Shoulder pain reduction using resistance training

Danny O'Dell explains the shoulder anatomy and suggests an appropriate training program to lower your risk of a shoulder injury possibly.

Shoulder pain does not have to be the inevitable consequence of exercise, overuse, or old age. Applying a small dose of common sense will go a long way toward the proper care of the shoulder joint. This recommendation needs to be kept in mind for maintaining an injury and pain-free shoulder complex. Constant hammering away at the bench and military press, consistently throwing overhand, and many of the popular swim strokes can slowly eat away at the integrity of the joint. An athlete who is not working on stabilizing underlying musculature is travelling down a road fraught with dangerous repercussions.

The shoulder anatomy

A quick look at an anatomy and physiology book (Tortora et al. 2002)^[1] will reveal an intricate and complex joint that comprises three bones and the tendons of the attaching muscles. The shoulder joint has a tremendous range of motion, but this comes at a price. Damage occurs due to overuse and to the fact that the shoulder is not a true ball and socket joint like the hip. The three bones in the shoulder complex are the Clavicle, Humerus, and Scapula (the collarbone, upper arm, and shoulder blade). These three bones are held in place by four relatively small underlying muscles called the rotator cuff muscles. They are the Infraspinatus, Subscapularis, Supraspinatus, and Teres minor. Some literature refers to these as the 'SITS' muscles. These diminutive muscles surround the shoulder joint and hold the Humerus in the shallow socket of the Scapula. They activate at the beginning of every shoulder movement and, as one physical therapist described them, they are the steering wheel of the shoulders. Common injuries to the four relatively small rotator cuff muscles are relatively easy to avoid with a few simple precautions.

The function of the rotator cuff muscles - SITS

The Subscapularis rotates the arm inward, bringing the elbow forward when the arm is held at the side of the body. It also aids in adduction (toward the centerline of the body) when the arm is above the horizontal position.

Body action

Arm inward rotation
Arm extension
Arm hyperextension
Arm adduction

The Infraspinatus lateral rotates the humerus with the teres minor and stabilizes the head of the humerus within the shoulder joint.

Body action

Arm outward rotation
Arm horizontal abduction (away from the centerline of the body)
Arm abduction
Arm adduction

The Teres Minor laterally rotates, slightly adducts and extends the humerus and stabilizes the humerus in the shoulder socket.

Body action

Arm outward rotation
Arm extension
Arm hyperextension
Arm adduction
Arm horizontal abduction

The Supraspinatus abducts the arm with the deltoids and holds the humerus in the shoulder socket.

Body action

Arm abduction

Preventive measures that may aid in injury resistance

Keep at the forefront of your mind the tendons (like all tendons) of most muscles receive very little in the way of nourishment and oxygen from the circulatory system. A limited supply of blood and oxygen translates to a long recovery period if they become injured. This recovery is even longer if you are an older athlete. Add in the daily living degenerative effects of becoming older plus the constant stresses of the exercises above, and it is no wonder the shoulder fails over time. In some cases, it does not matter if, but when an injury will happen. Setting up and adhering to an adequately designed strengthening and stretching (only the strengthening of the rotators is addressed here) program can lead to many years of near injury-free living. Some words of advice: if it hurts, stop the exercise or lower the resistance. Listen to what your body is telling you. Pain does not lead to gain, but over time, it will lead to the surgical table. The rotator cuff muscles do not need heavy weights to grow stronger. They are SMALL muscles and can become easily damaged with excessive workout resistance loads.

Strengthening program

This article contains several exercises that are commonly used to keep the rotators strong and injury resistant. If you are planning to use elastic bands make certain, the attachment points are solid, and the knots are tied correctly. An elastic band retracts violently from its stretched position back to the relaxed status when it breaks. Imagine how a large rubber band would feel when it breaks and then snaps back at you. NONE of these exercises or movements requires the use of heavyweights, e.g. one to five pounds is more than adequate to strengthen them. Begin each exercise at the high end of the repetition ranges to build up muscular endurance. Then do fewer repetitions with a bit more weight to increase their strength.

