CategoriesAssessment Corrective Exercise Strength Training

The Rotator Cuff and Boy Bands

Hey there.

If you’re a human being reading this blog post it’s a safe bet you 1) have impeccable taste with regards to the strength coaches you choose to follow 2) have a pair of shoulders and 3) are likely interested in keeping them healthy and thus performing at a high level in the weight room.

NOTE: If you happened to have come across this blog post by Googling the terms “world’s best tickle fighter” or “The Notebook spoilers”….welcome!

I’m a little biased given my years of experience working with overhead athletes and meatheads alike, but I’d garner a guess that nothing is more annoying or derails progress more than a pissed off shoulder…or shoulders.

My friends Dan Pope and Dave Tilley of Champion Physical Therapy & Performance just released a stellar resource, Peak Shoulder Performance, that’s perfect for any coach or personal trainer looking to help their clients/athletes nip their shoulder woes in the bud. AND it’s on sale for this week only at $100 off the regular price.

Copyright: improvisor / 123RF Stock Photo

 

The Rotator Cuff and Boy Bands

Guess what most people think is the cause of their shoulder woes?

The rotator cuff.

Guess what’s likely not the cause of their shoulder woes?

The rotator cuff.

It’s lost on a lot of people that the “shoulder” isn’t just the rotator cuff.

I mean, N’Sync back in the wasn’t just Justin Timberlake, right?

JC, Lance, Chris, and Joey (<— didn’t have to look up all their names) deserve our respect and admiration too. They all played key role(s) as individual entertainers to make the group more cohesive, successful, and relevant.

The phrase “the whole is greater than the sum of its parts” has never rang more true than right  here and right now, reminiscing on long past their prime 90’s boy bands.

[Except, you know, we all know Justin was/is the only one with talent. He can sing, he can dance, he can act, he’s got comedic timing. He’s a delight.]

The rotator cuff is Justin Timberlake.

It gets all the credit and accolades and attention with regards to shoulder health and function. However, the shoulder consists of four articulations that comprise the entire shoulder girdle:

  • Glenohumeral Joint (rotator cuff) – Justin
  • Acromioclavicular Joint – JC
  • Sternoclavicular Joint – Lance
  • Scapulothoracic Joint – Joey and Chris

I’d make the case, and this is an arbitrary number I’m tossing out here (so don’t quote me on Twitter), that 80% of the shoulder issues most people encounter can be pin pointed to the Scapulothoracic area (shoulder blades) and what it is or isn’t doing.

The shoulder blades, since you have two of them, are Joey and Chris.

Think about it:

  • Justin, JC, and Lance were generally considered the heartthrobs of the group and were always taking center stage, in the forefront, and amassing Tiger Beat covers.
  • Conversely, who was in the shadows, taking a back seat, presumably doing all the heavy labor, regional Mall appearances, and B-list talk shows the other guys didn’t want to do?

That’s right…..Joey Fatone and motherfucking Chris Fitzpatrick, son!

Lets Give the Scaps Some Love

All of this isn’t to insinuate the rotator cuff alone is never the culprit or that pain in that area should be shrugged off, ignored, and not addressed directly.

However, when lumping shoulder pain and the rotator cuff into the same sentence we’re often referring to something called “shoulder impingement.”

Shoulder impingement is a thing – loosely defined: it’s compression of the rotator cuff (usually the supraspinatus) by the undersurface of the acromion – and it is a nuisance.

There’s even varying types of shoulder impingement – Internal vs. External Impingement. Moreover, just saying “shoulder impingement” doesn’t say anything as to it’s root cause.

Many factors come into play:

  • Exercise Technique
  • Poor Programming
  • Lack of T-Spine Mobility
  • Fatigue (rotator cuff fatigue = superior migration of humeral head)
  • Faulty Breathing Patterns
  • Wearing White Past Labor Day
  • And Scapular Dyskinesis…to name a few

Just saying someone has “shoulder impingement” and telling him or her to perform band external rotation drills (oftentimes poorly) till they’re blue in the face doesn’t solve WHY it may be happening in the first place.

Often, the rotator cuff hurts or isn’t functioning optimally because something nefarious is happening elsewhere.

And on that note I’d like to point your attention to the shoulder blades.

Release, Access, Train

I have a lot of people/athletes stop by CORE because their shoulder(s) don’t feel great. Many have gone to several physical therapists prior to seeing me frustrated they’re not seeing progress, and if they are it’s often fleeting.

