Prevalence of Shoulder Pain and Rounded Shoulders
Shoulder pain has become a massive issue for the fitness and athletics community today. Surveys show that at any given time, 1 in 4 people are suffering from shoulder pain which is lowering their quality of life. In the neuromuscular clinic, shoulder pain seems to be nearly universal, especially among young athletes.
It's easy to understand why, people are sitting more today than ever before. We often sit at work, at school, in the car, and even when we are relaxing. Heavily cushioned chairs and couches take weight off your joints but slouch the spine and shoulders into rounded postures.
This pervasive sitting is on it's own enough to cause rounded shoulder posture, shoulder pain, and impingement. However, in the case of athletes and fitness enthusiasts, these rounded and impinged shoulders are put through the ringer with throwing motions, overhead lifts, and often bodybuilding style isolation work. This causes excessive wear and tear because the joint has no space to move freely, instead the impinged joint is subjected to pinching and shearing forces beyond the body's ability to heal it. Resulting in AC tears, rotator cuff tendonitis, bicep tendon tears and a host of other shoulder related issues.
The Road to Functional Shoulders
Mechanically speaking, the primary functions which are lost due to the forward rounded shoulder posture is a loss of space inside the joint itself as well as a loss of shoulder blade control and function.
There are many ways to address these issues but all require the lengthening of the short, tight anterior muscles and strengthening of the weakened posterior muscles. A good trainer or physical therapist could develop a program to assist in the training and a knowledgeable neuromuscular therapist or sports massage therapist could loosen the tight muscles and create space in the joint again.
And while I would suggest the help of these professionals to almost anyone, enlisting professionals can be time consuming, expensive and in my experience, often unnecessary. A number of the people who walk into my office have not caused enough damage to warrant the money they are spending, instead they are at an early stage in which a few simple interventions are likely enough to open up the shoulders and stop pain.
The simplest and most common interventions I suggest are shoulder dislocates and hanging from a bar. Both of these simple exercises help to create a mind-body connection with the shoulder blades while increasing the muscle tone and control in that area and stretching the tight anterior muscles.
Both can be used as warm ups, and both can be added to nearly any fitness routine as they don't usually cause much strain on the muscles.
Shoulder dislocates are performed with a loose, flexible material such as an elastic band or towel, or with a rigid staff or pvc pipe. I recommend beginning with a workout band or towel as it is much more forgiving at first. As this becomes easier to perform correctly you can move on to using a pvc pipe or staff which will take the mobility gains further.
To perform the dislocate you simply stand tall with both hands wrapped around the staff, the staff at your waist, and palms facing you. The wider you place your hands, the easier the exercise becomes, so begin with a very wide position before moving forward.
Next lift the staff overhead with arms straight. At this point you will begin to pull the shoulder blades down and slightly in towards each other as you pull the staff and your arms back behind your head and back. The movement ends at the low back before starting to reverse it and bring it back over the head and once again down to the waist.
Be mindful of your form as this can also create injury if done improperly. Be sure to follow these guidelines:
Keep the arms straight, the most common failure I see is beginners bending the elbows in order to maneuver around lack of mobility. This defeats the purpose so if you find yourself doing this, widen out your grip until you can finish the movement with arms straight.
If there is any pain, stop, widen the grip and slowly try again. If the pain persists you may need additional intervention before doing this exercise.
Control your shoulder blades, as this will teach control, build the muscle and position the shoulder joint for maximum mobility. As the arms go over head you must begin drawing the shoulder blades down, and often they will need squeezed into the ribs by the serratus anterior muscle. Though I'll cover this more in another post.
Progress by moving the hands closer, often by an inch a week or so. Though this will change based on the individual and the current level of tension in the shoulders.
Perform 30-60 second sets, continuously moving the arms back and forth through the motion in order to get blood flowing to the joint. After this you can perform a static stretch at the top of the overhead position if desired.
Shoulder dislocates are a great warm up for shoulder mobility, but I often use hanging for the bulk of my shoulder stretch and scapular strength. It feels great on the shoulders, makes me stand tall and even decompresses the back.
In fact, hanging is something that is quite natural to human nature. Though it's less common in the western nations, many populations around the world still climb trees and hang from branches to acquire fruit. In fact the human shoulder is capable of more range of motion than almost any other animal in the world, with the exception of some great apes and monkeys.
Our shoulders are designed to easily go overhead for things like reaching, throwing, climbing, and hanging. Because of this, hanging is one of those interventions the body rarely fights against. Certainly, anything can be overdone, and hanging is no exception, but I find my body and those of my clients seem to immediately take well to the act of hanging. The postural improvements are often noticeable almost immediately and continue to improve in the long run.
Give it a try and I'll wager your body thanks you quickly by feeling and performing better. To get the most out of it, though it's important to understand the two primary goals of hanging and the two basic types of hanging that accomplish these goals.
The Dead Hang- The dead hang is what most people think of when they imagine hanging. You simply grab onto the bar in an overhand grip with arms slightly wider than shoulder width apart and allow the body to hang completely. The only tension will be in the hands and forearms to maintain grip, the rest of body allows gravity to pull it towards the ground. Shoulders will be elevated up near the ears and the shoulder blades will be rotated up.
The primary goal of this hang is to stretch the shoulders and upper body while decompressing the spine and opening the rib cage. This will lengthen the pecs, lats, rhomboids, delts and teres major (the little lat). The end result will be better shoulder mobility, especially in the overhead position, and a straighter spinal posture.
