The third and final installment of my “30 Days of Shoulders” series went live today over at T-Nation.com. All three parts cover everything from shoulder assessment and tips on shoulder friendly pressing t0 how to improve shoulder health and performance.
Collectively it’ll make all your hopes and dreams come true.
Check it out —-> HERE
I’m willing to bet that if you’re reading this if you have two shoulders.1
I’m also willing to bet that, given the two shoulder scenario, and given this is a blog dedicated towards strength & conditioning, you’re interested in:
My latest article (which is a three-part series) just went live T-Nation.com today, and it covers anything & everything as it relates to shoulders.
Check it out…HERE.
If you missed Part I of Dr. Licameli’s guest post, you can check it out HERE. Now, you could read today’s post and get the gist of what was said yesterday, but you run the risk of missing out on some nitty-gritty details.
Kinda like watching Blade Runner 2049.
You could watch it without watching the original, but you’re missing out on some important context.
*** This is the part where’d you know what points 1-4 were all about.
There is good pizza and there is bad pizza. There is good pain and there is bad pain. Differentiating the difference is of utmost importance when training the shoulders.
We’re not talking about delayed onset muscle soreness (DOMS), which is felt 1-2 days after training.
We’re talking about pain during training.
What follows are some guidelines to help you navigate your way through pain.
KEEP IN MIND, THESE ARE GENERAL GUIDELINES. IF YOU HAVE PAIN, BE SURE TO SEE A QUALIFIED HEALTHCARE PRACTITIONER!
I stress finding a qualified healthcare practitioner. A qualified healthcare practitioner will explain all of this, in addition to providing several options to keep you training while recovering from injury.
Let’s face it…not all physical therapists have spent much time under a bar. Some have spent time at the bar or even at barre class, but many have no experience or expertise in weight lifting or bodybuilding. You deserve your goals to be taken seriously. You deserve more than things like, “stop squatting for 4 weeks” and standing internal and external rotation with a band to “strengthen” the rotator cuff…or is it rotator cup…no, it’s rotary cuff…rotary club!
That’s it.
-How Does It Feel?: Muscle burn; usually symmetrical right to left.
-Onset: Gradually increases as the set progresses.
-When Does It Stop?: At the completion of a set.
-How Does It Feel?: Sharp, numb, tingling; intensity may be asymmetrical right to left.
-Onset: Quickly; may be felt after only the first few reps
-When Does It Stop?: Days, weeks, months…; stays well after the set is completed, however may also end at the completion of a set.
If you find yourself experiencing bad pain, it may not be the end of the world. Bruce Lee also said, “Be like water.”
Water has the flexibility to take the shape of whatever container it is placed in, while still maintaining its identity…water.
In a similar way, our training can be modified without losing its identity or effectiveness. Try to modify your training. Sharp pain when pressing overhead with a barbell? Try a landmine press. Unable to perform a reverse flye? Try a face pull. Keeping the same exercises and modifying training volume may also do the trick.
It is no one’s fault but our own that, as a profession, physical therapy has a certain reputation when it comes to injury and injury prevention. The misconception is that in order to reduce pain or prevent injury, a hefty dose of classic “rehabilitation” exercises need to be added into an already packed training regimen.
For me, and many out there like me, gone are the days of separating “therapeutic exercise” from “regular training.” Say goodbye to blocking off a half hour pre and post workout to foam roll and perform straight leg raises and clamshells. If you look closely, you can find what you need for healthy shoulders right there in your existing training routine. Here are some examples:
Face Pull: Trains scapular retraction and external rotation. Great for scapular stability, rotator cuff strengthening, and balancing out internal vs. external rotation.
Farmer Carry/Overhead Carry: Excellent way to train postural, scapular, and global rotator cuff stability, not to mention full body/core strength.
Plank on Ball with Protraction and/or the Ab Wheel: Great way to dynamically train serratus anterior, core stability, and scapular stability.
Plank with Band Around Wrists with Protraction: Great way to train external rotation as well as dynamically train serratus anterior, core stability, and scapular stability
Landmine Press: With proper scapular movement (more on this to come), this is an excellent exercise to dynamically strengthen serratus anterior and improve scapular neuromuscular control.