Full Disclosure: I know my scope and am never diagnosing anyone or anything.

  • Actually, Things I Can Diagnose = poor deadlift technique, poor movement in general, and epic poops vs. average poops (#dadlife).
  • Things I Can’t Diagnose = MRIs, musculoskeletal injuries/limitations, gonorrhea.

I find it amazing, though, whenever I do work with someone with shoulder pain, how much of a rare occurrence it is anyone ever took the time to assess scapular function.

If the scapulae are in a bad position to begin with (maybe in excessive anterior tilt or downwardly rotated) and/or are unable to move in all their glory (upward/downward rotation, anterior/posterior tilt, adduction/abduction, elevation/depression), or altogether move poorly…is it any wonder then, why, possibly, maybe, the rotator cuff is pissed off?

Photo Credit: EricCressey.com

While not an exhaustive list or explanation – everyone’s their own unique special snowflake – the following approach covers most people’s bases:

Release

Scapular position is at the mercy of the thorax and T-Spine.

  • Those in a more kyphotic posture – think: computer guy – will tend to be (not always) more anteriorly tilted and abducted.
  • Those in a more extended posture – think: athletes/meatheads – will tend to be (not always) more downwardly rotated and adducted.

In both cases the congruency of the shoulder blade(s) and thorax is compromised often resulting in an ouchie.

“Releasing” the area is often beneficial:

 

Access

Now that the area is released we can then gain “access” to improved scapular movement by nudging the ribcage/thorax to move via some dedicated positional breathing drills.

Think of it this way: if the ribs/thorax are unable to move because they’re glued in place, how the heck are the scapulae going to move?1

A few of my favorites include:

NOTE: Which one you use will depend on an individual’s presentation. A good rule of thumb to follow would be for those in a more extended posture to include breathing drills that place them in flexion and vice versa. There are always exceptions to the rule, but for the sake of brevity it’s a decent rule to follow.

All 4s Belly Breathing

 

The Bear

 

Supine 90/90 Belly Breathing

 

Prone Sphinx

NOTE: I didn’t discuss it in this video but I’d also encourage people to include a full inhale/exhale with each “reach” or repetition on this exercise.

 

Train (and Go Lift Heavy Things)

Now that we’ve released and gained access to the area, we need to train. Specifically, almost always, we need to improve one’s ability to move their arms overhead (shoulder flexion) without any major compensations.

In order to do so, the scapulae need to do three things:

  • Posterior tilt
  • Upward rotation (which, as a whole, describes the end goal)
  • Protract

All three entail utilizing the force couples of the upper/lower traps and serratus anterior in concert to help move the shoulder blades into the upwardly rotated position we’re after.

There are a litany of drills and exercises that can be discussed here, and it’s important to perform a thorough screen/assessment to ascertain which ones need to be prioritized.

That said, here are some that tickle my fancy:

Prone 1-Arm Trap Raise (Posteriorly Tilt – Low Traps)

 

Quadruped Rockback Floor Press (Protraction – Serratus)

 

Half Kneeling Band Overhead Shrug  (Upward Rotation – Upper Traps)

 

Bye, Bye, Bye….

Not sure if my rotator cuff/Boy Band analogy made sense or resonated, but I’m going to go a head and give myself a pat on the back for attempting it.

It’s not always about Justin.

Remember: give Joey and Chris their due diligence too….;o)

For more insights on shoulder shenanigans I can’t recommend Peak Shoulder Performance enough. Dan and Dave go into detail on:

  • Functional anatomy of shoulder impingement, rotator cuff tears and labral injuries
  • Technical faults in the major lifts (bench press, snatch, dip, overhead press) and how they cause injury (and how to correct them).
  • Specific rehab protocols to return to the major lifts mentioned above.
  • Programming and periodization methodologies to reduce injury risk in the future.

And that’s just the tip of the iceberg.

It’s on sale this week only (ending on Sunday, 10/15) for $100 off the regular price, so act quickly.

—> Peak Shoulder Performance <—

CategoriesExercise Technique Exercises You Should Be Doing

Exercises You Should Be Doing: 1-Arm Bottoms-Up Anything

Drake said it best:

“Started from the bottom now we’re here.”

Based off last week’s article on Building the Squat From the Bottom and today’s apropos titled post, you may think I’m obsessed with bottoms.

