5 Exercises for Strong and Healthy Shoulders
The Shoulder Complex: A Brief Overview
When most people think of the shoulder they think of the Glenohumeral joint, which is the ball and socket joint between the head of the humerus (ball) and the glenoid fossa (socket) of the scapula. When it comes to the structure and function of the shoulder, and its vulnerability to injury and overuse, it is essential that we look at the entire shoulder complex as a whole. The shoulder complex is made up of 4 joints that must function harmoniously in order to achieve the vast amount of movement that is available at the shoulder. It may seem like I’m complicating things initially, but, it’s only for the purpose of simplifying the bigger picture. The 4 joints that make up the shoulder complex include: the Glenohumeral (GH) joint that I mentioned previously, the Acromioclavicular (AC) joint between the clavicle and the acromion of the scapula, the Sternoclavicular (SC) joint between the clavicle and the sternum, and the scapulothoracic joint between the anterior surface of the scapula and the thoracic cage. When you move your arm, a certain degree of movement has to occur between all 4 of these joints in order to allow for coordinated and optimal movement patterns. The shoulder is the most mobile joint in the body. This mobility is necessary in order to perform a variety of daily tasks from getting dressed in the morning to reaching up in a cabinet to grab a coffee cup to bathing.
In order to perform all of the dynamic movements required of the shoulder throughout the day, the muscles of the shoulder complex must be working to provide stability and motor control. Without adequate stability and motor control there will be a disruption in the biomechanics of the shoulder. In addition, tightness of any of these muscles will also throw off the balance of the shoulder complex. With time, any imbalance will ultimately lead to pain and dysfunction. Many of the muscles that make up the shoulder complex have multiple functions which adds to the complexity of the joint. In an effort to keep from drowning you with too much technical information, I’m going to briefly touch on some of the major muscle players when it comes to shoulder function. The two major groups of muscles that I am going to touch on include: the GH joint “stabilizers” and the muscles that control the dynamic movement of the scapula in relation to the humerus (aka scapulohumeral rhythm).
Shoulder Stabilizing Muscles
Most people are familiar with the rotator cuff. The rotator cuff is a group of 4 muscles that arise from the scapula and attach to the head of the humerus. The 4 muscles that make up the rotator cuff are: the supraspinatus, infraspinatus, teres minor, and subscapularis. These muscles are involved in essentially every type of shoulder movement. Their most important role, however, is to stabilize the head of the humerus within the glenoid fossa when performing shoulder movements. When functioning properly these muscles serve to depress the head of the humerus within the glenoid fossa in order to avoid mechanical obstruction (impingement). Any imbalance between these muscles, wether that be weakness or decreased flexibility, will leave you vulnerable for tissue injury at the shoulder.
Scapulohumeral rhythm refers to the ratio of movement that occurs between the scapula and the humerus. The dynamic movement of the scapula is controlled by the serratus anterior, upper trapezius, middle trapezius, lower trapezius, levator scapulae, latissimus dorsi, rhomboids, and pectoralis minor. Weakness of these muscles will result in altered scapular motion and position. Altered scapular motion and position will result in decreased subacromial space (increased impingement symptoms), decreased strength of the rotator cuff muscles, and tightness of the anterior shoulder ligaments. Tightness of the muscles located in the anterior region of the shoulder complex, such as the pectoralis muscles and the biceps muscle, can also effect scapulohumeral rhythm. Tightness of these muscles will result in protraction and anterior tilt of the scapula due to their attachment point to the coracoid process of the scapula.
Let me not leave out the deltoids. These guys often do not get the credit they deserve when it comes to shoulder stabilizing function. The deltoids play a major role in overhead movements. One of the great things about performing shoulder stabilization exercises in a close-packed position (hands in contact with a surface) is that it engages every single muscle of the shoulder simultaneously.
Is she ever going to get to the exercises? As boring as it may seem, I do feel that it is important to go over the basic structure and function of the joint in which I will be recommending the exercises for. I think that a basic understanding of all that is involved will help you to understand the purpose of the exercises and just how critical it can be to maintain a proper balance between flexibility and strength. So without further ado, let’s talk exercise.
(1) Posterior Shoulder Capsule Stretch
A great way to stretch the rotator cuff muscles and the posterior capsule of the shoulder. As I mentioned earlier, tightness of any of the rotator cuff muscles will throw of the balance and thus the function of the shoulder.
