According to the American Academy of Orthopedic Surgeons, of the 10 most common sports orthopedic injuries, shoulder injuries rank #6 (labral tears) & #7 (rotator cuff tears). However, with weightlifting the shoulder is the #1 most commonly injured joint. The most common structures injured in the shoulder with weightlifting are the labrum, rotator cuff, biceps tendon and acromioclavicular (AC) joint. We see this everyday. People give us the perfect tell tell sign. What is it? You must read on to find out.
- Front and lateral raises above 90 degrees with palms down impinges the supraspinatus tendon in the subacromial space. Modification - simply change the position of the hand to thumb up position which clears the supraspinatus tendon
- Stretching full body weight on TRX bands with shoulder above 90 degrees puts a tremendous amount of load on the supraspinatus tendon as well as stretches the anterior capsule especially if you are trying to relax your shoulder during. Modification - don't do under body weight.
- Push-ups with shoulder flexion >90 degrees pinches your supraspinatus with every rep under body weight. This is increased if you have your head forward and your scapula are winging during. Modification - don't do with the shoulders above 90 degrees and modify if your scapula wing a lot. If they do, this is an indication of serratus anterior weakness and you should include this in your strengthening program.
- Upright rows above 90 degrees - this not only impinges the rotator cuff but when done in combination with the shoulders rounded forward, there is an increased impingement on the labrum and biceps tendon as well. Modification - do reverse uprights or do uprights but do not bring above 90 degrees.
- Standing external rotation on cable with shoulder above 90 degrees - this is a common exercise in rehabilitation but it is one that is done wrong most of the time in the gym. Most do with too much weight and while performing with poor posture. Modification - do this in a sidelying or standing position in the scapular plane (demonstrated).
- Shoulder press/lat pulls behind the head - this puts a tremendous tensile load on the anterior capsule and ligamentous structures. If done under load, this compromises the integrity of the shoulder's stability. Modification - simply do them in front. The training benefit is the same and the stress to the shoulder is much less.
- Pec deck past 0 degrees of shoulder extension is a huge stress to the anterior capsule as well as the labrum of the shoulder. Some will even relax when they get to the end range which makes this stress even worse. Modification - only take to neutral shoulder extension and not past.
So, is the answer not doing these exercises? No. We provided some modifications but exercise is limited only by our imagination. There are numerous modifications we can do to these exercises which will make them much more effective at strengthening, make them more “shoulder friendly” and aid you in training to prevent an injury. Since shoulder injuries are so common in weight lifting, don’t try to train through them. If you are having pain with, see a physical therapist who is a sports certified specialist or athletic trainer who can assist you in remaining pain free while achieving your fitness or performance goals.