Jessica Bento, Physical Therapist (Co-Creator of DVRT Restoration Certification, Shoulder & Pelvic Control Courses)
Shoulder issues were one of the most common issues I would see patients in the clinic with. The amount of shoulder issues could almost rival those with low back issues, it seemed so frequent. At the time as a young physical therapist I did the pretty standard shoulder exercises. Band external rotations, wall slides, Y, T, and I’s, the pretty typical stuff that you would see by even many therapists today!
Why change though? Why did I look for something better for my patients if the program I had them on was working. The simple answer is because it didn’t. A lot of the people that get better simply did so from healing over time, or the fact they were doing no strength training and the tiniest bit helped their strength. What saddened me the most was far too often I would see many of these people back with very similar issues.
My path of looking for better got me to renown physical therapist, Gary Gray. I was so intrigued at how Mr. Gray looked at the whole body when he created exercises, not only the whole body, but how specific parts of the body worked together to create motion. There is a lot we could go into, but three concepts that I believe really changed how I think about training the shoulder is represented here…
I am blown away at how many physical therapists STILL train the body like a bodybuilder. Far too often my peers try to isolate a joint or body part in order to “fix it”. Which truly makes no sense when you look not just at the anatomy of the shoulder itself, but the great interplay that the shoulder has with our core and lower body. Ironically, I see many people try to take away the core and lower body when they train the shoulder and that is one of the biggest mistakes people can make!
Drills like the one above are well meaning, but they completely miss the boat on making the shoulders better!
If we look at the lats for example, they make a strong connection of the upper body (starting at the shoulder) to the spine and pelvis. There is a reason that the lat is that big and makes such a connection like we see. That is because what happens at the core/pelvis, and lower body have a big impact on how our shoulder functions and performs.
That is why when you see me perform BETTER shoulder exercises like those above, I am trying to integrate my entire body from feet to shoulders. That includes important aspects like my grip and making sure my core is able to keep my positioning under different conditions. Knowing that the shoulders function WITH the core and lower body should help you quickly determine if the advice you are getting on shoulder training is good or not! The Arc Press in our DVRT system is a great example of how we can integrate the body to create better shoulders.
Whenever you read an article about shoulder training you typically see the first section reference the anatomy of the shoulder. You see muscles, tendons, ligaments, and joint structures, but what you rarely see or hear is how the body puts all of this together to produce motion. The shoulder should be a very mobile joint that should be able to move in all 3 planes of motion.
It is interesting that before gyms were mainstream, our understanding and appreciation of functional anatomy seemed better in many ways. You see, the 3 planes of motion means that the shoulder is made for circular motions like throwing. Yet, we train it typically in only up and down movements. That is why equipment like Indian clubs were popular in the early days of Physical Education classes. The purpose was to train circular patterns that were so natural and innate to the body.
While Indian clubs are fine to use, they don’t build a lot of strength with the mobility that we need. Often I see people use Indian clubs to warm-up their shoulders, but then their lifting is purely sagittal plane movement. One of the great things about what we do in DVRT is use tools and concepts that allow us to take these ideas and put them in very practical terms like you see below where we strength train, stabilize, and perform mobility all at once.
As I have been helping Josh return to training after his neck surgery, we have been using these principles to help solve the nerve damage that came with the spinal degeneration and surgery. Many times people don’t know that the neck contributes to a lot of shoulder issues, but that is a topic for another time. Nerve damage in many ways can be more difficult than structural injuries because the nerves regenerate so slowly and we need coordination, stability, and strength all at once. That is why the exercises you may see Josh using for his shoulder don’t look like what you might expect in your shoulder rehab.
The way we have been able to restore function for Josh so fast is by thinking about the whole body contributing to his motion, not just his shoulders. That means again, everything from feet to hands. Not just putting him in positions where he has to use his whole body, but cuing it as well. From simple strategies like making sure he grips an implement tightly or the ground to giving feedback to using his feet. When we combine that with using important functional training ideas like diagonal patterns, we get some pretty powerful and unique shoulder exercises as you see my perform below.
My hope is the more you understand about the body, the faster and more significant the results you can achieve as well. NOTHING stops a well meaning training program like injury and exercise should NOT be a risk factor as Dr. Lee Burton says. Instead, our training should make us stronger, leaner, but also healthier and move better. I hope these training ideas show you how we can do it in fun and dynamic ways so you can enjoy not just the result of your training, but the journey as well.
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