An ideal fitness goal for every woman should be to cultivate a routine of optimal, pain-free training that ensures the ability to continue to engage in the physical activities she enjoys and that helps her stay fit and healthy. To sum it up in one word: longevity!
Key factors that dictate if an exercise is “joint friendly” lie not only in the execution of the movement pattern itself, but also in the preparation. An additional variable that must be respected, but is often neglected, is variety. Sticking with the same handful of lifts, performed in the same manner without much deviation, can lead to breakdown over time. For this reason, intelligently programmed variety in exercise choice, plane of motion, load, and even tempo is recommended.
The “Upper Body System”
When targeting any upper body exercise, it is important to focus not just on moving the weight that’s in your hands, but also on the interplay between the entire system involved in driving the movement to begin with — the head, neck, shoulder girdle, thoracic spine, and upper extremities.
Optimal movement happens with our upper extremities when we tap into the power of a functionally strong and mobile shoulder girdle while harnessing the strength of a stable core, with a well-positioned neck and head.
As an example, let’s look at the seemingly most isolated exercise of all time, the bicep curl. I encourage you to view this exercise through the lens that dictates that all lifts should recruit and originate from the entire upper body system, and not just from the prime mover (the biceps) itself. Your biceps aren’t the only muscles involved in a properly executed bicep curl:
- The rib cage must be stacked over a neutral lumbar spine and pelvis.
- To guard against compensating by leaning back as the weight goes up, the anterior core must be engaged to maintain trunk alignment.
- The cervical spine must be neutral with the chin slightly tucked to avoid straining the neck with a forward head posture (another common compensation).
- The scapulae should be retracted and engaged to create a stable “shelf” or foundation in order for the upper arms to effectively perform the lift.
- The entire arm should be squeezed into to the side of the rib cage and remain perpendicular to the ground to avoid compensating with shoulder flexion as the weight goes up.
The end goal of involving the entire upper body system in every lift, yes even in the bicep curl, is not only to protect against compensatory movement patterns that can set you up for injury, but also to help ensure optimal movement.
Lifestyle and Lifting-Style Interference
The degree to which the entire upper body functions as a system can be as much of a benefit as it can be the Achilles heel of your training. A combination of poor posture outside of the gym, compounded by less than optimal form at the gym, can lead to breakdown, injury, and sub-par results.
Long days slaving over a desk and endless hours of hand-held technology usage are two of the most common contributors to pain for my physical therapy patients. These lifestyle-based hazards can lead to chronic postural misalignment of the head, neck, and shoulders.
And what’s worse for the dedicated fitness enthusiast is that it can also interfere with the ability to achieve the positioning and range of motion required to properly perform many lifts in the gym.
Beyond manual therapy, a solid stretching routine, and a serious dose of work-related habit changes, much can be done to combat the effects of a day spent in flexion. With the addition of simple and targeted exercises like the five I share below*, you can limit the risk of injury and address postural deficiencies to untimely ensure maximal benefit and functional, pain-free carry over.
*Note: Before trying any of the following exercises be sure to watch each video and read the exercise description and key training cues.
1. Horizontal Rows
While many prep or “warm-up” exercises will not deliver a “pump” or an extreme burning in the working muscles, when performed properly, this exercise is designed to do just that.
Activation of the muscles of the posterior shoulder girdle to prepare and protect the upper body for what is about to come, is analogous to doing activation work for the glutes before training the lower body.
This horizontal rowing action sets the head of the humerus (“ball”) in a neutral position in the glenoid fossa (“socket”), allowing for pain-free, abduction. In other words, you won’t hear or feel that grinding that happens when performing this exercises with the elbows too high. This positioning will also allow you to perfect the movement pattern itself by activating the posterior delts and rhomboids without compensating with the upper traps.
Key training cues:
- The horizontal row can be performed with a band or cables.
- On a stable thoracic spine, retract the shoulder blades hard as you drive the arms back in horizontal abduction.
- Pause in the retracted and slightly externally rotated position for an isometric hold of about two seconds.
- Avoid compensations like hyperextending your lower back, shrugging your upper traps, or allowing your head to come forward.
- Focus on a slow eccentric phase as you guide the shoulder blades back to their resting position.
- Perform two sets of about 12 to 15 reps.
*You can also load up the cable column and use this exercise in any “pulling” based programing.
2. Three-Way Shoulder Prep
Sadly, all too often, I see people “prep” to lift by moving a stick around over their head, or worse, just hopping on a cardio machine. In order for your shoulders to perform at their highest level, you’ll need to give them what they crave: direct action that deals with multiple planes of motion and lights up the posterior musculature as well as the stabilizers by pumping blood flow to the area.
This three-phase movement is the perfect prep for many of your favorite heavy lifting exercises, especially if you’ve spent a full day in flexion at your desk.
Key training cues:
- Maintain the chin slightly tucked throughout the entire exercise.
- Drop the ribcage down and activate the anterior core to avoid puffing out the chest or excessively arching the thoracic spine. Maintain this position throughout the exercise.
- In the first movement, “rowing action,” squeeze the shoulder blades together while driving the arms into horizontal abduction and scapular retraction. (See number 1 above for full detail.)