Equipment

Required equipment:

Cable crossover with high and low attachment points
Tubing or elastic bands
Dumbbells
Barbell and weights

The Exercises

Arm abduction - arms away from the body

Side raises with dumbbell
Tubing or elastic bands attached to low
Tubing or elastic bands attached at shoulder level-external rotators
Tubing or elastic bands held at shoulder level-external rotators with straight arms

Arm adduction - arms toward the body

Cable crossover
Tubing or elastic high attachments
Tubing held high in both hands and pulled down level behind the neck in a downward motion
Tubing or elastic bands attached at shoulder level-internal rotators
Tubing or elastic bands held at shoulder level - internal rotators with straight arms

Arm circumduction - rotate the arms in a wide circle

Tubing attached at shoulder height
Bicycle wheel on the wall
Bicycle wheel on the wall with brakes and steering knob

Arm extension - arms brought down to the sides from overhead

The beginning position is on the knees facing the gear
Tubing or elastic high attachments
High attachment cables
Supine with overhead tubing attachment

Arm flexion - arms brought upward from the sides to overhead

Low cable attachment point
Low attachment tubing or band attachment
Supine with dumbbells

Horizontal abduction - moving the arms away from the front to the sides

Tubing attached at shoulder height Horizontal adduction - moving the arms from the sides to the front
Tubing attached at shoulder height

Arm hyperextension - move the arms backward from the front

Tubing attached low
Low cables
Prone with dumbbells

Exercise protocol

Be conservative in addressing the shoulder complex unless advised otherwise by your doctor or physical therapist. These exercises DO NOT require heavyweights, so set your ego aside and do them the right way.

The schedule

Reference to "a muscle group" refers to the Infraspinatus, Subscapularis, Supraspinatus, and Teres minor muscles.

Exercise selection:

First, select a body action for the nominated muscle, e.g. Teres Minor - Arm adduction (see body actions for the Teres Minor muscle above)
Then select an exercise for that body action, e.g. Arm adduction - Cable crossover (see exercises for arm adduction above).
For each exercise, choose a lightweight and perform two sets of fifteen repetitions.
Allow recovery of one minute between each set.

Day Activities

Select one exercise for the Infraspinatus muscle
Rest
Select one exercise for the Subscapularis muscle
Rest
Select one exercise for the Supraspinatus muscle
Rest
Rest
Select one exercise for the Teres minor muscle
Rest
Select two exercises for the Infraspinatus muscle
Rest
Select two exercises for the Subscapularis muscle
Rest
Select two exercises for the Supraspinatus muscle

For the next three alternating days (17, 19, and 20) choose one exercise for each muscle group and do twenty repetitions for two to three sets. Rest - one minute between sets. After this week is over rest for two days and then gradually build your endurance up over the next two months until you can do two exercises from each group for ten to fifteen repetitions for two sets. Once this is an easy task, then continue to maintain endurance by doing at least one exercise every other day. Do this as long as you continue to be involved in a sport or an exercise regimen that includes resistance training.

Summary

Exercise can be a beneficial activity, which may be useful in maintaining a healthy lifestyle. Too much of a good thing, however, can lead to injury or chronic pain. Heed your trainer's advice by working out correctly, with the proper intensity, duration, and rest periods built into the schedule.

Article Reference

This article first appeared in:

O'DELL, D. (2004) Shoulder pain reduction using resistance training. Brian Mackenzie's Successful Coaching, (ISSN 1745-7513/ 15 / September), p. 8-10

References

TORTORA, G. et al. (2002) Principles of Anatomy and Physiology, 10th ed, Harper and Row

Page Reference

If you quote information from this page in your work, then the reference for this page is:

O'DELL, D. (2004) Shoulder pain reduction using resistance training [WWW] Available from: https://www.brianmac.co.uk/articles/scni15a5.htm [Accessed

About the Author

Danny O`Dell is an NSCA Certified Strength and Conditioning coach from the USA. He is the author of several training manuals including The Ultimate Bench Press Manual, Wilderness Basics, Strength training Secrets, Composite training, and Power up your Driving Muscles. Danny has published articles in national and international magazines describing the benefits of living a healthy fitness lifestyle.


