Shoulder Training Myths Persist

I’ve addressed gym myths about shoulder training for 20 years. Much to my surprise, the myths still survive. I was presenting a sportsmedicine lecture on the shoulder in April 2009 when one of the doctors in the audience asked about performing lateral raises with the front of the dumbbell turned down. If doctors at a sportsmedicine lecture still wonder about that, I’m certain that trainees and trainers aren’t quite clear on it either.

We’ve all heard a training partner, friend or personal trainer instruct someone in the performance of the lateral raise. What do we typically hear? “Raise your arm to the side and turn the front of the dumbbell down as if pouring water from a pitcher.” That sounds innocent enough; however, there is a problem with that.

A part of the shoulder is predisposed to problems—the space under the roof of the shoulder. The roof of the shoulder is made of a bone, the acromion, and a ligament, the coracoacromial ligament. If you put your hand on top of your shoulder, you can feel the bony roof. The shoulder is a ball-and-socket joint, which is located beneath the bony roof. The ball has a bony prominence that can bump into the bony roof. Sensitive and important anatomical structures are in the space below the roof: the long head of the biceps tendon, a rotator cuff tendon a fluid-filled sac, or bursa.

When the ball bumps into the roof, the two tendons and bursa become entrapped, or impinged. Bumping the ball into the roof can create tendinitis and bursitis, or inflammation. The problem is called subacromial impingement. Two movements produce it. The first is raising the arm in any way with internal rotation, or “turning the front of the dumbbell down” during laterals. Upright rows are another way to raise the arm in internal rotation.

Internal rotation with elevation doesn’t allow the bony prominence to pass under the roof. Rather, it drives the bony prominence into the bony roof. The military press is exactly the opposite in that the shoulder is in external rotation, which is a much more natural motion. The bony prominence on the ball passes underneath the roof of the shoulder.

The second way to cause impingement is to raise your arm straight up, as if performing a full front delt raise. Many trainees have learned from experience that full front raises cause shoulder pain. It’s common to see trainees perform them to 90 degrees only.

When a trainee comes to my office complaining of shoulder pain from weight training, I ask him or her to go through the details of his or her shoulder, chest and back workouts. Often when I ask what exercises hurt the shoulder, the reply is, “Everything.” Everything hurts because the trainee has tendinitis and bursitis from performing exercises that cause impingement. Many physicians oversimplify, or don’t understand, the problem. Their solution is to stop weight training. No trainee wants to hear that.

The more logical solution is to remove the problem exercises. That means eliminating laterals with the front of the dumbbell turned down, full front raises and upright rows. It’s usually accompanied by rotator cuff strengthening and shoulder stretches. The result is a trainee who has less shoulder pain and is back in full training.

My advice is to keep your hands in a neutral to slightly upward rotated position to protect the shoulder. Drop upright rows altogether. If you have to perform front raises, take the raise to 90 degrees only, but keep in mind that you can still have impingement at 90 degrees. The exercises that develop the front delts include military presses, behind-the-neck presses, bench presses, incline presses, flyes and laterals. You won’t lose any development by dropping front raises. Please heed this advice, miss fewer workouts due to shoulder pain, and save yourself much care for your shoulder in the future.

Editor’s note: Visit www.SoftTissueCenter.com for reprints of Horrigan’s past Sportsmedicine columns that have appeared in IRON MAN. You can order the books Strength, Conditioning and Injury Prevention for Hockey by Joseph Horrigan, D.C., and E.J. “Doc” Kreis, D.A., and the 7-Minute Rotator Cuff Solution by Horrigan and Jerry Robinson from Home Gym Warehouse, (800) 447-0008 or at www.Home-Gym.com.