The Stable Shoulder
Preventing problems at the body’s most dynamic joint
Dr. Lynn Felege, PT, DPT
The shoulder is the most dynamic joint in the body, and with increased mobility comes increased risk of injury. It could be argued that the two most perceived body areas at risk of injury in Functional Fitness are the low back and the shoulder – so let’s talk shoulders. Specifically: achieving and maintaining stability to prevent injury.
The shoulder, much like the previously-discussed hip, is a ball-and-socket joint with significant rotational components that enable functional ranges of motion and torque production. It is unspeakably crucial to maintain appropriate starting- and finishing-positions in order to prevent injury.
Nearly all joint dysfunctions are caused by inadequate range of motion or faulty movement patterns. When the body can’t move in proper alignment, your clever systems will default to improper alignments in order to accomplish the task being asked of them – and it only takes one bad lift to cause an injury. For example: if you’re experiencing shoulder pain, look above and below the joint. I’d venture to guess you’re missing cervical and/or thoracic spine mobility (most often retraction/extension) and elbow/wrist range of motion (most often extension/supination).
Because the shoulder joint has so many muscle movers associated with its function, there is a tremendous relationship between soft tissue slack and tension that occurs. You’re not just dealing with the shoulder, but also the roof of the shoulder formed by the collar bone, as well as the actions and musculature of shoulder blade. To create a stable shoulder, an athlete must be able to create a stable core. You need a solid, locked foundation to safely transmit power to the joints doing the moving. This stability is inherently linked to range of motion. When you create stability in the spine (by eliminating the option for the spine to flex or extend) those movements default to the shoulder – which is good! You further create stability by taking up all the soft tissue slack surrounding the joint. This is done with rotation – particularly: external rotation.
To make this concept more relatable to Functional Fitness, remember these two rules: to create rotational stability when the shoulders are in a flexed (forward) position, they must also be externally rotated. Imagine your set-ups for the deadlift, front rack, or overhead press. Core stability is imperative to all three lifts, and creation of the safest, largest power output requires shoulder external rotation. This is why you hear cues like “bend the bar around your legs”, “elbows in”, and “point your armpits out” from your coaches during these lifts. They’re trying to teach you how to organize your core to create stronger, injury-free extremities.
Rule number two addresses the opposing motion: to create rotational stability when the shoulders are in an extended (backward) position, they must be internally rotated. Picture your launch position for a jump, and end-position for the split-jerk. Anyone launching to a box will extend their shoulders and elbows, and turn their hands in because it locks the spine and creates the safest, strongest position to transmit power from the lower body to the upper body in order to launch off the ground. Similarly, we end a split-jerk with internally rotated hips to take up soft tissue slack when the hips are extending to get the weighted bar overhead. The transmission of power from the hips, up the spine, to the shoulders is tremendous, and a safe landing position is vital to a safely, successfully executed lift.
Another method to optimize the creation of external rotation at the shoulder is the hook-grip. Not only does hook-grip enhance the transmission of power, but it tightens soft tissue tension from the distal portions of the upper body to control power output from the core. It’s often joked that athletes should “hook-grip life” for a reason: it’s safe, stable, and powerful. Weightlifting bars… pull-up bars… steering wheels. Everything. Hook-grip it. Cues like “bend/break the bar” during overhead squats and pull-ups lock in this idea of global stability from the spine, to the shoulder, to the elbow, to the hand, and back up the chain.
Now, some of you little smarty pants might be wondering, “But Doc, if external rotation is so important, why do I set up my snatch with my knuckles to the floor? Isn’t that internal rotation? And isn’t that the most complicated (potentially dangerous) lift?!” The answer would be – you’re completely correct. The difference in the snatch is that you move intoexternal rotation as the lift is completed. And because it is such a complex movement, you’re optimizing power transmission to lift a heavy weight and end in the safest position possible – securing external rotation by hook-gripping at the hand and pushing armpits forward at the top.
So before any and every lift, remember: organize your core, take up the slack in your extremities with proper alignment, and take up slack from the bar instead of just “ripping” it from the floor. Years from now, your shoulders will thank you for all the degradation you’ve spared them.