This hang can be performed for 30 seconds to 2 minutes. I've seen some people go longer but I haven't seen much benefit from increasing the time past this and there is always the potential of injury as there is with any excessive static stretching.
Active Hang- The active hang is the yang to the dead hangs yin, it is the hang which strengthens the muscles surrounding the shoulder blades and helps the mind map out the ideal shoulder position for stability and strength training.
When coaching men's gymnastics the youngest athletes spend ample time at every practice drilling this position so that the shoulder blades and grip become strong enough to withstand further calisthenic progressions on the bar, parallel bars and rings. It is the foundation upon which further bar work is built because without this scapular control and strength, none of the other bar movements can be done safely.
The primary goal of the active hang is shoulder control and strength, while also strengthening the grip, the lats, and the core. The end result is a functional foundation of shoulder strength, control and stability which will serve the individual in all overhead movements while also actively pulling the shoulders back and out of a rounded shoulder position.
I recommend performing 2-3 sets of 30-60 seconds for awhile in the beginning. Again, I've seen some people perform the active hang for much longer than 1 minute but honestly, most of the gains developed by it could just as easily be gained by progressing into other hanging or brachiating variations and just maintaining a few weekly sets of active hangs at one minute each.
If you can't Hang
If your grip can't support your entire bodyweight or at least it can't do it for long, have no fear. Simply position yourself on a bar low enough that you can your feet can touch the ground. Then hang as you would normally but support some of your weight on your feet and squat down to put the rest of the weight on the arms.
You can progress by going onto one foot or by putting the toes or tops of the feet on the ground with the knees bent. These options won't allow you to support as much weight on your legs but still some. Build up until you don't need your legs anymore.
You can also use lifting straps to help with grip strength until you can do it without. I've had a few elbow injuries that wouldn't allow me to overuse my grip and I've used lifting straps with great success to still hang and get the benefits for my shoulders and back just the same.
The grip you use can have an effect on the experience and results you will get from hanging. Below is a quick run-down of what you can expect from the various available grips.
Underhand Grip- This grip externally rotates the bone of the upper arm and puts a greater stretch on the latissimus in particular. Though for some people it does place stress on the elbows and wrists. If you find this uncomfortable, I would avoid it, as the benefits of it don't out way the potential negative effects.
Overhand Grip- This is the standard grip and is in general well tolerated by most people. I usually recommend this grip to those who are using a pull up bar and those who are looking to progress to more advanced hangs and static bar skills in the future. As this is the grip used in most advanced bar skills.
Parallel (Neutral) Grip- This grip requires parallel bars so it may be more difficult to accommodate. However, this grip is the easiest on the shoulders and I would recommend it to anyone who has or has had any shoulder injuries.
In-Line (Commando) Grip- This grip presents a unique rotational stabilization challenge to the shoulders and the core making it a good grip to use from time to time during an active hang. As far as dead hanging this isn't as effective because the body tends to rotate and put the shoulders in a compromised position.
Mixed Grip- This a good grip for those who find their grip strength is weak or their bodyweight too heavy because it will increase grip strength. However, this will also put a rotational tension in the shoulders and may not be appropriate for everyone.
Where to Hang
Most people hang from a pull up bar in a gym or at home but if you don't have these options there are plenty of other ways to get your hanging in. Here's a short list of ideas so you can hang anywhere.
Pull up bar- This is the obvious one but it's worth noting that if nothing else a doorway pull up bar has become pretty cheap in recent years and easy to obtain. Here are a few links to decent doorway pull up bars on amazon, a mid range option and a basic option that's a little cheaper, and also some more advanced pull up bars at Rogue Fitness for wall mounting if you're interested in having room for more advanced bar progressions later.
Jungle gym- I can't count how many times I've gotten a morning or afternoon calisthenics workout at a local park before all the kids get out of school and take them over. There are usually monkey bars, railings or some other type of high bar available for hanging and it's nice to get some fresh air anyway.
Ledge- Depending on the ledge, what it's made out of and how sharp it this, this one can be less comfortable than a bar but it gets the goals accomplished just the same. I've hung from tall retaining walls, the underside of stairs and deck hand rails. All worked well and even though the edge can sometimes hurt, a simple pair of workout gloves can fix that, or just let your hands develop some thicker skin over time.
Doors- It goes without saying, but I'm going to say it anyway, you have to trust the strength of the door your thinking of hanging on. Many interior doors are hollow and have very short screws attaching them to the door frame, so exterior doors tend to be better. Also be careful, you'll have to open the door to hang on it and you want to be sure it doesn't close on your fingers in the process. When I do this I often put something in the door way so the door cant shut.
Tree Branches- This is often my favorite place to hang, though it does have it's draw backs. First, depending on where you live it's sometimes difficult to find nice and strong horizontal branches. And even then the bark of the tree can sometimes be rough and cut up the hands unless you have gloves on. I've also had a lot of bugs buzzing around my face or crawling on my hands while doing this so if that's not your thing this likely won't be your first choice. For me I loved climbing trees as a kid so this never bothers me much.
Hopefully this article has set you up to succeed adding hanging into your workouts and your shoulders will soon thank you. If your still further interested in shoulder mobility and health check out this article on Indian clubs, another great functional shoulder builder.