Without going too far down the rabbit hole (and without a PubMed reference in site), I have been “caught” saying a time or two that 99% of the shoulder issues I come across – whether working with an overhead athlete or Martin from Tort-Law-R-Us1 – has it’s roots in what the shoulder blades are (or in most cases) are not doing.
For a myriad of reasons most of us have been programmed to think that “shoulder blades together AND down” is the end-all-be-all of shoulder health.
It works splendidly when 1) you’re working with someone who’s stuck in a more flexed/rounded/computer guy posture and/or 2) the goal is to lift as much weight as humanly possible.
I.e., good luck bench pressing (or even squatting/deadlifting) appreciable weight with shoulder blades that aren’t “set” in a more stable position.
That being said, too much of anything can have its inherent drawbacks.2
The “together and down” cue can lead to overactive lats and a more extension-based pattern where the shoulder blades get stuck or “cemented” together – making it all the more challenging for them to freely move about the rib cage (which they’re designed to do).
The scapulae are meant to move:
Upward/downward rotation
Protraction/retraction
Anterior/posterior tilt
However, they often get “stuck” in a more downwardly rotated and retracted position from all the “down and back” cueing we’ve been inundated with.
One drill I have been using to help “un-glue” the shoulder blades is this one:
Band Assisted Scapular Upward Rotation
Who Did I Steal It From? – Dr. Michael Mash from his excellent Barbell Rehab course.
What Does It Do? This is such a simple drill to implement and works well with pretty much everyone. Except Orcs (for obvious reasons).
The pulldown trains scapular downward rotation and retraction, which is all well and good. I’m not a hater. It’s the reverse action, though, using the accentuated eccentric to emphasize scapular PROTRACTION and UPWARD rotation (with the assist from the band) that makes it a truly unique exercise to considering using.
This drill helps improve the full spectrum of scapular motion as well as to help gain “access” to overhead range of motion in general.
Key Coaching Cues: Attach a band to the top of a squat rack (or anything that doesn’t move) and sit directly underneath. From there, pull down as you normally would, but then SLOWLY resist the pull of the band as you allow it to pull your arm fully up overhead.
If you have a shoulder (or two) chances are there’s been a time in your life where things haven’t felt great. This sentiment is only amplified if you happen to be someone who lives an active lifestyle playing sports and/or enjoys lifting heavy things.
There are a myriad of culprits that can lead to shoulder pain.3
One of the staple drills I like to use to accomplish the above (scapular upward rotation & protraction) is the Forearm Wall Slide.
Admittedly, it’s a simple looking thingamabobber of a drill.
I mean, all you do is move your arms up and down on a foam roller, right?
Weeeeeeeeeeeeeeeeeeee.
Alas, simple in appearance, not so simple in execution.
TOP VIDEO showcases two common faults I see when most people perform this drill.
❌ Reps 1-3 = depressed or “pinned down” scapula. Incessantly cueing your clients/athletes to retract & depress the shoulder blades has ramifications.
Sure, it’s an excellent cue to lift a metric shit ton of weight. There’s a reason why we tell people to bring their shoulder blades together and down during a bench press.
However, the scapula is meant to move around the ribcage and it’s imperative for overall shoulder health. When someone is pelted over the head with “together & down, together & down” cues the end result is a shoulder blade that’s cemented in a downwardly rotated position.
This can (not always) lead to shoulder ouchies.
❌ Reps 4-6 = shrugging pattern. The upper traps do play a significant role in shrugging (elevation). Shrugging, however, is NOT upward rotation.
In both scenarios there’s no “real” upward rotation happening.
The drill is ineffective.
Bye, Felicia.
BOTTOM VIDEO showcases what we actually want to see happen.
I like to cue people to “reach” towards the ceiling through their pinky finger, and then to sorta lean into the wall as the arm straightens overhead.
Here we get the upper trap to kick in more effectively and we can now see a shoulder blade that’s upwardly rotating (and moving around the rib cage via protraction & Serratus activation).
Performing with shirt off = 37% more Serratus Anterior activation. #science.
It’s crucial when choosing certain drills – even the seemingly simple looking ones – that they’re executed the right way. The details and nuances matter.
Just to help calm the waters: I am not anti “corrective exercise.”
And I am not really going to throw my face into a brick wall.
I respect and can appreciate that, sometimes, our jobs as fitness professionals require us to pump the brakes and to venture down the corrective exercise rabbit hole.
Some people require a bit more TLC with regards to improved movement, motor control, and/or, and I’m paraphrasing here…”just learning to turn shit on.”
Some people will require a laundry list of additional mobility work, stretching, or positional breathing drills to point them in the right direction and to help them feel better.
What I am against, though, and what drives me bonkers, is when coaches and personal trainers go out of their way to:
1) Overstep their scope of practice and end up performing really shitty physical therapy with their clients and athletes.5
OR
2) Highlight every minor “dysfunction” with a client/athlete – excessive anterior pelvic tilt, kyphotic posture, left eye is lower than the right (you freak) – making him or her feel as if they’re walking ball of fail.