Kim Kardashian and J-Lo jokes aside, you’re 100% correct.

When I was coaching at Cressey Sports Performance and working with numerous overhead athletes, utilizing bottoms-up exercises was a daily occurrence…many times serving as a starting point for guys traveling to Massachusetts to train after a tenuously long baseball season or maybe recovering from an injury.

Get it?

Started From the Bottom?

Bottoms-up? Starting point?2

In case you’re not picking up what I’m putting down: I like bottoms-up (kettlebell) exercises.

Like THIS one. And THIS one.

There are many reasons why, too.

1) Better Shoulder Health and Rotator Cuff Activation

With regards to shoulder health and rotator cuff activation, there aren’t many things more effective than holding a kettlebell upside down. Because grip becomes more of a “thing” here, a phenomenon called irradiation comes into play. Simply put: grip strength helps the shoulder to “pack” itself, providing more stability to the area.

Don’t believe me?

Hold your arm out in front of you making a fist. But don’t do anything, just hold it there.

Now, MAKE A FIST (as if you were going to thunder-punch a T-Rex). Notice how your shoulder kinda tensed up and “packed” itself. That’s irradiation.

Moreover, when we start talking about the rotator cuff muscles and what the anatomy books tells us their function is we get this:

  • Internal/external rotation of the humerus.
  • Abduction of the humerus
  • Humeral depression (counteract pull of delts)

All of this is correct. And, I defy anyone to put this bit of trivia in their Match.com profile and not be beating people off with a stick.

However, the RC’s true “function” is to keep the humeral head centered in the glenoid fossa.3Bottoms-up KB carries are an excellent choice to train the rotator cuff in this fashion.

https://www.youtube.com/watch?v=PnpS41ag5ME

 

2) De-loading

I am a firm believer in lifting heavy things. The slogan of this site is “Because Heavy Things Won’t Lift Themselves” for crying out loud.

That said, it’s important to pump the brakes from time to time and understand (and respect) that lifting “heavy,” all the time, isn’t necessary to build a strong, durable, aesthetically pleasing body.

It’s the backbone, of course. But the “go heavy, or go home” mentality can be just as deleterious and stagnating as going too light.

What I also love about bottoms-up exercises is that they serve as a built-in “de-load” mechanism for many trainees, not to mention a tricky way to place a spotlight on any glaring side-to-side strength/muscular imbalances.

Have someone perform a 1-arm Bottoms-Up Bench Press or Overhead Press and watch as it becomes abundantly clear which arm is stronger than the other.

 

What’s more, because so many trainees like to “muscle” their exercises4, many of the smaller, stabilizing musculature gets the shaft. And thus, nagging injuries may occur.

Relax: I’m not going all Tracy Anderson and saying something asinine like “it’s important to use lighter weights so we can target our deep, less angry, stabilizing muscles. Also, dipping your left hand into a bucket of unicorn tears detoxes the body of sadness.”

What I am saying, however, is that it’s okay to use an exercise such as this as an accessory movement to help address a gross imbalance or weakness, or to even help build some muscle. The Bottoms-Up KB Overhead Press is actually one of my favorite shoulder exercises to build mass because it forces people to be strict with their technique.

  • Squeeze glutes, quads, and abs.
  • Lock rib cage down.
  • Press

3) Core Stability

I don’t feel I need to spend a lot of time on this one. Performing any unilateral movement (upper or lower body) has obvious core training benefits.

Here, not only are we getting all the benefits described above, but we’re also getting the benefit of challenging our core musculature to prevent any un-wanted motion (in this case: lateral flexion, rotation, extension, etc).

Bottoms-Up Split Squat

 

Bottoms-Up Bulgarian Split Squat

 

Bottoms-Up Reverse Lunge

 

With all these drills the objective is to stabilize the kettlebell so that it stays upright throughout, while at the same time maintaining a good thoraco-pelvic canister (minimizing rib flair and excessive anterior pelvic tilt).

[A good way to visualize this is to think about an invisible line being drawn from your nipple line to your belly button. You want to “connect” your rib cage to your pelvis and LOCK IT DOWN. The invisible line should stay the same throughout the duration of a set and not get longer].

You’ll notice on all the examples above I make a fist with my free hand to help increase bodily tension. This is important to help maintain that canister

4) And Lastly, Because I Said So

How’s that for a legit reason to give these exercises a try?