Pull-up/Pull-down: With proper scapular depression at the initiation of the pull, this is a fantastic exercise to target the lower traps, which play a key role in scapulohumeral mechanics. Full range of motion and a long eccentric will also help lengthen the lats, which can limit shoulder mobility.
Squats/Deadlifts: Train “shoulder packing” position. A proper warm-up prior to these lifts will also include thoracic mobility work.
Seek out experts like Tony Gentilcore (obviously), Andrew Millett, John Rusin, Jeff Cavaliere, Quinn Henoc, Mike Reinold, Mike Robertson, Eric Cressey, Dean Somerset, Zach Long, Joel Seedman, Ryan DeBell, Teddy Willsey, and many more.
But if you have pain, GO SEE A QUALIFIED HEALTHCARE PRACTITIONER FIRST!
As previously mentioned, weightlifters tend to be very “internal rotation dominant,” and for good reason.
Let’s look at the muscles that internally rotate the shoulder.
Just to name a few: pec major, lats, subscapularis, teres major, front deltoid.
Let’s take a look at the muscles that externally rotate the shoulder: infraspinatus, rear deltoid, teres minor.
The muscles that internally rotate the shoulder are of greater number and greater size (the pecs and lats are two of the strongest muscles of the upper body). The external rotators are less in number and much smaller. Give those external rotators a fighting chance to create some balance! Don’t neglect them!
It’s important to note that just performing an equal amount of presses and rows/pull-downs will not improve shoulder rotation symmetry because, as previously mentioned, both the pecs and the lats internally rotate the shoulder. So even though pull-downs and rows are “back” exercises, they still train the lats and therefore still train internal rotation.
Some of my favorite exercises to train external rotation are face pulls, W raises/pulls, reverse flyes with external rotation bias, wall slides with a band, and planks with a band around the wrists.
Adequate thoracic mobility is crucial to optimal shoulder function. If the scapulae are the foundation of the shoulder, the thoracic spine is the ground on which the foundation is built.
Thoracic mobility should be included in almost every warm-up, regardless of the body part being trained. One of my favorite thoracic mobility exercises is a kneeling protraction sit-back into a lat stretch with deep breathing. Be sure to check out this video of a sample lower body warm-up routine that includes this exercise.
It happens all the time.
An idea comes out and soon gets morphed into an extreme.
“Dynamic stretching may be better than static stretching pre-workout” turns into, “Don’t ever do static stretching because it’s a waste of time.”
“Foam rolling may help improve short-term soft tissue restriction and range of motion” turns into “I have to foam roll for 30 min when I wake up as well as pre workout, post workout, and before bed in order to break up adhesions and prevent injury.”
The idea of “shoulders down and back” seems to have experienced a similar course. Yes, keeping the shoulders in a retracted and depressed position with a properly extended thoracic spine will place the muscles, nerves, and joints in a structurally advantageous position as well as open up the subacromial space by about 30%. It also allows for unrestricted overhead shoulder range of motion.
However, the scapulae must move, and they must move correctly. The scapula is the base and foundation of the shoulder and dysfunction can most certainly lead to injury.
Note From TG: Check out THIS article I wrote a while back touching on the same topic; in this case how it relates to performing a DB Row correctly.
Generally, the scapula remains relatively stationary during the first 30 degrees of shoulder abduction (lifting the arm out to the side as in a lateral raise), with the movement coming primarily from the glenohumeral joint. As abduction continues past 30 degrees, the scapula begins to move and the glenohumeral joint and scapulothoracic joints move in about a 2:1 ratio.
This means that at 120 degrees of abduction, the glenohumeral joint has contributed about 80 degrees and the scapula has contributed about 40 degrees. If the scapula remains pinned “down and back,” range of motion will be restricted and the glenohumeral joint will be forced to overcompensate. This dysfunction will likely limit performance and increase risk of injury.
In addition to upward rotation, the scapula also needs to protract (glide forward) during both overhead and pulling movements. Serratus anterior is one of the main muscles responsible for protraction as well as for adhering the concave surface of the scapula to the convex surface of the ribcage. Pinning the scapulae down and back is not what we need…we need controlled, scapular motion.
If at least one person benefits from these tips, I have done my job. My hope is that you will keep these tips in mind and reap the benefits of strong, healthy shoulders. You’re putting the work in, now let’s capitalize on it.
