Five Reasons Why Your Shoulders Hurt
Let's start out with a list of some common things that contribute to soft tissue problems in the shoulders and some suggestions for minimizing them. Then we'll finish off with four moves that'll heal your shoulders up fast.
Barbells fix our shoulders in position and don't allow them to rotate or use shoulder-friendly grips. To make matters worse, we typically press bars with a pronated (overhand, palms facing away) grip, which is a position of loaded internal rotation for the shoulder. This can promote existing rotator cuff/shoulder girdle imbalances. Also, if you have weakness in one shoulder, it can't be addressed with a bar that distributes the load evenly across both shoulders.
If you have shoulder pain, keep barbell use to one day a week per upper body movement (preferably for horizontal pressing as opposed to vertical). Limit barbell use to short, heavy sets and switch between a pronated and supinated grip from time to time.
If you're going to use body-part training splits, you need to make sure that you're balancing your ratio of pushing and pulling. People balance horizontal push and pull all the time (think bench press and row), but it's all too easy to neglect to balance vertical pushing and pulling (think overhead press and pulldown.) Things like cleans, shrugs and overhead pressing must be balanced with things like chin-ups and pulldowns at different angles. Organize your program to keep a 2:2 ratio of vertical pulling/pressing to horizontal pulling/pressing.
The tendons at the front of the shoulder can get "chewed up." These tendons protect the shoulders by keeping the humeral head from translating too far forward in the glenoid fossa (the socket). This forward or anterior translation is referred to as "anterior humeral glide" and can lead to chronic connective tissue irritation and lingering pain and soreness, especially after pressing workouts.
It can be made worse with tight lats that pull our humeral head forward. This is seen in people who perform rowing/pulling reps that end with the elbows in retroversion way behind the rib cage and with the top of their humerus jutting out in front of their pecs. If this is you, shorten your range of motion when doing pulling exercises. Focus on getting a good scapulae squeeze/retraction and stop there. It'll help to restore the tissue quality of these abused supportive structures.
Ground substances are basically what lubricate our individual muscle fibers and allow them to smoothly cooperate and glide over one another. They're composed of water and other entities known as glycosaminoglycons (GAGs). GAGs are amino groups containing polysaccharides that, combined with water, support the connective tissue (like collagen and elastin) and help it to remain moist.
GAGs act as a medium of exchange for oxygen and nutrients and also allow for removal of cellular waste. They therefore play a major role in the work capacity, health, and daily function of our muscle fibers and are as crucial for hypertrophy and performance as fascia and muscles themselves.
With chronic stress, immobility, and injury, these substances can change from being water-like to becoming viscous, hindering our movement. Then they become solid and gunky, restricting our movement. This last stage is where problems like painful, frozen shoulders come into play. Self-myofascial release (SMR) and other restoration methods will keep our ground substances watery and in their natural state.
Our joints are subjected to the same loading patterns over and over again without the ameliorating effects offered by performing movements that are altogether different from what your joints are accustomed to. To help deal with this, be more disciplined in the daily management of your soft tissue.
Here's a simple rehab protocol to help your soft tissues return to normal and get your scapulae moving properly again.
Med balls can be great tools for self-myofascial release. Due to their shape, they're often better than foam rollers. Balls can really get into the nooks and crannies. Many med ball are harder too, with a tackier surface which increases friction and makes it easier to maintain contact with you and the floor.
To use the tack and floss with a med ball, find a knot or sore spot. Pin the sore spot down and actively go through a full and varied range of motion. This is a great way to knead the tissue from the point of pressure outward, tenderizing the tense tissue and gradually decreasing the layer of adhesions and dysfunction that have built up. It'll also re-mobilize ground substances, help the fascial layers to glide smoothly on top of one another, and mobilize any scars.
Perform the tack and floss with two movements and two progressions using the wall and then the floor. For the wall, place a small or medium-sized med ball between the wall and the area under your collarbone – in and around the pec and anterior deltoid – and lean against it. To get the pec minor, get your feet back and really lean in. Maintain a rigid anterior core and a slight posterior pelvic tilt to protect your posture.
Tack and Floss, Anterior 1
Get your arm into a position of full internal rotation – back of the hand placed at the top of the butt or as close to it as you can get – and slowly rotate it counter-clockwise all the way up overhead and then back to the starting position.
Be sure to also rotate the hand and wrist to access and release the maximum amount of fibers in the shoulder girdle. You can also raise your upper arm to shoulder height and flex the elbow to 90-degrees and go through an internal/external rotation pattern.
Tack and Floss, Anterior 2
The more you perform this, the better your tissue quality will become and the more pressure you'll be able to apply against the ball. Eventually you'll be able to move to the final progression, which is on the floor.
