Jessica Bento, Physical Therapist (Creator of DVRT Restoration Certification, DVRT Rx Shoulders, Knee, and Pelvic Control Courses & NEW Shoulder Online Seminar)
Shoulder issues are always going to be very personal to me. They were the reason that my hopes of swimming in the Olympics were dashed and even though I found a very positive path for myself, it is hard not to think about “what if”. So, when I see all these posts about wanting to provide solutions for shoulder issues on social media, I become sad mostly because they are often almost dangerous if not at best, highly ineffective.
There are so many things we could discuss when it comes to the shoulders, but I thought these 3 concepts were some of the most important to understand how we build truly healthy shoulders and avoid many of the pitfalls of social media.
Stop Taking The Core & Lower Body Out
I see it even with coaches and therapists I know well. As much as they want to say they are functional training based, I see them time and time again take the core and lower body out of their shoulder exercises. This is probably the number one mistake because your core and lower body are so integral to what happens at the shoulder.
This 2018 study found in throwing athletes, “Throwing athletes with shoulder pain have lower core stability and shoulder function compared to healthy athletes.”
This 2010 paper found in female volley players that those “participants who demonstrated core instability also had greater SICK (Scapular malposition, Inferior medial border prominence, Coracoid pain and malposition, and dyskinesis of scapular movement) scapula scores and were more likely to report a history of shoulder problems”
This 2014 paper from “Orthopedic Journal of Sports Medicine” explained, “Core stability and functional deficiency was found in patients with subacromial impingement syndrome. According to this study, greater shoulder dysfunction is correlated with greater stability deficiency. Therapists should consider incorporating core strengthening as an integral component of rehabilitation program in patients with shoulder dysfunction.”
So, this is not just some random DVRT theory, it is reinforced by study after study after study. Why don’t people do it then? Probably because most are stuck in bodybuilding and thinking focusing on the shoulder by itself is the key to healthy shoulders. However, nothing could be further from the truth!
How do we do it? Here are some of my favorite ideas from our DVRT system…
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Stop Forgetting The Grip
How we grip a weight or the ground during an exercise gets very little discussion outside of a few examples. Like the core and lower body, grip has a HUGE correlation to shoulder health.
This 2016 paper explains, “A strong correlation between grip strength and lateral rotator strength was shown at all positions for both left and right hands, suggesting that assessment of grip strength could be used as a rotator cuff monitor of recruitment function.”
A 2010 paper found, “The positive relationships between HG (hand grip) isometric strength and isokinetic strength of the shoulder stabilisers was probably attributed to mechanisms providing stability to the elbow and shoulder joints either by force transmission via myotendinous and myofascial pathways or by “overflow” of muscular activity via neural circuits. The results of the present findings suggested that HG isometric strength can be used to monitor isokinetic strength of certain muscle groups contributing to the stability of the shoulder joint;”
The quote above refers to the idea of irradiation which is where we create tension at one area, it can travel up the body to another. This is why gripping a weight or the ground appropriately is so key for helping the shoulders. It isn’t about just gripping tightly, but how we position our arms/hands in the movement.
You can see how I use my grip is essential in great shoulder and core drills like lift/chops
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Most wouldn’t think of side planks as ways to build healthy shoulders, but the grip into the ground and the way I use the Ultimate Sandbag are huge keys in building healthy shoulders.
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Strength Coach, Martin Adame, shows some great examples of how we use grip to build better shoulder stability and mobility at the same time.
Consider, But Don’t Abuse The Neck
When I was interning in high school at a physical therapy clinic I started to have some shoulder pain. The therapist I was working for took pity on me and gave me an evaluation. I was pretty surprised when they were really looking at my neck and telling me I had some cervical issues that were impacting my shoulder. How could that be, I thought. It was my shoulder, not my neck bothering me. Of course that was my first introduction to the idea that because you are having pain in an area doesn’t mean that is the cause of your pain.
Understanding at the very least that your neck can play a big role in your shoulders is important to be aware of if nothing else. The amount of nerves that come from the neck and bypass structures of the shoulders are quite large. Considering the shoulders are right under your neck you hopefully could see the very close connection of the two.
If you have ever been in a car accident, played sports that created head trauma, or had any type of accident that created impact upon the head/neck, don’t be surprised if you develop some shoulder issues. Of course, if you suspect anything like this, you should go see a medical professional. If you aren’t sure if the neck MIGHT be an issue, there are some very simple screens that you can do to look at if the neck is something that should be considered more in your efforts.
Then if we do see some issues what types of movements can we do to see if the neck plays a role in our efforts to build healthy shoulders.
By NO means should this result in you training the neck a lot, in fact, that would probably screw up most people. Soft-tissue work? Fine. Stretching? Fine. Mobility drills, great, but not loading one’s neck.
These are some of the biggest issues I see with people building healthy shoulders, even as I lay out the science I know some will struggle to move past of only looking at the shoulders. However, these ideas aren’t really new, they have been around for a long time in therapy circles, but bodybuilding is a strong force for many because the basic ideas of “it hurts here, work here” requires a much deeper and better understanding of how our body works and performs. I hope blog posts like this help convey this ideas so that anyone can benefit them!