How To Improve Scapular Stability For Healthy Shoulders
Keeping the shoulders healthy is an issue that is near and dear to me because my left shoulder is anything but healthy. It’s an issue that I deal with on a regular basis, always having to be conscious of how my activities may affect my shoulder and always trying to make it stronger. (Unfortunately, I had another partial dislocation in my sleep last week…and do you want to talk about something that will take you from sound asleep to wide-freaking-awake in no time!) So today, I thought I’d discuss some of the exercises that I do to help strengthen and stabilize my shoulders.
But first…the shoulder, itself.
The Shoulder Joint
No other joint in the human body has as many ranges of motion as the shoulder. The blessing of this is all of the wonderful things you can do with your arms, from throwing a 100 mph fastball to hitting that same fastball, from shooting three-pointers to getting the rebounds when your teammates miss. Pressing and pulling movements can be undertaken in virtually any direction because of the ability of the shoulder to move.
The curse is that with great mobility comes great instability. The shoulder is one of the most frequently injured joints and is the most frequently dislocated (especially when we’re talking about my body!), due to its inherent instability. It is comprised of three bones: the humerus (upper arm bone), the clavicle (collarbone), and the scapula (shoulder blade). Technically, these three bones form three joints, not just one, referred to as the glenohumeral, acromioclavicular, and the sternoclavicular joints.
The glenohumeral joint is the ball-and-socket joint that most people refer to when discussing the shoulder. Here is where the upper ball of the humerus joins into the concave portion of the scapula. Unfortunately, the socket that the ball sits in is smaller than the head of the humerus and strong muscles, tendons, and ligaments are required to keep it in place.
The acromioclavicular joint occurs where the acromion (that raised bony part on top of your shoulder) meets the clavicle. The sternoclavicular joint is the point where the clavicle meets the sternum.
The Scapula
What we’re interested in today is the scapula and movements that help to stabilize the scapula. As you can see, it’s heavily involved in the working of the shoulder, being part of two of the three joints, including the major one. It’s also not directly attached to the torso, effectively hanging between the clavicle and the upper arm.
Instability of the scapula is a major cause of shoulder issues, so my goal is to teach the muscles to work together to make sure my scapula is moving within the joint as it should be. And there are a load of muscles that connect to this bone: deltoid, traps, biceps, pectoralis minor, rhomboids, serratus, and rotator cuff to name a majority.
So that means the shoulder has to be worked in quite a few ways. You can’t just go with standard pushing exercises like the bench press or pushups and hope for scapular stability. You have to incorporate various types of pulling, pushing, and rotation, as well as scapular retraction and protraction. Plus, you need to stretch the muscles around the joint to keep your range of motion. It’s like a full-time job!
Let’s get to the exercises.
Diesel Crew Pre-hab
The first video is one that I’ve been using since I had surgery in June 2007. These exercises have done an excellent job of getting my shoulder back to full strength and nearly full range of motion. I need to get back to doing these more consistently because they work very well.
I typically throw these in at the end of my workout to make sure I’m not exhausting my shoulder before going into full-body exercises like the squat and deadlift. They also serve as a nice cool-down.
RKC Arm Bar
A new exercise that I found is called the RKC Arm Bar. I really like this one because I can feel it working very well in my lats and scapular region. I started very low on the weights, using only a 5 lb dumbbell, and have worked up to using 20 lb dumbbells, working in a Turkish Get-up (see below) sandwiched between two 15-second holds.
As Adam mentions in the video, using a dumbbell is less effective than a kettlebell for this exercise because the weight doesn’t pull your arm back. I compensate for that by holding the dumbbell by one end instead of by the handle.
Kipping And Deadhang Pullups
I think everyone knows how to do a pullup. Overhand, underhand, mixed grip…doesn’t matter. I find both kipping and deadhang pullups to be beneficial, though I unfortunately don’t have anywhere to do kipped pullups right now. I think that may actually be slowing progress of getting my shoulder back to where it was a year ago before the first post-surgery dislocation.
Now, if your shoulders are messed up, you should be careful with kipping pullups. But the kipping motion does seem to help my shoulders loosen up and strengthen. Just be careful not to drop too quickly with any kind of pullup until you’re sure your shoulders can handle absorbing the extra force at the bottom of the pullup.
Kipping itself, without the pullup, can actually be beneficial, just by moving the arm through a range of motion while weighted.
Turkish Get-ups
This is an exercise that will get you funny looks, but works very well. As you can see in the video below, you just hold a weight vertically and stand up from a supine position. This forces your shoulder to stabilize the weight through a very broad range of motion.
Jeff Martone of Tactical Athlete has credited the Turkish Get-up, or TGU, with rehabbing his chronically dislocating shoulder. I’ve seen videos of him doing TGUs while holding people instead of weights…I’m a LOOOOOOONG way from that.
Use These For Pre-hab Or Rehab
Of course, you may wonder how well these exercises actually work when I still dislocate my shoulder. It’s unfortunate that I completely undid the surgery by getting the labrum anchors ripped out playing basketball, then fully dislocating playing volleyball (I have since given up volleyball and basketball). But until that fateful rebound, my shoulder was as strong and healthy as it was before the surgery.
So the exercises do work…I just happen to have retorn my labrum, so things that should be holding my shoulder in place aren’t. But that’s why I keep working all the harder to get the muscles where they should be, in hopes of staving off a second surgery.
What other ways do you know of to rehab your shoulders?