Here’s another gleaming example of how TRAINING is corrective and how, if we do our jobs as coaches, we can often accomplish a lot sans the brick wall.
My client, Emily, who’s a trainer herself, has been dealing with some left shoulder issues. I had her come in the other night to see if I could offer some insights and to listen to some sick EDM beats.
The latter has nothing to do with anything, but whatever….give THIS a listen.
Emily showed up and I took the picture below. It shows something clearly awry and that some sort of shoulder clusterfuckey was at play; namely lack of shoulder flexion on the left side.
What was the culprit?
It could have been a few things:
Capsular issue
Lack of scapular rotation (namely upward rotation).
Soft tissue restriction.
Lack of lumbo-pelvic control.
It was a Wednesday.
I don’t know.
What I do know is that I had to respect my lane and understand it wasn’t my job as a strength & conditioning coach to diagnose anything.
I could, however, assess her general movement capacity, use my knowledge of anatomy, and perform a little trial and error to see if I could improve things.
What follows is more or less a brain dump and an attempt to explain my thought process as I worked with Emily for the next hour.
I’m not gonna say that what ended up happening was on par with some Matrix level shit, but I will say I basically know Kung-Fu.
“What actions have to happen at the scapulae in order to get the arms overhead?”
– Upward rotation
– Protraction
– Posterior tilt
Emily wasn’t getting much upward rotation on that left side. When I asked her to bring her arms overhead it was as if her left arm hit a massive speed bump and came to an abrupt stop. She could push through it, but not without pain.
So I had to think about what muscles help with that action (upward rotation)?
– Upper and lower traps
– Serratus
Too, I noticed she also had a more depressed shoulder girdle as a whole; her clavicular angle was more horizontal rather than having a slight upward grade.
HERE‘s Eric Cressey discussing this in a little more detail.
I surmised her UPPER traps needed some attention.
The upper traps often get a bad rap and are avoided like a Coldplay concert. In certain populations (think: desk workers) and instances, the upper traps are OVERactive and can play a role in increased shoulder elevation as well as superior migration of the humeral head, and hence an increased risk for shoulder impingement.
In this scenario, it behooves us to not go out of our way to increase upper trap activation.
However, we often forget the upper traps are a major player in UPWARD ROTATION, not to mention help with scapular elevation…both of which, in my eyes, Emily could have used some more of.I didn’t get over corrective with Emily and start having her perform some voodoo like tapping her pinky finger three times while flossing her teeth with a strain of hair from a Hippogriff.
I didn’t have her perform a laundry list of “correctives” that, for all intents and purposes, would have likely made her feel like a patient and bore her to tears.
Nope, I had her TRAIN and just modified a few things.
We did:
1. Landmine Presses with a Shrug/Reach
2. Face Pulls in an upwardly rotated position (so the upper traps were more engaged)
3. And, instead of performing movements that would pull her into more shoulder depression and downward rotation (deadlifts, farmer carries, etc) we opted for Landmine Squats, Zercher RDLs, and Hip Thrusts.
In short: We turned shit on (upper traps) and trained movements that (likely) wouldn’t feed into the root causes of her symptoms.
Here’s the picture I took at the end of her session:
Sometimes as coaches and trainers we need to take a step back and really think about why we do things. Why do we prescribe “x” exercise? What purpose does it serve? How will it help any given client become bigger, faster, stronger, or more sexifed? Not only that, why for “x” number of sets and reps? Why does it matter if it’s done as the first movement of the day rather than the third? Is there a specific tempo involved? What type of rest periods are we talking about? Are there any other intricate things to consider like foot stance, hand placement or grip variation?
I mean, these are all important questions, and the list could easily go on and on.
Shirt optional, right?
More to the point, as a coach or trainer, you should be able to explain, definitively, the rationale as to why you programmed what you programmed. What purpose does it serve?
In a like manner, you should also be objective about your programming and not be afraid to admit when you’re wrong or that you possibly overlooked something.
Unfortunately, we all like to think we’re perfect and infallible, but we’re not. We all like to think we’re open minded and adaptable, but really, many of us our set in our ways.
ESPECIALLY, as coaches.
Take for example today’s exercise you should be doing. If you happened to have a few ounces of plutonium on hand (and a Flux Capacitor), and decided for shits and giggles to go back in time two years to ask me whether or not I’d include any direct upper trap work into my programs, you’d more than likely find me laughing in your face.
Given most people are walking around with FUBAR’d shoulders as it is, and that recent research has shown that upper trapezius dominance plays a significant role in subacromial impingement, it makes sense. It’s dumb.
The last thing you want to do with a muscle that’s already jacked up or overactive is to target it even more. This is almost always the case when you’re dealing with someone who spends the majority of their time sitting in front of a computer all day and then heads to the gym, grabs a barbell, and shrugs their face off.
In this instance, they’ll undoubtedly play into the dysfunction (upper cross syndrome, among others), and probably have a pissed off shoulder to boot.
Buuuuuuuut…………..
