When you walk into the gym, I can almost guarantee you, there will be at least one gym-goer grasping their shoulder after a heavy set of chest press. This begs the question… is this really necessary?
Some may claim ‘no pain no gain!’ is the way to go. In my opinion, this is absolutely the opposite of the truth. Just imagine, you set up for your top set on the bench, rep out six heavy controlled reps, put the weight down, then notice, that niggling pain you usually get on the front of your left shoulder… no longer exists!
The majority of anterior shoulder pain that has no clear reason for being injured is often the result of irritation of the structures that lay beneath the front deltoid muscle. This space can become inflamed due to the shoulder being rotated forwards as a result of months or years of either training with incorrect form or lack of muscular balance.
An example of this would be the external rotator muscles not being strong enough to cope with the strength or lack of mobility at the front of the shoulder complex. This can pull the shoulder into a position that compresses the front of the shoulder and top of the chest leading to irritation, a dull ache, or, if left untreated, can develop into a more severe chronic pain.
When training the rotator cuff, at the beginning, we want to place real focus on rotating the humerus in order to place the four cuff muscles under the most stress. If the shoulder blade begins to move when performing these movements, the emphasis on the rotation of the shoulder joint has been lost.
Finally, it is also important to progress these exercises. I too often see people go from a 60kg bench press to an 80kg bench press, but they are still doing the same rotator cuff exercises, with the same load, range of motion and time under tension then wonder why their shoulder pain has returned. The job of the rotator cuff is to support the larger muscles around the shoulder, as the other muscles develop, we must also find ways of improving the rotator cuff to keep the strength and durability needed to cope with demand.
At Jigsaw Physiotherapy we can use soft tissue techniques paired with corrective strength exercises and education to re-locate the shoulder back into a position where there is no irritation to the structures on the front of the shoulder. We can also use follow up sessions to evaluate, make changes and progressions to plans when necessary.
Written By Harry Vickery
BSc (Hons) Sports Therapy