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Shoulder pain? Here’s what you can do about it!

As a shoulder specialist PT, I often hear complaints of shoulder instability and sharp pin-point pain that prevents full participation in activities. Often times, the pain prevents the athlete from lifting weights overhead, skiing, or rock climbing. Do you ever feel like something is “moving” in your shoulder while doing overhead presses at the gym? Do you feel limited while double poling, performing hill intervals or feel sore after your ski? Are you a rock climber who is hesitant to make that big “dyno-move” to grab onto the holds? If so, keep reading. I am about to explain shoulder pain and what you can do about it!

  • What is the rotator cuff? 
  • Why reaching overhead can be difficult
  • Stabilizers of the shoulder joint
  • 7 of the BEST exercises you can do to improve shoulder strength and stability. 
Let’s get started!

What is the rotator cuff?

The rotator cuff is part of the shoulder joint. It is made up of muscles and tendons that keeps the head of the upper arm bone firmly within the socket of the shoulder. The rotator cuff is made up of four muscles:

  1.  Subscapularis
  2. Infraspinatus
  3. Teres Minor
  4. Supraspinatus Muscles

All 4 muscles originate from the scapula (shoulder plate) and insert into the humerus (arm bone). Every time you bring your poles up to power through your double pole, bring a weight overhead at the gym, or reach out for a handhold on the climbing call, you can thank these muscles. In a healthy shoulder joint, they provide stability and allow for that wide range of motion. 

Image of female flexing showing muscles of the shoulder

Shoulder pain while reaching overhead? Why?

“Ball and socket” joints like the rotator cuff allow the greatest range of motion. But, there is a catch. Everything in the shoulder has to work together to allow this. The scapula must be able to rotate up to allow the humerus bone to reach vertically.  If you can’t reach straight up, the problem may not be the joint itself, but the scapular rotation.

The systems that allow movement and strength in the shoulder are complex!

Pictured LeftThe arm elevation depends on not only the arm bone flexing upward, but also the rotation of the shoulder blade to face the plate for the humeral head to “sit on” while you reach higher.

Stabilizers of the shoulder

The shoulder joint looks like a skinny golf ball and golf tee (see images below). You can imagine, the structures are not very secure on their own. This is where the shoulder stabilizers come in.  There are two types of stabilizers that keep our shoulders healthy. 

  • Passive Stabilizers: Passive stabilizers include the ligaments, labrum and shoulder capsule. We CAN NOT strengthen these, but certain exercises can help protect them from undue injuries and overtraining. 
  • Active Stabilizers: Active stabilizers include the upper-back, scapular, rotator cuff, arm and forearm muscles. The We CAN strengthen these to increase stability in the shoulder joint.
Golf ball and tee anatomy
Golf ball and tee anatomy

7 of the BEST Exercises to Increase Shoulder Stability and Strength

Gaining stability and strength safely requires progression. Start with light or no resistance and low reps. Gradually increase the difficulty and intensity as you progress. Once you feel confident in Phase 1, you can move on to phase 2, and then to Phase 3! 

Phase 1:

  1. External Rotation (pictured top left)
  2. Internal Rotation (pictured top right)

Phase 2: 

  1. Pick-Up and Cross (pictured bottom left)
  2. Draw the Sward (pictured bottom right)
Diagram of internal and external rotations and D1 and D2 pulls

Phase 3:

  1. Wall Slides (pictured left)
  2. Single-Arm 90-90 External Rotation (pictured middle)
  3. Double Arm W’s (pictured right)
examples of wall slides, 90-90, w's

Disclaimer: Since we don’t know you, we can’t prescribe exercises to fit you, your body, and your activity tolerance. These exercises are only a suggestion. Approach these with caution, listen to your body. 

If you have questions, feel free to schedule a FREE discovery session with be below! 

Image of Natalie Snyder, PT, DPT, OCS, CSCS

By: Natalie Snyder, PT, DPT, OCS, CSCS 

  • Shoulder Specialist Physical Therapist 
  • Female Athlete Physical Therapist 
  • Strength and Conditioning Specialist 
AUTHOR

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