Shoulder Savers: Training Smart & Preventing Injury

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In this great article from T-Nation, fitness guru Eric Cressey outlines several ways to prevent shoulder injury and/or rehab shoulder injury when strength training. These tips from a well-seasoned powerlifter and coach will surely help save those shoulders.
Do you experience nagging pain in the shoulders when pressing weight overhead? How about when performing a pull-up or a push-up? As with so many people deeply involved with fitness, CrossFitters put their shoulders through overtime regularly.

With CrossFit, it’s easy to overlook the volume and frequency at which we utilize our shoulders in training. Just like the hips (gluteals), your shoulders are a fulcrum necessary for stability and power; however, because of the complexity of this joint, injury and pain are almost inevitable due to the demands of most CrossFit programs.

The good news? You can be injury- and pain-free with the help of some of these shoulder savers.

#1: Avoid what hurts

The next time your shoulder starts to act up in the middle of a training session, put down the weights, take a deep breath, and walk over to the water fountain.
It seems logical, but we all know how tough it is to resist the exercises we’ve grown to love. Face the facts; you just might not be able to overhead press or bench with the straight bar.

Not all bodies are created equal in the first place; a good example would be the different types of acromions, a portion of the scapula. Those with type III acromions are more likely to suffer from subacromial impingement due to the shape of this end of the scapula:

These are the 3 types:

Type I Acromion: flat, minimal impingement risk, normal subacromial space.

Type II Acromion: curved, higher rate of impingement, slight decrease in subacromial space.

Type III Acromion: beaked, highest rate of impingement, marked decrease in subacromial space.

Now, ask yourself this: when someone universally recommends overhead pressing, how often do you think they’re consulting x-rays to determine if it might not be the best thing for you?

If you feel shoulder pain while training, determine an appropriate course of action — including an alternative exercise.
Moreover, not all bodies are equal down the road, either. If you’re a type I or type II acromion process, you can “acquire” a type III morphology due to reactive changes. These changes may be related to a specific activity (e.g. weight-training) or just a case of chronically poor movement patterns (think of a hunchbacked desk jockey who’s always reaching overhead).

There’s almost always going to be something else you can do to achieve a comparable training effect without making things worse. So, the next time your shoulder starts to act up in the middle of a training session, put down the weights, take a deep breath, and walk over to the water fountain.

Use this stroll as an opportunity to recognize that something is out of whack and determine an appropriate course of action — including an alternative exercise. You might need to experiment a bit, but it’ll come to you.

#2: Serratus Anterior Activation Work

The serratus anterior will always be the first muscle to “shut down” in the face of any sort of scapulohumeral dysfunction, and activating it is a crucial component of all rehabilitation programs for the shoulder girdle.
The serratus anterior is a small muscle, but it’s of profound importance when it comes to scapulohumeral rhythm and, in turn, shoulder health.

Essentially, this muscle locks the scapula to the rib cage to prevent the scapula from winging out. It assists the pectoralis minor with protraction, but most importantly, it’s involved in a delicately-balanced force coupled with the upper and lower trapezius for scapular upward rotation, a movement in which you need to be perfect to function safely with overhead movements.

Serratus Anterior

Unfortunately, the serratus anterior will always be the first muscle to “shut down” in the face of any sort of scapulohumeral dysfunction, and activating it is a crucial component of all rehabilitation programs for the shoulder girdle.

I could literally give a day-long seminar on all the different pathologies in which serratus anterior dysfunction is involved in some way. So, why not take care of it ahead of time? Two great exercises are the scap push-up and supine 1-arm dumbbell protraction:

Scapula Push-ups
Supine 1-arm Dumbbell Protraction

Stick with high reps on these; a few sets of 15-20 a few times per week will do wonders for you without interfering with the rest of your training.

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