Tack and Floss, Anterior 3
This final position will provide a much fuller release of the shoulder girdle by adding in a sideways rotation to include the release of the superior attachment of the lats, the teres major and minor, the infraspinatus, and the long head of the triceps.
Perform the same movements on the posterior (back) region of the shoulder girdle. The floor works best here.
Tack and Floss, Posterior 1
Tack and Floss, Posterior 2
Do two sets of ten before moving on to exercise two of the series.
After releasing the soft tissue of the shoulder girdle that's been hindering movement, do the handcuff drill. This strengthens and promotes blood flow to the muscles of the scapula and humerus, which operate in a supportive function during pressing. The muscles you hit depend on whether you perform the exercise in protraction or retraction, so do both.
Handcuff Drill, Wall
Start in a full kneeling position close to the wall. Wrap a small, taut band over the wrists and place the hands against the wall with the wrists at shoulder height and the elbows locked. Now imagine a clock. Make small movements with each hand, alternating them one at a time toward 12, 3, and 5 with your right hand and 12, 9, and 7 with your left hand.
Progress the exercise by kneeling further from the wall, up to about a foot out from the original position. Then move to standing and progress it the same way. Once you can perform it standing far from the wall, progress to the floor (or on a slightly elevated surface) where you perform the exercise in a straight-arm plank.
Handcuff Drill, Floor
At first your shoulder girdle will quickly fatigue and burn. However, that feeling of fatiguing and burning (the build-up of metabolic waste) isn't the same thing as pain. If it hurts, stop and continue next time, building your way to the point of doing the entire exercise pain-free. You're not ready to move to the next position/progression of this exercise (moving further out from the wall) until you can complete two sets of the handcuff drill pain free, in both retraction and protraction, without taking a break between reps.
Perform two sets of ten in each position.
The next exercise is all about obtaining vertical push/pull balance. This means coordinating the activity of the upper and lower fibers of the trapezius, as well as some of the lower fibers of the serratus anterior, all while keeping our scapulae in retraction.
This exercise can be done with both a cable (for passive activation of the upward rotators), or a kettlebell (for active activation of the upward rotators). While the kettlebell variation is great as a warm-up for performance, the cable variation is great as a more corrective measure to grant the user healthy lat-length (to prevent anterior humeral glide and a kyphotic posture) and long-head triceps length. This will loosen up the often stiff and gunky posterior capsule of the shoulder.
A stiff and immobile posterior capsule can force the humeral head to the front of the glenoid fossa and contribute to further anterior glide of the humerus and a lack of joint centration within the glenohumeral joint. The cable variation also gives us some vertical pulling at an atypical angle to hit fibers we normally wouldn't, and to promote that crucial vertical press/pull balance.
Restoring Scapula Movement, Cable
Do the cable variation by attaching a dual or single high-pulley to a moderate load and hinging backward at the hips. Simultaneously flex the shoulders overhead so that the bottom position has you at a 45-degree angle at the hip with the arms fully extended alongside the ears.
The hinge and the overhead flexion at the shoulder gives the lats and long head triceps a nice, long dynamic stretch and helps to provide the positional mobility and stability at both the lumbar and thoracic spine that's required when performing the kettlebell variation.
The kettlebell variation is performed by holding the kettlebell in a goblet while remaining in the bottom position of a hinge, and pressing it out overhead keeping the arms in-line with the ears. Start light!
Restoring Scapula Movement, Kettlebell
Do two sets of ten for each of the cable and kettlebell variations (in that order) before moving on to the final exercise.
The serratus press will get the shoulders re-acclimated to overhead pressing. The focus is to train the lower fibers of the serratus anterior to keep your scapula abducting and rotating snugly and efficiently along and against the ribcage, closely following the humeral head and maintaining proper congruency of the ball and socket.
Serratus Press, Foam Roller
For the first progression, take a foam roller and place it horizontally against the wall. Then get into either a wide or a staggered stance and lean against the roller with the distal portion of your forearms. With the arms bent to 90-degrees at the elbow and shoulder, protract the scapulae and press into the roller while simultaneously moving the arms overhead, gradually gliding the roller upwards. Keep the arms narrow, no more than shoulder distance apart. Once you can perform it pain free for three sets of ten, it's time to progress.
Serratus Press, Barbell
Set the pins at just below shoulder height in a power rack with an unloaded or very lightly loaded barbell and perform the same action. Slowly press the bar up while maintaining forward pressure against the rack. Don't progress to the power rack until you can do two to three pain-free sets with the foam roller. Remember, everything here is about progress. Don't rush. You may increase the load slightly with each set.
Try these four exercises prior to training and also on your off-days. Once you heal up, keep doing these movements as a preventative care program to maintain shoulder health.