The MVP of Overhead Mobility
Shoulder mobility - it's a hot topic in the fitness community. If you don't have the range, you won't hit the lift. This may be true in a general sense, but the bigger question is what is causing the overhead deficit. Is it latissimus dorsi tightness? Is it poor spinal mobility? Often times yes, but a component that is often ignored is the external rotation of the shoulder.
It almost never fails. When I have a patient with acute shoulder impingement or overhead mobility deficits, they are almost always going to show deficits in shoulder external rotation strength and/or mobility. This same rule can be applied to countless other shoulder pathologies that I have seen throughout the years. Shoulder external rotation is the MVP of the shoulder.
Okay so how does this make sense? In order for the glenohumeral (shoulder) joint to move through its full range overhead, the humerus must rotate laterally to keep a bony prominence called the greater tubercle from pinching on soft tissue structures under the acromion (the roof of the shoulder). When imbalances occur, namely tight, overpowering internal rotators (pecs, lats, etc.), there is an internal rotation moment that both causes both stiffness and inhibition of this necessary rotation of the humerus.
As this imbalance persists, we often see a migration of the shoulder joint itself marked by forward translation of the ball in the socket, forward tilting of the scapula, and rounding of the thoracic spine. These changes in the shoulder complex limit the space for the glenohumeral joint to operate leading to pinching with overhead movement and often tightening of the muscles in the neck from compensation.
So what muscles are key for balancing out these deficits and restoring normal mechanics of the shoulder? The infraspinatus and teres minor are the prime shoulder external rotators and two of the four rotator cuff muscles. These muscles are in charge of stabilizing the ball in the socket and countering the pull of the deltoid to keep the mechanics fluid through the full range of the shoulder. When these muscles weaken, we begin to see the deltoid take over causing a superior or upward translation of the ball in the socket. This causes pinching in the shoulder and significant compensation as we attempt to push into full overhead motion. So if you are feeling tightness in your neck and/or pinching in your shoulder, chances are the external rotators of the shoulder aren't as strong as they should be.
So what should we do about this? First step is to be aware of these imbalances. Be cognizant of how you hold your shoulders throughout the day. Are your shoulders rolled forward and your palms facing behind you? Is your upper back rounded and head pushed forward? These are things we want to recognize and work on correcting throughout the day.
Next we need to recognize the gaps in our movement diet and workout programming and fill in those gaps. Most workouts do not include much (if any) shoulder external rotation. Supplement with these movements often! If we ignore intentional rotation of the shoulder, we often see the dysfunction mentioned above and adaptations of the joint itself that are difficult to undo.
We then must load and strengthen these rotator cuff muscles like we would with any other muscle in the body. Just like with our other muscle groups, to strengthen these external rotators, we must increase the load that these muscles are having to take on. And no, that red piece of Theraband is not going to cut it. Progressively overload your rotator cuff just like you would your glutes, quads, chest, and all of the other beach muscles. Think starting with sets of 5-10 reps at a weight that is challenging in the last couple reps of each set. Build your volume as tolerated!
Check out these movements to help build up the smaller muscles in your shoulder for optimal shoulder health:
Prone External Rotation (ER) with Reach
ER w/ Diagonal Overhead Press
Swiss Ball Isometric w/ Reach
Side Plank ER to Overhead
Supported ER w/ Single Arm Z-Press
Have pain or stiffness with these exercises or other overhead movements? Call 205-304-1181, email aaron@movewellmobile.com, or Book Now to set up your movement evaluation with MoveWell!
Also did you know MoveWell has a new referral program? Refer friends and family and receive a $20 MoveWell credit for every referral that books a session! Also, qualify for our big monthly giveaways by referring 3 or more people. The winner will receive a free month of MoveWell Premium and a $100 Lululemon gift card!
