When I moved to rural PEI, I began working in a gym where, previous to my arrival, there was little access to personal trainers and strength training personnel who were properly trained and certified.
I came across a lot of highly questionable behaviours in the weight room; stuff that would make me cringe and wince or shake my head in total disbelief. There were times when, my best advice blown off by the-injury-waiting-to-happen, I would just have to leave the room in order to not pay witness to the corporeal carnage being wrought. And, not surprisingly, I began to notice, and became the ear to, quite a number of injuries and body complaints.
Poorly executed weight lifting (of which I saw plenty) and/or inclusion of higher risk movements, were resulting in plenty of injuries, with rotator cuff damage and Shoulder Impingement Syndrome high on the list. These were so common that members were dropping their memberships because exercise was just plain damaging to them or they were the walking, but tough and committed, wounded. What’s a bit of chronic shoulder pain and a daily dose of anti-inflammatory pain killer? For the diehards, this was the price they thought they had to pay.
Shoulder Impingement Syndrome is the result of one of the tendons in your shoulder (the supraspinatus tendon) rubbing against a part of the scapula (shoulder blade) called the acronium. Think of this like a rope being rubbed in one place repeatedly. Eventually the fibres of the rope begin to break down and there is a fraying — an inflammation in the tendon which causes pain. The result is tendonitis, bursitis, or a tearing in the rotator cuff muscle(s).
This condition happens when the shoulder joint is held and exercised in a position which does not allow for a healthy, open positioning of the joint. So, for example, when the glenohumeral joint is closed, there is no free movement of the muscles, tendons and ligaments of the shoulder structure. Close the joint, push weight, wait for injury. It is a simple, tried and true, progression.
I should mention here that injury in your body is cumulative. Microtrauma in the muscles, tendons and ligaments accumulates over time. So, you might be able to move weight with poor form or perform higher risk exercises without noticing damage immediately. The straw that breaks the camel’s back is simply and precisely that – it is the final load which takes your accumulated injury and tips it over the edge. Your shoulder (or back or knee) performs one insignificant movement, and debilitating pain ensues. Don’t bother to shake your head and shrug your shoulders in confusion and disbelief, you have been building to this moment for a while.
Some exercises carry more risk of impingement of the shoulder than others. Overhead work, like military presses, especially lowering behind your head…lat pulldowns behind your head…upright rows…. Each of these exercises, even when executed with perfect form, carry a risk to which, I would suggest, you not expose yourself.
Take, for example, the upright row. The shoulder is forced to abduct from a position of inward rotation which becomes more acute as the elbows lead upward. This position closes the glenohumeral joint, creating the optimum environment for impingement. The deltoids, elbow flexors and upper trapezius muscles are poorly aligned against the force of the weight being lifted. This movement trajectory does not present a favourable or effective line of pull for the targeted muscles.
As a trainer, I must make decisions daily about the risks to which I will expose clients. This assessment is based on the client’s goals, the client’s knowledge and understanding of the risks (of which I must appraise her/him), and the client’s informed consent. It also requires that I be a trainer who can assess biomechanical advantages and disadvantages, and this knowledge can only be built on a foundation of formidable and informed training, education and continuing education.
When you walk into a gym and an employee of that gym provides you with a new member’s workout program, it is incumbent upon that employee to understand the biomechanics of body movements, to determine your level of conditioning, to have a clear understanding of your short and long term goals, and to know which exercises under which conditions will assist you in meeting those goals. Only upon this basis can the trainer prescribe exercises of appropriate risk levels which will help you achieve your goals in a safe, efficient, informed and enjoyable manner.
If your goals are anything less than competition level power lifting or body building, you should not be performing high risk movements with your shoulder joints. Lat Pulldowns behind your head, military presses behind your head, upright barbell rows with narrow grip or upright dumbbell rows close to the midline are all contraindicated for healthy shoulders.
An incorrect exercise prescription from a fitness professional is as dangerous to your health and wellbeing as an incorrect prescription from your medical physician. Do not let fast talk, ‘free’ sessions, face to face consultations, or pretty forms dupe you. Stay calm, ask questions, check credentials, look at certifications.
Imagine yourself at age 18, finally getting your driver’s license and purchasing your first car – second hand, clean, well-maintained, regularly serviced, shiny. If you were told that was the ONLY car you were going to get in this life time, how would you treat it? Now think of your body. It is the ONLY one you will get in this lifetime. Treat it with at least as much respect and care as you would that car.