Nicholas M. Licameli
Doctor of Physical Therapy / Pro Natural Bodybuilder
Youtube: HERE
Instagram: HERE
Facebook: HERE
Every single thing he does, Nick believes in giving himself to others in an attempt to make the world a happier, healthier, and more loving place. He wants to give people the power to change their lives. Bodybuilding and physical therapy serve as ways to carry out that cause. Nick graduated summa cum laude from Ramapo College of New Jersey with his bachelor’s degree in biology, furthered his education by completing his doctoral degree in physical therapy from Rutgers School of Biomedical and Health Sciences (previously the University of Medicine and Dentistry of New Jersey) at the age of 24, and has earned professional status in natural bodybuilding. His knowledge of sport and exercise biomechanics, movement quality, and the practical application of research combined with personal experience in bodybuilding and nutrition allows him to help people in truly unique ways. Love. Passion. Respect. Humility. Never an expert. Always a student. Love your journey.
Categoriespersonal training Program Design Strength TrainingThe shoulders (delts) are an area that many trainees wish were bigger. They’re also an area that’s often injured. In today’s guest post by Dr. Nicholas Licameli he discusses and breaks down some of his top training tips for shoulder health and hypertrophy.
Enjoy.
In order to build a quality and symmetrical physique, all muscle groups must be trained and developed equally. An overdeveloped muscle group can never compensate for an underdeveloped one. That being said, a well-developed set of shoulders, along with a narrow waist, can really enhance a physique and create a nice V-taper.
While the shoulders are one of the most sought after muscles to develop, they also tend to be one of the most stubborn and most commonly injured. Here are my top shoulder training tips to help you on the journey to strong, healthy shoulders.
Early in my training career, I remember feeling as if there were some aspects of my training that could not be changed. Compound lifts had to be performed using a barbell only and with heavy, lower rep sets. Dumbbells and lighter/higher rep training were for isolation movements.
For years, I trained in the 6-10 rep range for barbell overhead presses and in the 12-20 rep range for lateral raises, rear deltoid work, and other isolation movements. I never really felt “satisfied” or that “good” fatigue after completing heavy sets of overhead presses.
I eventually took the leap out of my comfort zone and started using dumbbells and a landmine set up for overhead pressing.
What a difference!
I felt a connection to my deltoids like never before. The overhead press soon went from one of my least favorite movements to one of my favorites.
I also started to realize that my lighter warm up sets seemed to feel better (even when not taken anywhere near failure) than my heavier working sets. I took another leap and started training the overhead press in the 12-20 rep range and again, I was blown away at how my body responded. Does this mean I completely removed heavy overhead pressing from my training?
Of course not, but I am definitely not afraid of lighter training.
The take home message here is listen to your body.
If heavy barbell training doesn’t quite “click” for your shoulders, don’t be afraid to change it up.
We now know that if hypertrophy is your goal, overall volume (volume = weight lifted x sets x reps) and progressive overload at an appropriate intensity is what matters.
Note From TG: Technically speaking, for muscular hypertrophy three factors take precedence: Mechanical Tension, Metabolic Stress, and Muscle Damage.
For more insights you can’t ask for a better resource than Brad Schoenfeld’s Science and Development of Muscle Hypertrophy.
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Hypertrophy can be seen by training with heavy weight and low reps as well as light weight and higher reps. Keep in mind that if your goal is strictly to increase strength on the barbell overhead press, you’re going to have to train the barbell overhead press with heavy loads, as specificity is much more important when it comes to strength.
The upright row seems to have more controversy surrounding it than Donald Trump administering a flu vaccine to a gluten-free, ketogenic, vegan, transgender circus elephant in captivity while drinking creatine sweetened with aspartame.
Is the traditional “muscle magazine” upright row the safest or most effective exercise to build big, strong, and healthy shoulders?
Probably not.
Can it be modified?
Absolutely.
By nature of the movement, the barbell upright row places the shoulder in resisted internal rotation with elevation. This is a less than optimal and, dare I say, vulnerable position because it narrows the subacromial space, which can increase risk of injury.
Does that mean our shoulders will break on the first rep?
No.
Our bodies are resilient and can handle less than optimal positions, but why risk it if we can find a better way? Need a refresher on what the sub-acromial space is and how narrowing it can lead to injury? Check out Tony’s awesome article right here.