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Shoulder pain does not have to be the inevitable consequence of exercise, overuse, or old age. Applying a small dose of common sense will go a long way toward the proper care of the shoulder joint. This recommendation needs to be kept in mind for maintaining an injury and pain-free shoulder complex. Constant hammering away at the bench and military press, consistently throwing overhand, and many of the popular swim strokes can slowly eat away at the integrity of the joint. An athlete who is not working on stabilizing underlying musculature is travelling down a road fraught with dangerous repercussions. The shoulder anatomy A quick look at an anatomy and physiology book (Tortora et al. 2002)^[1] will reveal an intricate and complex joint that comprises three bones and the tendons of the attaching muscles. The shoulder joint has a tremendous range of motion, but this comes at a price. Damage occurs due to overuse and to the fact that the shoulder is not a true ball and socket joint like the hip. The three bones in the shoulder complex are the Clavicle, Humerus, and Scapula (the collarbone, upper arm, and shoulder blade). These three bones are held in place by four relatively small underlying muscles called the rotator cuff muscles. They are the Infraspinatus, Subscapularis, Supraspinatus, and Teres minor. Some literature refers to these as the 'SITS' muscles. These diminutive muscles surround the shoulder joint and hold the Humerus in the shallow socket of the Scapula. They activate at the beginning of every shoulder movement and, as one physical therapist described them, they are the steering wheel of the shoulders. Common injuries to the four relatively small rotator cuff muscles are relatively easy to avoid with a few simple precautions. The function of the rotator cuff muscles - SITS The Subscapularis rotates the arm inward, bringing the elbow forward when the arm is held at the side of the body. It also aids in adduction (toward the centerline of the body) when the arm is above the horizontal position. Body action Arm inward rotation Arm extension Arm hyperextension Arm adduction The Infraspinatus lateral rotates the humerus with the teres minor and stabilizes the head of the humerus within the shoulder joint. Body action Arm outward rotation Arm horizontal abduction (away from the centerline of the body) Arm abduction Arm adduction The Teres Minor laterally rotates, slightly adducts and extends the humerus and stabilizes the humerus in the shoulder socket. Body action Arm outward rotation Arm extension Arm hyperextension Arm adduction Arm horizontal abduction The Supraspinatus abducts the arm with the deltoids and holds the humerus in the shoulder socket. Body action Arm abduction Preventive measures that may aid in injury resistance Keep at the forefront of your mind the tendons (like all tendons) of most muscles receive very little in the way of nourishment and oxygen from the circulatory system. A limited supply of blood and oxygen translates to a long recovery period if they become injured. This recovery is even longer if you are an older athlete. Add in the daily living degenerative effects of becoming older plus the constant stresses of the exercises above, and it is no wonder the shoulder fails over time. In some cases, it does not matter if, but when an injury will happen. Setting up and adhering to an adequately designed strengthening and stretching (only the strengthening of the rotators is addressed here) program can lead to many years of near injury-free living. Some words of advice: if it hurts, stop the exercise or lower the resistance. Listen to what your body is telling you. Pain does not lead to gain, but over time, it will lead to the surgical table. The rotator cuff muscles do not need heavy weights to grow stronger. They are SMALL muscles and can become easily damaged with excessive workout resistance loads. Strengthening program This article contains several exercises that are commonly used to keep the rotators strong and injury resistant. If you are planning to use elastic bands make certain, the attachment points are solid, and the knots are tied correctly. An elastic band retracts violently from its stretched position back to the relaxed status when it breaks. Imagine how a large rubber band would feel when it breaks and then snaps back at you. NONE of these exercises or movements requires the use of heavyweights, e.g. one to five pounds is more than adequate to strengthen them. Begin each exercise at the high end of the repetition ranges to build up muscular endurance. Then do fewer repetitions with a bit more