How To Avoid Rotator Cuff Injuries
Have you ever suffered from shoulder
discomfort after working out? I am referring to aching
or sharp pain experienced in the front of the shoulder
or lateral upper arm that is felt with overhead
activities, reaching behind the back or even laying on
the shoulder. These symptoms are often indicative of
rotator cuff inflammation. This is a common problem for
many people who perform resistance training on a regular
basis. It is also a problem that can easily be prevented
by modifying the following “dangerous shoulder
exercises.”
Bench Press – This is a popular exercise chosen
to build the chest, along with the anterior deltoid and
triceps. Most teach taking the bar down until it lightly
touches the chest. However, I believe this is unsafe
because it exposes the anterior shoulder capsule to
excessive load, in addition to compressing the soft
tissue of the rotator cuff between the humerus and the
acromion. Over time, with repeated bouts and heavy
loads, the rotator cuff becomes inflamed.
Individuals with any anterior shoulder laxity (loose
joints) or history of subluxation / dislocation are also
at increase risk for rotator cuff injury or labral
(shoulder cartilage) damage. Furthermore, you also have
the potential to rupture the pectoralis tendon with full
range pressing during heavy loads. The safe answer is to
lower the bar until the upper arm is parallel to the
floor (elbow bent to 90 degrees). This prevents the
shoulder joint from moving into the unsafe range. The
same advice applies to push-ups.
Lat Pull Downs – This is a good exercise to
strengthen the back, but when done behind the head it
can cause problems. Like the bench press, pulling the
bar down behind the head positions the humerus in such a
way that the rotator cuff can be pinched. This may
depend on other factors, including the shape of a person’s
acromion and degree of any present arthritis, but I
still believe the risk outweighs any benefit. Not to
mention that keeping the bar in front of the head still
accomplishes the same movement for the target muscle,
while eliminating the risk of shoulder injury. Remember
not to sway during the movement, and position the body
in a slightly reclined position, pulling the bar toward
the sternum. Another unrelated reason not to do behind
the neck pull downs is that it places undue stress on
the cervical spine.
Military Press – This exercise when performed
behind the neck with a bar, positions the shoulder in
the aforementioned unfavorable position. Done
repeatedly, the rotator cuff can become inflamed.
Similar to behind the neck pull downs, you also expose
your neck to unnecessary stress. It is safer to perform
the exercise in front of the head or utilize dumbbells
and work in the scapular plane. You must watch to avoid
arching the low back and it is best to use a bench with
back support to prevent this.
Dips/Upright Row – As before, the key mistake
made with these exercises is allowing the shoulder to
move beyond 90 degrees relative to a position parallel
to the floor or perpendicular to the body. I always
recommend stopping at 90 degrees to protect the shoulder
capsule and the rotator cuff.
Dumbbell Lateral Raise – In my opinion, this
exercise is often done incorrectly. The mistakes include
lifting too much weight, keeping the arms straight, and
raising the arms out away from the body in the plane of
the body. The force on the rotator cuff reaches 90% of
your body weight when the arms are raised to 90 degrees
with the arms straight and in the plane of the body.
That is a lot of force on four relatively small rotator
cuff muscles. The target muscle is the lateral deltoid,
but the rotator cuff is extremely active, and it
functions to allow you to raise the arm by depressing
the humerus so that it passes under the acromion during
active elevation. When heavy loads are introduced in the
wrong plane of motion, disaster usually occurs. I am
fanatical about performing this exercise correctly.
The proper way to execute a lateral raise is to keep the
elbows comfortably flexed (20-30 degrees) and raise the
arm to no higher than parallel to the floor. The arm
should be in the scapular plane of motion (approximately
30-45 degrees from being perpendicular to the body) and
the weight should be relatively light. Once you feel you
have to shrug or use momentum to raise the weight, you
need to rest or lower the weight. In my opinion, this is
one of the worst exercises for the shoulder if done
incorrectly.
In summary, I want to emphasize that good intentions may
spell bad results for the shoulder if proper form is
lacking. The rotator cuff and shoulder joint is
extremely vulnerable to heavy loads and repetitive bouts
of exercise. Gradually, it may become inflamed and
hinder or limit your workout altogether. Be sure to
master form before increasing weight, and do not attempt
to work through pain, as this often perpetuates the
problem. Remember to assess risk and reward at all
times, and rest assured that these modifications will
not hinder your gains. Instead, they will prevent missed
time in the gym and produce happier, healthier
shoulders!
We would like to thank Brian
Schiff, PT, CSCS
for this excellent article on way to avoid Shoulder
(Rotator Cuff) injuries. Please check our Brian's site
for more information www.BrianSchiff.com
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