- As you move into the second portion of the movement, the “external rotation action,” stabilize your scapulae be keeping them depressed and retracted as you fire the rotators.
- In the third movement, “overhead pressing action,” press the arms overhead to further trigger reflexive control of the rotator cuff as you work on scapular stability.
- Perform two sets of about 12 to 15 reps.
3. Transverse Plane Press
This movement pattern takes place in one of the most neglected planes of motion, the transverse plane. Since most traditional exercises like benching and Olympic lifts are focused almost exclusively in the frontal and sagittal plane, consider adding variety to your programming with the Transverse Plane Press.
Key training cues:
- Don’t mistake this for a “pressing action” that comes solely from the chest or arms. The power in this movement comes from the “punch” created by the rotation at the hips, pelvis, and thoracic spine.
- Counter-rotate the opposite shoulder back as you punch forward to ensure appropriate thoracic spine rotation.
- Pause for an isometric hold in the extended position to give all stabilizers a chance to sync in this position.
- As you step back in, this last phase is the anti-rotational component of movement. On the return to starting position, stop the hands at midline and when the trunk is in the neutral position.
4. Floor Press
For those who may experience the occasional cranky shoulder during or after the traditional bench press, removing the bench from the exercise is a nice way to continue working this movement pattern in a pain-free and protected manner.
Please keep in mind that pain during a lift is a warning sign that either your form is off or the supporting musculature is inadequate (in this case, your shoulder stabilizers.) If you experience frequent or chronic pain during the bench press, consider seeking a consult with a doctor or physical therapist to get to the root of the issue.
Because the floor shortens the range of motion of the lowering phase of the press, the head of the humerus cannot shift as far forward as it can when the exercise is performed on a bench. Therefore, this variation allows for decreased pressure on the anterior shoulder joint, the most common place of pain for most serial benchers.
Since anatomical make-up varies widely from one person to the next, it is hard to define one set-up position that is right for everyone. Therefore, one of the many benefits of using dumbbells instead of a barbell is that dumbbells allow for more degrees of freedom to explore which hand position (from neutral to supinated) as well as which shoulder position (from elbows at sides to elbows and shoulders at 90 degrees) feels most optimal.
Key training cues:
- Begin lying on your back on the floor, knees bent
- Engage the core as you support the dumbbells directly over your shoulders
- Inhale as you slowly lower the dumbbells down
- Stop right before your elbows reach the ground (avoid resting them on the ground between the lowering and lifting phase)
- Exhale and then press the dumbbells back up to the start position
- Be sure track the dumbbells through the same path on the lifting and lowering phase
5. Kettlebell High Pull
Biomechanically speaking, the amount of weight you can lift in the frontal plane with a “front raise” for example, is limited. As the weight gets heavier, the negatives at the glenohumeral joint (true shoulder joint) start to outweigh the positives.
However, with the controlled ballistic action of the kettlebell high pull, you can hit the anterior deltoid in a safer manner. The “rowing action” at the top of the movement intelligently activates the rotator cuff and rhomboid complex, simultaneously adding the benefit of anterior and posterior core control.
Key training cues:
- As with any swing, hinge at the hips with strong engagement of the anterior core as the kettlebell drops between the legs.
- Drive the weight up with a rapid extension of the hips, and a strong glute squeeze to stabilize the pelvis and trunk at full hip extension.
- As the kettlebell is halfway up from the bottom, begin drawing the kettlebell in with the “rowing action” of horizontal shoulder abduction and scapular retraction.
- While maintaining awareness and activation at the scapulae, drop the kettlebell back through the legs and repeat from the beginning.
Part of our job as a fitness professional is to strategically program the exercises that are appropriate for each client and their individual needs. These decisions should be based on cleaning up their weakest links (strength and range of motion imbalances and limitations) in combination with working towards their performance and aesthetic related goals.
If your client experiences pain with any of the exercises mentioned in this article, go back to the basics. Do a basic movement screen. Check for full, pain-free, and compensation-free range of motion in the shoulder, scapulae, and thoracic spine. If you discover major limitations, stop and address any issues found. If the movements are clear, go back to the exercise and check the mechanics.
If pain is still present and/or you cannot uncover how to eliminate the problem, recognize your limits. A great rule of thumb that I teach trainers is that if the client is mechanically executing the movement pattern with precision, and they have the pre-requisite strength and full range of motion to perform that lift, but they are still experiencing pain on a regular basis where they shouldn’t be, it’s time to refer out to a sports orthopedic doctor or a physical therapist.
Pain is a warning sign; it is the body’s request for change. However, it is important not to assume that the location of pain is the actual problem itself. Very often, pain is a result (a symptom) of faulty movement or breakdown somewhere else in the chain, typically a joint level above or below the pain site.
On the spot? If pain is present during a movement, “working around the pain” or finding an alternative or regressed exercise that does not aggravate the client’s issue can be justified in the short run, especially when you are in the middle of a session.
Once you have tried everything in your toolbox, consider referring out to a physical therapist. They are trained to assess, diagnose, and treat musculoskeletal issues, the physical therapist will work to uncover the root cause of the issue and help the client get back to performing better, faster. I always recommend developing a relationship with the physical therapist. This way, your sessions with the client can complement the work they are doing and expedite their return to pain-free performance.
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