The shoulder is a complicated body part. It is an extremely mobile joint that is able to move within many different planes of movement; however, as a result of its ability to move excessively, its stability may sometimes become compromised. In addition, there are other parts of our body that are required to move efficiently in sync with the shoulder in order for healthy shoulder mobility to occur. Because the shoulder is quite complex, proximal body parts are often overlooked when creating various shoulder exercise programs. The glenohumeral joint (shoulder ball-and-socket joint) sits on the scapula (shoulder blade), which moves in accord with the thoracic spine (Mid-Back). A shoulder exercise program is not comprehensive unless all components of the shoulder are addressed. This article will help you understand the various motions that must occur at the shoulder, the spine, and upper extremity as an entire unit, as well as show you excellent exercises that will guide you in how to bulletproof your shoulders!

 

Learn How To Bulletproof Your Shoulders

Of the optimal 180 degrees required for shoulder elevation, did you know only about two-thirds come from the shoulder joint, meaning the glenohumeral joint? In fact, a whopping 60 degrees of shoulder elevation is initiated by the scapulothoracic joint! This is why you can’t have full shoulder mobility unless the scapula and thoracic spine are addressed!

 

Let’s take two examples:
1. A person is walking across a room on top of Bosu balls step after step.
2. The same individual walking across a room on a sturdy floor.

Would you want to walk across the room on a sturdy floor, or an uneven floor? Most would agree with taking the easy route of the sturdy, more level surface. Wouldn’t it be easier to perform higher-level exercises such as jumping, cutting, landing, and running on a more sturdy surface? The shoulder moves off of the shoulder blade in a similar manner. This is why it is imperative to address scapular muscle function when the goal is to prevent overuse injuries and enhance the performance of the shoulder.

 

Bulletproof Your Shoulders With Our Program!

Are you looking for the ultimate guide that will help you optimize your shoulder health? The Shoulder [P]rehab Program is a physical therapist developed, step-by-step program that teaches you how to optimize your shoulder health. Learn more HERE

 

How To Bulletproof Your Shoulder

• Part 1: Lumbar Spine Control with Overhead Motion

 

• Part 2: Thoracic Spine Mobility

 

• Part 3: Scapula Control

 

• Part 4: Shoulder Mobility

 

• Part 5: Shoulder Strength

 

Lumbar control with Overhead Motion

Poor control in this region will result in the excessive extension of the lumbar spine (low back) which is noticeable with a rib flare. This will give you a false sense of achieving shoulder elevation when in reality this is a compensatory pattern. Your lumbar spine should remain relatively neutral as you perform overhead exercises. Below are 2 exercises that will help with lumbar spine control as you reach into an overhead position.

Bulletproof Your Shoulders: Quadruped Shoulder Overhead Reach

Sample [P]rehab Shoulder Program Exercise

• HOW: Begin on your hands and knees; hands under shoulders and knees under hips. Spread your shoulder blades by pushing your body away from the floor. Find a neutral pelvis. To do this, you may need to arch and tuck your low back to find a neutral position. While keeping a neutral low back, elevate one arm out to your side into a 90/90 position, then slowly reach overhead. Attempt to keep the arm as close as you can to the ceiling. As you reach overhead, rotate your thumb towards the ceiling. Return to starting position and repeat!

 

• COMPENSATION: Avoid allowing your shoulder blade to sag during this exercise. Make sure to keep your torso directly towards the floor,  and avoid trunk rotation, especially to the side you’re reaching overhead with.

 

Looking For Some Higher Level Shoulder Exercises?

 

Supine 90/90 Wall slide

 

Thoracic Spine Mobility

Thoracic mobility is key for shoulder motion. This mid-back region is where you want the spinal extension to occur. The thoracic spine is responsible for about 20 degrees of shoulder elevation. Without appropriate mobility here, the scapula will not move optimally thus limiting your shoulder motion. As you reach your arms overhead you should have the appropriate thoracic spine extension for optimal scapular function and shoulder mobility. The key is to vary your movement which will avoid allowing your body to become stiff in one position.

Thoracic Spine Foam Roll Overhead Reach

Sample [P]rehab Shoulder Program Exercise

• HOW: Place the foam roller perpendicular to your spine onto a segment that you want to work on (personally I like to work from bottom to top). Now elevate your arms as far back as you can in an attempt to touch the floor. This movement is very similar to a wall angel. Spend a few repetitions on each segment and then move up toward the next segment.

 

• FEEL: You will feel this in the middle of your back, specifically the area that is hinging over the foam roller.

 

• COMPENSATION: Don’t allow your butt to come off the floor or your ribs from flaring out. This is typically due to excessively hinging at the lumbar spine. This exercise is designed to target the thoracic spine.

 

Thoracic Spine Active Rotation

• EXERCISE 1: Start in a half-kneeling position with a ball between your inner leg and the wall. This will ensure you DON’T cheat with any hip motion! Try to rotate with your hand all the way around and back.

