The Worst Thing You Can Do
Trying to increase mobility may be the single worst thing you could do to treat shoulder pain. Want to relieve the pain and start lifting hard and heavy again? Then stop chasing your tail. Here's what you need to know.
You need to see the whole picture of shoulder health. When you're dealing with the most naturally mobile joint in the body, don't be tempted to try and make it more mobile. As with anything, too much of a good thing is no longer useful, and it can work against you.
Would you put out a forest fire by dousing the trees with gasoline? Essentially, that's what you're doing when you aggressively stretch and roll your achy shoulder. Sure, there will always be structural injuries and anomalies that warrant a more in-depth diagnostic look, but you can't roll out a shitty joint surface, nor can you repair rotator cuff tears on a lacrosse ball.
Most of the time, a painful shoulder is already mobile enough at the gleno-humeral joint. What the shoulder really needs is a smoother, more coordinated use of its natural mobility. And the way we achieve that is by stabilizing the other three joints of the shoulder complex, mainly the scapulo-thoracic joint.
The gleno-humeral joint is highly dependent on the other joints and regions adjacent to the shoulder. But we don't need to turn this into an advanced lesson in biomechanics. So here's the deal:
When the shoulder starts to hurt, one of the most common culprits is a stiff and excessively rounded thoracic (upper-mid) spine position. While the thoracic spine has a rather large amount of relative range of motion available throughout its 12 segments, this region needs to have the ability to get in an extended position, and it needs to have the skill and control to dynamically stabilize this position moving into extension. The thoracic spine also commonly lacks rotational capabilities in people presenting with shoulder pain.
When the thoracic spine fails to extend and rotate properly, the mobility that the human body was designed to control at the mid back is often shifted to the shoulder joint, causing hypermobility, especially in overly extended ranges of motion commonly used in the gym and in sports.
So if you can achieve and use better thoracic spine extension and rotation, you can mitigate the migration of unwanted range of motion into the gleno-humeral joint, thus decreasing the overall stress to the ball and socket joint and the soft tissues surrounding.
To improve your thoracic spine mobility, try these three foundational drills.
Thoracic Mobility Movements
Many times, thoracic spine extension and rotation can be improved quickly with corrective exercises, breathing re-patterning, and even some targeted soft tissue work, but the shoulder still remains painful. If this is the case, it's time to look elsewhere when trying to identify the dysfunction in the upper quarter of the body causing the shoulder pain.
Sure, targeting soft tissue work to one or more of the 17 muscles attaching directly to the scapula may alleviate some spot soreness and pain, but is it really working to strengthen motor control and coordination between the shoulder and scap? Probably not. This is why mobility is not a cure-all.
The tougher movement dysfunction to identify has more to do with the stability and control of the shoulder blade on the backside of the thoracic cage. And you can't improve stability by sitting a lacrosse ball behind your shoulder blade and making it hurt so good.
While mobility is a largely overused type of target treatment for not only shoulder pain, but hip and lower back pain as well, stability is the true player when it comes to positioning and protecting naturally mobile regions against unwanted ranges of motion.
Stability isn't just the ability to stay super stiff and not allow movement from happening at a given joint or region, but rather a continuum of static and dynamic skill at each end of the spectrum. While the most foundational skill to teach novice or dysfunctional athletes is how to achieve static positions that are stable, the learning curve will start to open up allowing for more "dynamic" stability to be coordinated into smoother, more symmetrical and synergistic movements.
Consider the three types of muscular contractions: eccentric, concentric, and isometric. Static stability can be honed and improved through the use of exerting force to maintain a solid position with isometric based training, while dynamic stability is almost always exhibited in combination with segments of the body working to maintain static stability.
Take the push-up for example. When moving into a push-up plank position hold, the pillar – including the shoulder, core, and hip complexes – are all firing together to stabilize the joints to avoid unwanted positional deviation. This would be considered static stability practiced with an isometric-based full body muscular contraction.
As soon as the initial descent starts to happen with the push-up, a combination of static and dynamic stability happens to complete the movement pattern. The hips and core maintain a statically stable position to maintain proper spinal and lower extremity alignment and position, but the shoulder complex begins to display dynamic stability to control both the lowering and raising portions of the push-up in a coordinated fashion.
A lack of control of dynamic stability at the shoulder blade translates into either the loss of a strong and stable core and hip position, or most commonly, an unwanted deviation and increase of quality range of motion from the gleno-humeral joint. This is why being strong in many postures, positions, and types of contractions is key to long-term success orthopedically.
It's important to understand that mastering static stability before challenging dynamic stability is the progression that needs to happen if you have any chance of keeping your shoulders healthy for the long run. Master your foundations first so you can maximize your performance later.
Should you let your shoulder blade move during pressing and pulling movements or keep it stable throughout the movement? Your shoulder blade's positioning depends on the type of exercise you're doing. Each exercise will have its own specific requirements.
The answer depends on your main goal, current issues, skill level, and orthopedic health. There's no faking individuality when it comes to training around pain, or ultimately eradicating it from movement patterns. But there is a progression.
You earn the ability to use advanced exercises by doing foundational variations first. Maintaining stable shoulder blade positions is a big part of that foundation. Learn to activate surrounding muscles and stabilize safe positions at the shoulder and general spine region. From there, progress into more dynamic stability control required in compound exercises.
Take the horizontal row: The base skill requirement while training under loads safely is locking the shoulder blade down into a strong and stable retracted, downwardly rotated, and depressed position. Check out the video:
Neutral-Grip Low Cable Row
By allowing the shoulder blade to move in a controlled and stabilized position around the posterior thoracic cage, you can target more synergistic and transferable skills into other areas of life and sport. You can also increase the muscular stress on the targeted tissues by extending available ranges of motion.
The video below shows the same low-row movement with slightly more shoulder blade movement that has been strategically programmed.
Low Cable Row, More Shoulder Blade Movement
These two similar videos show the importance of detail when enhancing movement, dealing with dysfunction, and ultimately building back up a weak link that usually exhibits itself in shoulder pain. The stability continuum needs to be respected, but also maintained on both ends. Just because you can statically stabilize a joint doesn't mean you'll be able to display that skill and control forever.
The best programs will combine both static and dynamic stability of the shoulder blade when earned and warranted for long-term health and function. And if your wing continues to hurt without spending the time to focus on stability, stop blaming the exercises, and start blaming yourself. Or go see a movement specialist and have them do the work for you.