There are cases where some direct upper trap work is warranted.
See what I just did there? I blew your mind.
With regards to shoulder function we all know that of “stuff” goes down in that area.
The shoulder complex can partake in: flexion/extension, internal/external rotation, abduction/adduction, horizontal abduction/adduction, elevation/depression, and of course, (scapular) upward/downward rotation.
The latter (upward/downward rotation) is what will be highlighted here.
Sadly, due to any number of factors – namely, the ungodly number of hours people spend sitting playing Angry Birds, poor programming choices, flawed technique, etc – we don’t move very well as a society. Further still, we just get in our own way and end up hurting ourselves.
Using an easy example: I remember watching Eric assess an older client once who came to the facility with a litany of shoulder issue. To put it bluntly, the guy couldn’t even extend his arms straight over his head. Yet, the very first question right out of the gate was, “so, when do you think I’ll be able to add snatches and shrugs into my program?”
See what I mean? We get in our own way.
However, given we train a fair share of baseball players at Cressey Performance, and it’s kind of a big deal that they have the ability to throw a baseball (which entails going over the head) without compromising the shoulder, doing some upper trap work may indeed be a crucial component to overall shoulder performance and health.
Up until recently, we’ve done little (if any) upper trap work. Again, as noted above, it’s readily apparent that the upper traps are overly dominant in most individuals (compared to the lower traps and serratus anterior), and haphazardly throwing in exercises like shrugs may only make the issue worse.
That said, we can’t neglect the fact that the upper traps DO play a role in scapular upward rotation, and that optimizing their function is worth some of our time.
Here’s what we noticed, which has been a paradigm shift for us – especially as it relates to our baseball guys (and even some of our general population clients): we are constantly (like, all the time) telling athletes and clients to retract and depress their scapulae. Normally this isn’t a bad thing, as it targets the lower traps more and will help offset upper trap dominance. But sometimes, it can be to the detriment of the shoulder.
Take the following exercises and how we typically like to cue them:
Seated rows: pull the shoulder blades together and down.
Chin-Ups: keep the shoulder blades in your back pocket (depressed).
Deadlifts: shoulder blades “locked” and set (and subsequently the upper traps are on stretch)
Farmer Carries: don’t shrug, set the shoulders (again, upper traps are on stretch).
Those are just a few examples, but hopefully you get the idea. And just so we’re clear: I am in no way saying that these are bad cues to use. Just that, sometimes, we need to be objective. Anyhoo……..
Soon you may notice a downwardly rotated scapula due to a lengthened upper trapezius. In this scenario, the excessive length makes the upper trap weak and a less than effective upward rotator of the scapula. And, I don’t think I need to reiterate that less than optimal upward rotation is a going to be a massive monkey wrench when it comes to shoulder health and performance.
Take me for example. Other than that being the coolest t-shirt ever, what else do you notice about the picture to the right?
See those sloped shoulders? Definitely not ideal, and sets the shoulder girdle a little too low for optimal function. Now, thankfully, my baseball career is long over, and I don’t suffer from any long-term shoulder issues. But needless to say, some dedicated upper trap work would be in high order for someone like me.
Likewise, this is exactly the type of shoulder symmetry (or, more appropriately, asymmetry) we’re more cognizant of at the facility when dealing with overhead athletes.
The key, though, is to step away from the stupid and not hightail it for the barbell shrugs. As both Mike Robertson and Bill Hartman have noted on numerous occasions:
A shrug with the arms at the sides will certainly activate the upper trapezius, however it also strongly recruits the levator scapulae and the rhomboids, the downward scapular rotators. This feeds the imbalance causing the downward scapular rotation dominance.
The key, then, is to perform a movement where the scapulae is already in an upwardly rotated position which places a larger activation of the upper traps, which in turn will help offset the pull of the downward rotators (rhomboids and levator).
Half Kneeling Band Overhead Shrugs
This was a video I took while I was down in Florida last week at the commercial gym I was training at (so you may see some exercises you SHOULDN’T be doing in the background). In it, you’ll see how I use a regular ol’ exercise band and place it underneath my knee.
From there, with my arm fully extended, I shrug and hold for a 1-2 second count. I reset my scapulae and repeat for the desired number of repetitions. Ideally, I’d shoot for anywhere from 8-12 reps per side.
Key Coaching Cues: Squeeze the glute of the kneeling leg to gain more of an active stretch in the hip flexors. Wrist should be neutral. And, you may need to play around with the band tension. I was pretty limited with what I had available at the time, but suffice it to say, you may need to finagle a bit with how much of the band you place underneath your knee.
Additionally, this isn’t the type of exercise where I’m looking to overload the traps, so don’t be too concerned with using a monster band or anything like that. Rather, it’s more of an activation and it’s imperative that you focus on the QUALITY of reps (feeling the actual muscle do its job).
scenario, the excessive length makes the upper trap weak and a less than effective upward rotator of the scapula. And, I don’t think I need to reiterate that less than optimal upward rotation is a going to be a massive monkey wrench when it comes to shoulder health and performance.
