You’ve been on FIRE, hitting the gym regularly getting stronger, healthier and improving your skills. Then out of nowhere you start having shoulder pain. Thinking it will get better, you keep training. Then you start getting weaker, losing skills because your shoulder gets in a cycle of hurting then getting better, then hurting again.
This is a common occurrence with training, we can fatigue our small muscles, especially the small muscles of the rotator cuff that stabilize our shoulder. These muscles work to keep it in the best possible position for high level functioning. When they fatigue, or have a small injury, they shut down. This is our body’s natural protective mechanism but unfortunately, we can override and push through it if we want. By doing this, we start to over use other muscles, and put stress on other tendon and ligament structures that are not meant to take on these types of forces. The most common structure at the anterior shoulder that is over used and cause pain is the biceps long head tendon. It runs over the front of the shoulder and can be used as a shoulder stabilizer. It crosses the shoulder gleno-humeral joint. Often rolling out the tendon or the area in the front of the shoulder will cause an increased inflammatory response, prolonging pain and decreased functioning.
Mobility and stability exercises are important for full recovery of anterior shoulder pain. Mobilization normalizes movement, stability and re activate the rotator cuff muscles to take pressure off the biceps tendon. These are some of my favorite exercises to help.
The long head of the biceps muscle crosses the shoulder joint and can be used as a stabilizer muscles when the small rotator cuff muscles begin to deactivate with over use, pain or injury to the surrounding tissue. Stretching the muscle out will help take the passive tension off of the muscle, allowing the tendon to heal.
This exercise is typically performed by my athletes for 5-10 seconds, for 10 reps, 1-2 times a day, 4-5 days a week.
Watch an example of biceps stretch here:
STM to posterior cuff
The muscles at the back of the shoulder are important shoulder stabilizers and often deactivate with pain from the shoulder. These are 2 of your 4 rotator cuff muscles. The exercise is designed to decrease tension in the muscle allowing the muscle to become more active and increase blood flow to the area.
This exercise is typically performed by my athletes for 1-2 minutes, 1-2 times a day 4-5 days a week.
Watch an example of smashing posterior cuff here:
Row and rotation
This exercise is focused on following up on what we did with the first exercise after loosening up the posterior cuff. We then need to remind the muscles how to work. It is used for the transition of moving the arm overhead.
This exercise is typically performed by my athletes for 8-12 reps, 2-3 sets, 1 time a day 4-5 days a week. Form is more important than weight.
Watch an example of standing row with external rotation here:
STM to pecs
The pecs can be a huge limiting factor in the ability to move. Most of us live in a world of poor posture working on a computer, sitting at a desk or watching TV. These and similar daily positions cause the pecs to tighten and limit motion especially with activities that require good posture and shoulder retraction.
This exercise is typically performed by my athletes for 1-2 minutes, 1-2 times a day, 4-5 days a week.
Watch an example of smashing pecs here:
Sub Scap release
This muscle is located on the front side of the shoulder blade. It is the largest rotator cuff muscle and an important shoulder stabilizer. It is used when the arm pulls or stabilizes overhead. This exercise is designed to decrease tension in the muscle, allowing the muscle to become more active and increase blood flow to the area.
Watch an example of how to release the sub scapularis here:
This exercise is typically uncomfortable and can be performed for 20-60 sec and 1-2 times a day, 4-5 days a week.
Thanks for reading.
Dr. Scott Layne PT, DPT, CSCS, CF-L1