouching in front of computers and desks was something I often did for hours, reinforcing bad habits. My upper chest and front delts were pulling everything forward, and the constant internal rotation (picture how you use a keyboard and mouse at a desk) created muscular imbalances. I didn’t stop pressing until I was in pain and couldn’t press at all or even open doors properly. I had constant clicking and popping from subacromial impingement, and strained rotator cuff muscles. It took about 6 months of rehab and little to no pressing to be confident that I’d recovered from my last shoulder injury, but I don’t take any chances. I can safely do pressing twice a week now, and I’m stronger than ever, but if I get any indication that there’s a problem I stop. Here’s a summary of what I do.

 

Rehab and Prehab
There are many corrective/preventative exercises. The ones you do should be suited to your problem. What I find useful are:


(Initially when you do these, it’s actually good to do them positioned near a mirror with your top off, or wearing a vest perhaps, so you can make the connection with your rear delts and focus on contracting them.)




(I do these using a lying row machine.)

(Always initiate the movement with the scapular retraction. These can be performed with bands like in the video below.)

(It’s important to go very light with these at first.)

(I like to do these in a dip machine as an upper chest movement.)
(Use an empty bar at first.)

Voyer shrugs:I would recommend following a dedicated rehab routine until you are sure that it’s safe to resume pressing. Here’s a suitable collection of shoulder rehab circuits: http://www.dieselcrew.com/how-to-shoulder-rehab

Posture

Posture
If you notice yourself slouching, consciously reset. Pull your shoulder blades back, engage your core muscles and adjust your pelvic tilt. If you look side-on in a mirror when standing up, you should not be able to see your shoulder blades sticking out. The shoulder is a capsule joint and it needs space to function optimally. Practise good posture as often as you can. I used to focus on keeping my shoulder blades down and back during bus journeys, almost like I was setting up for a bench press on the seat.

There’s an excellent series on how to fix your posture by Eric Cressey and Mike Robertson:

http://www.t-nation.com/free_online_article/sports_body_training_performance_repair/neanderthal_no_more_part_i
http://www.t-nation.com/free_online_article/sports_body_training_performance_repair/neanderthal_no_more_part_ii
http://www.t-nation.com/free_online_article/sports_body_training_performance_repair/neanderthal_no_more_iii
http://www.t-nation.com/free_online_article/sports_body_training_performance_repair/neanderthal_no_more_part_iv
http://www.t-nation.com/free_online_article/sports_body_training_performance_repair/neanderthal_no_more_part_v

It’s a long series of articles, and there is a lot to digest, but there are lots of useful bits of information to take from them, even if you don’t follow all of their recommendations.

Soft Tissue Work
I foam roll my chest and upper back before doing any pressing. I use a tennis ball to roll my upper chest and front delts; and I do this standing upright against a wall for comfort, rather than lying down. For the rotator cuff muscles I follow the method described in this article: http://laurensfitness.com/2008/02/29/tennis-ball-part-3-upper-body/ (Note that the first time you tennis ball roll the rotator cuff muscles it will probably be exceptionally painful, even if you have done soft tissue work before.)

Exercise Selection

Ditch pressing movements that are painful or risky. I switched to reverse-grip bench, decline bench and dips (keeping upper back tight at all times, this is important). I do DB bench but initiate the movement with a neutral grip and rotate as I press. Floor presses are an excellent variation, and are a good chest exercise anyway, certainly better than flat bench for chest in my opinion. Make sure that when you do deadlifts or rack pulls that you retract your scapulae with each repetition.

Avoid anything which puts your shoulder joints at unnecessary risk: moron shrugs where you rotate your shoulders (this does nothing except grind your shoulders up), benching without upper back tightness or flared elbows (I think everyone here benches with good form though), even lateral raises without properly retracted scapulae feel dodgy to me! Your program should take account of this, if you do too much front delt and bicep work it may be cause bicep tendon issues. Remember to balance pressing with rowing and upper back work. If you do back squats note that your shoulders may get beat up if you have an injury or impingement, and front squats may be a better choice. But if you have AC joint issues they will be worse!

Summary

If your shoulders are healthy, keep them that way. Balance your program and include enough prehab work to avoid developing problems. If you do develop shoulder problems, get them diagnosed immediately and properly. Take the time to fix them and reinforce good habits that will help you stay healthy.

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