Got Shoulder Pain?
Tom McCullough MEd.
Shoulder pain is one of the most common injuries in the gym.
Almost 40% of these shoulder injuries involve the shoulder joint.
Most of these injuries can be prevented if more attention is paid
to the smaller muscle groups in the shoulder joint, more
especially the external rotators which are located in the back of
the shoulder which include the Infraspinatus and the Teres minor.
These types of injuries are commonly refereed to as subacromial
Kolber MJ, Cheatham SW, Salamh PA, Hanney WJ. Characteristics of Shoulder
Impingement in the Recreational Weight-Training Population.
J Strength Cond Res.
2013 Sep 25. [Epub ahead of print]
Despite reports implicating subacromial impingement syndrome
(SIS) as an etiological source of shoulder pain among
weight-training (WT) participants, a paucity of case-controlled
evidence exists to support this premise. The purpose of this
study was to determine if WT participants present with
characteristics of SIS. Additionally, we investigated the role
of exercise selection among those identified as having SIS.
Seventy-seven (154 shoulders) men (mean age 28) were recruited,
including 46 individuals who engaged in WT a minimum of 2 days
per week; and 31 controls with no history of WT participation.
Prior to testing, participants completed a questionnaire
summarizing their training patterns. Upon completing
questionnaire, two previously validated tests used to identify
SIS were performed on both groups and included the painful arc
sign and Hawkins-Kennedy test. When clustered, these tests have
a positive likelihood ratio of 5.0 for identifying SIS when
compared to diagnostic gold standards. Analysis identified
significant between group differences in the combined presence
of a positive painful arc and Hawkins-Kennedy (p < .001)
test. A significant association existed between clinical
characteristics of SIS (p ≤ .004) and both lateral deltoid
raises and upright rows above 90°. Conversely, a significant
inverse association was found between external rotator
strengthening and characteristics of SIS. Results suggest that
WT participants may be predisposed to SIS. Avoiding performance of lateral
deltoid raises and upright rows beyond an angle of 90 degrees;
as well as efforts to strengthen the external rotators may
serve as a useful means to mitigate characteristics associated
So what can be done to prevent impingement in the shoulder
Of course this first thing to do is strengthen the Infraspinatus
and the Teres minor by doing exercises that perform external
rotation of the shoulder joint. Here is an example using rubber
bands. The can also be done with cables or by laying on your side
and using DB's.
The above study also show that we need to be very careful doing
shoulder exercises like lateral raises or upright rows where you
position your upper arms above the horizontal line or 90 degrees,
which causes stress to the connective tissue in the shoulder
joint. Trust me, I see more people than not doing both exercises
seen below where the arms are above 90 degrees.