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Shoulder Injury? Read This Before You Let Them Cut

Incorporate these shoulder training tips and tweaks to avoid surgery.

Last summer I found myself at a critical crossroads - have the shoulder surgery being recommended and miss hunting season or rehab it myself. The failure rate on shoulder surgery of any kind hovers around 40 percent and I was confident in my ability to develop a successful rehab program, so I opted for the DIY route. Roughly a year later my shoulder is strong and healthy, my posture better and core stronger. I started slow, with light weights, focused on the basics, and rebuilt a foundation that should help me keep my shoulders strong and healthy. That is assuming of course, that I don't overdo it...and I might.

Here is some advice to keep you out of rehab and off the operating table, or if like me your looking down the barrel of surgery, a foundation to help you develop a rehab program.

We should start with some common reasons many of us end up with shoulder problems.

1. Poor posture

Many of us spend a lot of time facing forward, working in front of us. We slouch over our laptops, steer down at iPhones, sit in traffic, and when we're doing these things, much of the time it's with very poor posture. Poor posture lengthens our posterior muscles (behind you) and shortens the anterior muscles (in front). Today's inactive lifestyles also lead to weak core muscles, which can cause or exacerbate shoulder, back, neck and other imbalance-driven or chronic use musculature or skeletal issues.

Additionally, the small stabilizing muscles in your back become weak because they are not being properly trained to hold your shoulders, back and spine in proper alignment. So what happens when you introduce training with a pack or shooting your bow? It depends on the person, age, general fitness, etc. but if you have posture issues, and most of us do to some degree, you're setting yourself up for injury. So, strong shoulders begin and end with proper posture. All of the shoulder raises, cable pulls or bow draw mimicking work in the world isn't going to help prevent injury if you have a weak core and poor posture.

2. Counter-productive exercise choices

Do you do overhead presses, behind the neck pull-downs, upright rows with a narrow grip, wide grip bench press, turn your hands out at the top of dumbbell presses or "pour that water" at the top of your shoulder raises? If you answered yes to any of these, you are doing exercises that put the shoulder in a compromised or impinged position, and continuing to do these exercises may lead to an acute injury or chronic pain. 

So what can you do?

Start with your posture.

Correcting your posture has to start outside the gym. Be conscious of your posture during all daily activity and diligent about maintaining good posture. Your shoulders should be rolled back and pulled down, head forward and neck straight. It will take some getting use to for most of us but don't give up and go back to rolling your shoulders forward or slouching. A good checkpoint is to place your hands on your chest palms down.  That will put your shoulders in the basic position you want to achieve.

Exercise recommendations to build a strong core:

  • Work on your feet. Chest, shoulders, legs - any exercise that you do on your feet will require you to engage your core.
  • Do standing balance work. Single leg movements, work on your toes or balls of your feet - anything that requires you to balance will increase your coordination and strengthen your core.
  • Plank, which can be progressed to incline and decline exercise ball plank to increase difficulty and involve more stabilizing muscles. This exercise also works your rhomboids, the small muscles in your back that are integral for good posture.
  • Weighted exercise ball sit-ups

Exercise recommendations to strengthen stabilizing back and shoulder muscles

  • Face Pulls
  • W Lateral Raises
  • Lying prone Ys or Supermans
  • "X" Cable Crosses

Evolve your chest and shoulder routine.

Your pectoral muscles are much larger and capable of moving far more weight than your shoulder muscles. Also, when working your chest you have the added benefit of the stability being offered by your back and core. Training your shoulders, given the added complexity of the joint requires added attention to exercise and weight selection, and proper form.

Training Tweaks

  • Narrow your grip on chest work. Your chest muscles stop at the shoulder joint so working with a grip outside your shoulder is no longer engaging your chest as the primary mover of the weight and more importantly, you are putting your shoulder joint in a compromised, overloaded, position and increasing your risk for injury.
  • Skip the last few inches on your bench press. Once your elbow falls below 90- degrees to your body, you no longer efficiently working your chest and you are impinging your shoulder joint and overloading the anterior deltoid, ligaments and shoulder capsule.
  • Don't pronate your hands during pressing movements. This means your best off trading using dumbbells for all pressing exercises for chest or shoulders. A neutral (think hands parallel to your body when doing dumbbell bench press) or supinated grip (palms facing body) are the most ideal hand positions for pressing exercises.
  • Skip upright rows. This used to be a core exercise for me but not any more. Pulling the weight up under your chin, especially with a close grip is horrendous for your shoulders. Just don't do it.
  • Don't "pour the water out" at the top your lateral raises.   This is not an ideal movement for your shoulder joint as you're internally rotating the joint in a raised, and compromised position. The more natural way to do this exercise is to externally rotate your shoulder, lean over slightly and raise the weight straight out from your body with your pinky finger up and thumb down.
  • Don't press or pull anything behind your head. I cringe every time I see someone doing behind the neck pull downs at the gym. This one exercise might be the quickest way to a neck injury or shoulder impingement.

If, like me, you want to be mountain hunting into your 80s, then your shoulder health is paramount. Integrating these basics will start you on the trail to working toward better long-term shoulder health.

Train hard, train smart, and good luck out there!


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Shoulder Injury? Read This Before You Let Them Cut