Start lying on the side that you wish to stretch with bottom arm straight out in front of you
Trap your arm with your body by rolling over your outstretched shoulder onto your stomach
Be sure to keep your shoulder depressed and flex your opposite arm straight out so that it is also serving to stabilize your bottom arm in place
To increase the stretch hike up the same side leg in a frog-like position
Hold for 2 min
(2) Push-up Plus
A classic shoulder stabilization exercise. As much as my husband, Dr. Kevin Landreneau, despises the conventional sometimes you just can’t overlook what works. The push up plus exercise is a traditional push up with an added movement at the top of the push up. At the top of the push up round your back by protracting your shoulder blades (pushing your upper back towards the ceiling). The “plus” part of this exercise helps to engage the serratus anterior muscle, an important shoulder stabilizer. To modify the exercise you can perform the push up on your knees or even more so using a wall or elevated surface.
Position hands underneath your shoulders with elbows tucked close to your body
Lower your self down toward the floor keeping the elbows tucked in
Slightly angle your hands out in order to better keep elbows tucked in, rather than out.
Once your chest reaches the floor push back up to the start position
Protract your shoulder blades by rounding your upper back pushing it up towards the ceiling
Pause at the top and repeat the exercise until failure or onset of pain
(3) Scorpion Stretch for the Shoulder
The scorpion is one of those stretches we find ourselves going back to again and again because it’s a great total body stretch. When done properly, this stretch is particularly great for the anterior muscles of the shoulder. The anterior chest and shoulder muscles are vulnerable to tightness due to poor posture and excessive rounding of the shoulders. This stretch helps to reverse the effects of poor posture by working to elongate and open up all of those muscles that make up the anterior aspect of the shoulder.
Start on your stomach with arm that you want to stretch out to the side with elbow flexed 90 deg and elbow high enough so that it is even with or slightly higher than the level of the shoulder
Keeping the stretch arm in place, kick the opposite side leg back and over so that your trunk rotates away from your stretch arm.
use your opposite arm on the floor to increase the stretch by pushing your trunk further into rotation
Try to keep the top leg floating and not in contact with the ground
Keep the stretch shoulder down, it has a tendency to come up towards the ear.
(4) Frog Stand
Here is where we get to go outside of the traditional box a little bit. The frog stand is another great shoulder stabilization exercises that engages all of the stabilizing muscles of the shoulder. As I mentioned earlier, when the arms are in a close-packed position with the hands in full contact with a surface and load is applied (usually some portion of bodyweight) this engages every single muscle of the shoulder complex. When you combine this with positioning yourself in such a way that requires core engagement to maintain balance and you have got a great exercise. While this move may seem intimidating to some of you, I encourage you to try it any way. You may not be able to perform it right away but with daily practice you will get better and you will be amazed at the changes you will start to see in your body, shoulders and all.
Start in the bottom of a squat position with hands on the ground in front of the feet
Move your knees so that they are resting against the bent elbow for support
Lean forward taking your weight on your hands so that your feet are raised completely off the floor
If you are unable to get your feet off of the floor this is fine! Get as much of your feet off the ground as possible and hold. With practice, you will be able to raise the feet entirely.
Hold the position as long as you can. Gradually build up from a few seconds to a minute
(5) Weighted Lats Stretch
Another favorite exercise of ours because of its focus on shoulder and thoracic mobility. The latissimus dorsi muscle is a huge muscle that attaches from the humerus, down the spine, and then it transitions into the thoracolumbar fascia, which inserts into the pelvis. When tight, the lats will limit shoulder flexion as well as shoulder external rotation. Tight lats will definitely become problematic if left unaddressed.
grab a light weight (3-5lbs) and a foam roller placed horizontally on the ground behind you
Position foam roller horizontally behind your back at about the nipple line
With knees bent and feet in contact with the ground take the weight in both hands and slowly extend back over the foam roller
Allow gravity to pull the weight down toward the floor
Hold for 2 minutes
If your hands get to the floor, engage core by rounding lower back and drawing your belly button in
Give these 5 shoulder exercises a try and see how you like them. You may feel some mild discomfort but not pain. If any of the exercises do cause pain discontinue immediately. Modifications are available for most exercises and we can hep you with those if you reach out. Please do not hesitate to reach out if you do have questions. As with anything “new” it may take a period of adjustment before the exercise feels natural. I encourage you to not give up if you can not perform an exercise right away. Keep persisting and I promise you will see progress. The biggest key to these exercises is persistence. In order to truly reap the benefits you must continue to practice these exercises on a regular basis. If you find that one exercise is more challenging spend more time on that one. Usually it’s challenging for a reason. Listen to your body and discover what you are capable of.