 

• EXERCISE 2: In half-kneeling – Keep both hands behind your head. Perform a thoracic spine around the world against the wall. Rotate all the way around and come back. Try to challenge yourself from keeping the elbow away from the wall. Avoid side-bending in the opposite direction, this is a compensation.

What is the difference between this and the open book exercise? This requires a more active range of motion!

 

Scapula Control

Your scapula, which is also known as your shoulder blade is often difficult to find. If you do not engage periscapular muscles (muscles around the scapula) with exercises such as rows, pull-ups, or push-ups, then you will likely “arm” the movement. This means you will rely heavily on shoulder and arm muscles. Your scapula is able to handle more load than your arm muscles. With any movement, you want to move proximally followed by moving distally (from top to bottom), as the scapula should initiate the motion when performing a movement like the Row, Lat Pull-Down, or when performing Pull-Ups. Shown here are a couple of movements that will help improve scapula control.

Realize that at first when implementing this strategy, it may decrease your overall performance; however, the potential to improve your long term performance will increase!

READ: SERRATUS ANTERIOR EXERCISES

 

Serratus Anterior Activation

Sample [P]rehab Shoulder Program Exercise

To perform this exercise:

• Anchor the resistance band around your back- here I use a CLX Thera-Band. Then I place the band over my elbow and trace it down my forearm to my hand. Begin by pushing your elbow up towards the ceiling. Focus on the protraction of the scapula.

 

• Option 1: Elevate the shoulder to 120 degrees of shoulder flexion and 30 degrees of horizontal abduction to maximize the activation of the serratus anterior.

 

• Option 2: Externally rotate the shoulder while protracting the scapula, as this will help reduce the activity of the pectoralis musculature to better isolate the serratus anterior.

 

The serratus anterior is an important muscle for optimal shoulder function. We have written an article that will help you understand what this muscle is, and why it is important to work on the motor control and strength of this muscle in order to promote optimal shoulder health!

 

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Enhancing Shoulder Mobility

Passive shoulder stretching

Sample [P]rehab Shoulder Program Exercise

• Modified Child’s Pose Against Wall: In addition to improving shoulder flexion, this stretch will improve thoracic spine extension while minimizing lumbar spine (low back) extension.

 

• Across Body Stretch: The first stretch is an example of a common fault during a posterior shoulder capsule stretch. This is due to allowing the entire shoulder girdle including the scapula to be pulled with the stretch. This targets the scapular retractors (rhomboid/mid-traps). Ideally, you will perform this WITHOUT the scapula protraction. Set your shoulder in a good stable position before pulling across your body as this will allow for a good stretch of the posterior capsule of the shoulder.

 

• Hand Behind Back: Reach your hand towards the opposite shoulder blade, or as close as you can get towards it. From this position, squeeze the scapula together. This will assure the motion is coming from the shoulder (Glenohumeral joint) instead of the scapula-thoracic joint.

 

• Pec Stretch: Bring your arm up to a 90/90 position and place your shoulder onto a stable surface. Rotate until you feel a good stretch in the chest/anterior shoulder and hold. Try pinching your shoulder blade back to avoid excessive stress on the anterior shoulder.

 

Passive stretching only gives temporary mobility gains.  We recommend activating in these newly afforded ranges to maintain this improved range of motion!

LISTEN: HOW MUCH SHOULD I BE STRETCHING?

 

Lat Mobility Drill

 

Building Strength

Although the primary intent of this article was to bring awareness to addressing proximal limitations, there is no way you can bulletproof your shoulders without strengthening your shoulders! Although this is the last component of the article, it is the MOST vital in maintaining shoulder health. Check out additional Evidence Based Shoulder Exercises.

Kettlebell Overhead Carry

 

Closing Thoughts

As it is now evident to you from reading this article, the shoulder has many moving parts to it, requiring a lot of stability to avoid compensatory movements or potential injury. As you have gained a further understanding of the key parts of the body that are necessary to help the shoulder move optimally, you can use tips from this article to implement into your exercise routine! Ultimately, gaining a solid understanding of and executing thoughtful movements will allow you to gain an even higher level of function as well as bulletproof your shoulders for life!

Bulletproof Your Shoulders With Our Program!

To win an NBA championship in this current era it seems at least 3 superstars are needed on the team. Behind these 3 superstars includes the entire support staff that takes care of the day-to-day operations allowing the stars to perform. Sounds like they are using the model of the shoulder! You will learn how to create balance among the support staff which will allow the 3 joints of the shoulder to perform to their superstar abilities!

 

About The Author

Arash Maghsoodi, PT, DPT, CSCS

[P]rehab Co-Founder & Chief Marketing Officer

 

 

 

Disclaimer – The content here is designed for information & education purposes only and is not intended for medical advice.