Shoulders are important for athletes in almost every sport. Shoulder joints are versatile because they have exceptional range of motion. But it’s that same large range of motion that makes shoulder joints very unstable. Because of its mechanical instability, the shoulder joint is very dependent on its surrounding muscles. Shoulder muscle imbalance equals high risk of shoulder pain. Shoulder pain exercises and other remedies can be in order.

Myth #1: “If My Shoulder Is Really Weak, I Probably Tore My Rotator Cuff”

Facts: The shoulder rotator cuff is made up of four key muscles, which control most motions of the upper arm.

The majority of athletes who suffer from a gradual onset of shoulder weakness and pain without a significant shoulder trauma probably don’t have an acute (new) full-thickness rotator cuff tear. If an active athlete can’t attribute their suddenly weak and painful shoulder to a violent fall or painful incident, a shoulder impingement is a likely diagnosis. Shoulder impingements are a common injury for athletes like Spartan racers who climb, lift, crawl, and carry. Because a shoulder impingement or shoulder bursitis typically shuts down the shoulder rotator cuff, it has a weakness pattern similar to a torn rotator cuff. A skilled evaluation by an orthopedic doctor, athletic trainer, or physical therapist can help you confirm the exact diagnosis.

Myth #2: “If I Want to Get My Shoulders Strong, I Need to Do Lots of Overhead Strength Work”

Facts: The same muscles that lift and move the arm to the horizontal shoulder level lift the arm overhead.

Lifting the arms with weights above the horizontal shoulder level puts a lot of stress on the shoulder joint. Therefore, the risk of injury to the rotator cuff, labrum, muscles, tendons, and joint surfaces is higher when performing a resisted upward overhead “press.”

I know what you’re thinking right now: “But man, as a Spartan racer my arms are always overhead on the ropes, monkey bars, rings, Twister, and wall climbs, so I need to get stronger up there!”

Here’s the difference: With all those obstacles, you’re pulling down not pushing up. Therefore, the mechanics of the shoulder joint and acromioclavicular (AC) joint vary greatly when you pull down while climbing compared to when you push up against resistance. The pulling down motion is easier on the shoulder joint and AC joint than the more dangerous pushing upward exercises.

Myth #3: “The Most Important Muscle Group to Prevent a Shoulder Injury Is My Chest Muscle”

Facts: The two pectoralis muscles of the chest are very important for pushing and bear hug–like motions like push-ups and the bucket carry.

For most athletes, the most important muscle group to prevent shoulder injury is the shoulder external rotators. This group of muscles forms the back wall of the armpit. When contracted, they rotate the upper arm outward. It’s a similar motion to when a tennis player hits a backhand shot.

This muscle group is important because it controls the motion of the humerus or upper arm bone whenever the arm moves. Weak external rotators allow the humeral head to glide upward too much, and the dreaded shoulder impingement syndrome is soon to follow.

Shoulder Pain Exercises and More

Arm Balance—Good shoulder pain exercises include upper body balance exercises, planks, and crawls are fun ways to strengthen all 17 muscles that attach to the shoulder blade. Want to make these exercises harder? Try closing your eyes, which forces your muscles and joints to communicate with your brain without feedback from your eyes.

Pain Control Is Spelled I-C-E—Spend more time getting to know your new best friend: ice. With dozens of muscles, tendons, and ligaments working hard to keep your shoulders strong, ice will prove to be a smart partner to keep your shoulder joints pain-free.

Don’t Forget Your Loyal Trunk—Shoulder bones, muscles, tendons, and ligaments, directly or indirectly, are all connected to your trunk. Hence shoulder pain exercises don't necessarily have to be local. Warming up your trunk should be part of your routine. Trunk twists, bar hangs, side bends and deep breathing are simple ways to prime your trunk for the onslaught to follow.

Learn more about Mike Ryan, PT, ATC, SGX: MikeRyanSportsMedicine.com.

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