weight to increase their strength. Equipment Required equipment: Cable crossover with high and low attachment points Tubing or elastic bands Dumbbells Barbell and weights The Exercises Arm abduction - arms away from the body Side raises with dumbbell Tubing or elastic bands attached to low Tubing or elastic bands attached at shoulder level-external rotators Tubing or elastic bands held at shoulder level-external rotators with straight arms Arm adduction - arms toward the body Cable crossover Tubing or elastic high attachments Tubing held high in both hands and pulled down level behind the neck in a downward motion Tubing or elastic bands attached at shoulder level-internal rotators Tubing or elastic bands held at shoulder level - internal rotators with straight arms Arm circumduction - rotate the arms in a wide circle Tubing attached at shoulder height Bicycle wheel on the wall Bicycle wheel on the wall with brakes and steering knob Arm extension - arms brought down to the sides from overhead The beginning position is on the knees facing the gear Tubing or elastic high attachments High attachment cables Supine with overhead tubing attachment Arm flexion - arms brought upward from the sides to overhead Low cable attachment point Low attachment tubing or band attachment Supine with dumbbells Horizontal abduction - moving the arms away from the front to the sides Tubing attached at shoulder height Horizontal adduction - moving the arms from the sides to the front Tubing attached at shoulder height Arm hyperextension - move the arms backward from the front Tubing attached low Low cables Prone with dumbbells Exercise protocol Be conservative in addressing the shoulder complex unless advised otherwise by your doctor or physical therapist. These exercises DO NOT require heavyweights, so set your ego aside and do them the right way. The schedule Reference to "a muscle group" refers to the Infraspinatus, Subscapularis, Supraspinatus, and Teres minor muscles. Exercise selection: First, select a body action for the nominated muscle, e.g. Teres Minor - Arm adduction (see body actions for the Teres Minor muscle above) Then select an exercise for that body action, e.g. Arm adduction - Cable crossover (see exercises for arm adduction above). For each exercise, choose a lightweight and perform two sets of fifteen repetitions. Allow recovery of one minute between each set. Day Activities Select one exercise for the Infraspinatus muscle Rest Select one exercise for the Subscapularis muscle Rest Select one exercise for the Supraspinatus muscle Rest Rest Select one exercise for the Teres minor muscle Rest Select two exercises for the Infraspinatus muscle Rest Select two exercises for the Subscapularis muscle Rest Select two exercises for the Supraspinatus muscle For the next three alternating days (17, 19, and 20) choose one exercise for each muscle group and do twenty repetitions for two to three sets. Rest - one minute between sets. After this week is over rest for two days and then gradually build your endurance up over the next two months until you can do two exercises from each group for ten to fifteen repetitions for two sets. Once this is an easy task, then continue to maintain endurance by doing at least one exercise every other day. Do this as long as you continue to be involved in a sport or an exercise regimen that includes resistance training. Summary Exercise can be a beneficial activity, which may be useful in maintaining a healthy lifestyle. Too much of a good thing, however, can lead to injury or chronic pain. Heed your trainer's advice by working out correctly, with the proper intensity, duration, and rest periods built into the schedule. Article Reference This article first appeared in: O'DELL, D. (2004) Shoulder pain reduction using resistance training. Brian Mackenzie's Successful Coaching, (ISSN 1745-7513/ 15 / September), p. 8-10 References TORTORA, G. et al. (2002) Principles of Anatomy and Physiology, 10th ed, Harper and Row Page Reference If you quote information from this page in your work, then the reference for this page is: O'DELL, D. (2004) Shoulder pain reduction using resistance training [WWW] Available from: https://www.brianmac.co.uk/articles/scni15a5.htm [Accessed About the Author Danny O`Dell is an NSCA Certified Strength and Conditioning coach from the USA. He is the author of several training manuals including The Ultimate Bench Press Manual, Wilderness Basics, Strength training Secrets, Composite training, and Power up your Driving Muscles. Danny has published articles in national and international magazines describing the benefits of living a healthy fitness lifestyle.