Great alternatives to the barbell upright row are the dumbbell upright row and the face pull.
Face Pull
As mentioned above, the barbell upright row puts us into internal rotation, which narrows the sub-acromial space.
External rotation, however, can be a shoulder’s best friend.
The dumbbell upright row frees up our joints and allows us to externally rotate throughout the movement. The face pull reduces the amount of internal rotation at the bottom of the movement and increases the amount of external rotation at the end of the movement.
Many training routines tend to be abundant in internal rotator strengthening (pecs, lats, etc.) while lacking strengthening for the external rotators (posterior rotator cuff, rear deltoids, etc). Both the dumbbell upright row and face pull involve resisted external rotation, which means they can help balance out a traditional training routine (more on this to come).
Note From TG: Speaking of Face Pulls I am reminded of THIS classic T-Nation.com article by Mike Robertson and Bill Hartman on the topic.
The lateral raise is a staple in most shoulder training routines, however if done incorrectly, can be very similar to the barbell upright row.
By internally rotating at the top of a lateral raise, as if pouring a pitcher of water, the shoulder gets placed into resisted internal rotation with elevation, which we now know is not that great of a position.
Why is that a common cue (even Arnold recommends it!)? Because in order to maximally target the middle deltoid, it needs to be directly in line with the force of gravity and the “pouring-the-pitcher” position accomplishes this.
Middle deltoid is directly in line with the force of gravity (good!), however the shoulder is in internal rotation and elevation (bad!)
Anterior deltoid is directly in line with the force of gravity
Bending forward or lying face down in a bench targets the posterior deltoid because it is directly in line with the force of gravity.
Posterior deltoid is directly in line with the force of gravity
So how do we reduce our risk of injury while still maximizing the force through the middle deltoid?
Simple.
Hinge at our hips and lean forward, just a bit.
The line of gravity has now changed. We’re now able to externally rotate (reversing the pitcher pouring motion) while still placing the middle deltoid in perfect alignment with gravity.
Middle deltoid is directly in line with the force of gravity (good!) AND the shoulder is in external rotation (good!)
For a video demonstration and explanation of this, go HERE.
When looking at weekly shoulder volume, don’t forget to account for all of the exercises that involve the shoulders as secondary movers.
Shoulder presses, lateral raises, and reverse flyes are not the only exercises that add to weekly shoulder volume.
The shoulders get worked during exercises like bench presses, rows, dips, and even pull-ups and pull-downs. If you have a volume goal you are trying to hit, be sure to keep this in mind to avoid overtraining and overuse injuries. Remember, more is not better…better is better.
Bruce Lee said,
“I fear not the man who practiced 10,000 kicks once, but I fear the man who has practiced one kick 10,000 times.”
Too much variety for the sake of novelty can limit your ability to progress, especially when it comes to shoulder training.
In general, the basic variations of shoulder movements are presses, lateral raises, extension-based movements (face pulls, reverse flyes, etc.), and global stability movements (farmer carries, planks, bird dogs, etc.).
My suggestion would be to find your preferred variations of those movements and perfect, fine tune, overload, and progress them. Yes, change it up every once in a while, but don’t swap out a solid landmine press for a banded, blood flow restricted, single-arm kettlebell press while standing on a BOSU over a pool of sharks with laser beams attached to their heads.
Stay tuned for Part II tomorrow where I offer four more of my top shoulder training tips.
Nicholas M. Licameli
Doctor of Physical Therapy / Pro Natural Bodybuilder
Youtube: HERE
Instagram: HERE
Facebook: HERE
Every single thing he does, Nick believes in giving himself to others in an attempt to make the world a happier, healthier, and more loving place. He wants to give people the power to change their lives. Bodybuilding and physical therapy serve as ways to carry out that cause. Nick graduated summa cum laude from Ramapo College of New Jersey with his bachelor’s degree in biology, furthered his education by completing his doctoral degree in physical therapy from Rutgers School of Biomedical and Health Sciences (previously the University of Medicine and Dentistry of New Jersey) at the age of 24, and has earned professional status in natural bodybuilding. His knowledge of sport and exercise biomechanics, movement quality, and the practical application of research combined with personal experience in bodybuilding and nutrition allows him to help people in truly unique ways. Love. Passion. Respect. Humility. Never an expert. Always a student. Love your journey.