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23 Reader Comments
Man this is crazy, I come across this 2 days after I mess up my rear delt overhead/bench pressing. I actually started the rehab protocol from the diesel video yesterday along with resistance band dislocates, after determining I may have a weak subscapularis and things feel better already. I hadn’t seen the TGU or arm bar exercises before though, I’ll definitely give those a go when the shoulder feels up to it. Thanks for the article man, great read.
Great post Scott! I have been doing the TGU for years and really like the Diesel Pre-hab. I will definitely be trying out the Arm Bar this week. Thanks!
my shoulder was FUBAR also with a torn labrum but after a year of rehab from http://www.solution4pain it is really good. I tried everything but surgery(various PT exercises like these and others) and nothing else worked.
It used to dislocate in my sleep all the time.
I cant recommend it highly enough. As long as your body is out of alignment you will continue to be prone to injury. Strengthening only the shoulder will be minimally effective if your entire body is not corrected.IME
Great Article man — gotta keep those shoulders healthy!
Later,
Caleb
I use “scapular pushups” to learn the retraction correctly. Got them from Eric Cressey. Great article by the way, TGU’s are such an undervalued exercise! Keep it up
Coming from someone who has messed up both shoulders at some point (and couldn’t do a pushup for like 6 months after one recent injury), I feel the pain. I found using more dumbbells (than barbells) helped with scapular stability (esp overhead work). Also doing pushups on rings or staggered/walking pushups helps and I still do those today.
Interesting. I spent a lot of money last year at the physical therapists for my sore neck/upper back. We finally decided that tight muscles around the ribs and shoulders were the cause of my problems. I do a modified pushup against the wall – but I think I might try some of the other exercises you describe. Thanks!
I’m no physical therapist, but over the years I (and my clients) have made good use of some pretty creative soft tissue magicians.
And when it comes to shoulders, I have found over and over again that unless someone has a congenital structural abnormality or has suffered a traumatic soft tissue injury, most of the problems with shoulder joints stems from muscular imbalance.
Because of our resistance training programs and our day to day activities, a good number of us inflict more stress on our anterior upper body musculature (chest, front delts,and abs) and ignore our upper back muscles, rear delts and lower back)
As a result, the overworked muscles become chronically tight and the ignored muscles become chronically stretched and weakened
This situation quite often pulls our shoulder joints out of proper alignment, leading to soft tissue damage, chronic inflammation, swelling, pain & weakness
Alex Kay mentioned Eric Cressey – I would have to second that recommendation, Take a look at his blog or his articles on T-nation for a good intro to fixing your bad joints
I blogged on this topic as well – http://healthhabits.wordpress.com/2008/04/14/structural-balance/
There are some great links to some great PTs in my post
Sam, good luck with your rehab!
Alex, scapular pushups are great. They are part of the Diesel Crew video. I subbed them instead of clapping pushups in my plyometrics this weekend since I wasn’t about to do clapping pushups right after shoulder issues.
Elizabeth, it’s always worth making sure you don’t have general muscle imbalances. If something is overly tight, you probably do, so these exercises should help rebalance the muscles and loosen things up.
DR, great points. Most people are busy working the pretty muscles that they see in the mirror…biceps, pecs, quads, instead of the all important posterior muscles.
Also, here’s some information I came across on “winging scapula,” which suggests general shoulder instability and issues. And one thing I find that a lot of people do that is really rough on bad shoulders is pressing or pulling behind the neck. There’s no need for it and it tends to destabilize the shoulders. Too wide of a grip on pullups does the same for me.
Cheers
Scott
Hi,
Great post. I’ve been struggling with a winging scapula and thoracic outlet syndrome for years now. It’s causing me a lot of pain and it stops me from doing the kinds of exercises I would want to do. So I concentrate on legs, etc – as a result of which my top half looks kinda…weedy!
It seems obvious to me that strengthening the shoulder would help but every doctor/physio I’ve seen seems reluctant to recommend specific exercises. Which is maddening! So I might try these and see how I get along.
You say ‘Here’s some information I came across on winging scapula’ – and then there isn’t any?! Or am I missing something?
Cheers,
Danka
Danka, you’re not missing anything. I forgot to post the link: http://www.shoulderdoc.co.uk/article.asp?section=492 Oops! Thanks for catching me!
Good luck with the shoulder.
Scott
Scott,
I was wondering how you’d incorporate the TGUs/arm bars around strength training, because I can see them becoming much more difficult as the weight ramps. For example on a day that includes 3×5 Overhead Press, would you still do the TGU as prehab afterwards or leave that for days that don’t include direct shoulder work? Thanks man,
Sam
Sam,
I never got above 20lbs on the TGU/Arm Bar combo before last week’s setback, so it wasn’t a huge deal. But I typically don’t do a lot of shoulder rehab on days I’d do OH Press. So I’ll either do OH Press and some pullups and that’s enough or I might throw in a couple light sets of one of the Diesel Crew circuits before my workout. Just enough to hit the shoulder without taxing it too much for the OH Press.
I typically prefer to do my rehab stuff before doing the press. I’d rather lose 5-10lbs on my press because my shoulder is a bit tired than try to do effective rehab after I’ve already killed my shoulders pressing. Make sense? Your mileage may vary of course…gotta find what works for you and your shoulders.
TGU/AB is usually done after deadlifts and such where there’s little direct shoulder work.
Cheers
Scott
Hey man,
You look like you nailed a majority of shoulder rehab and stability techniques.
One person that has really helped me improved shoulder stability and flexibility is Rob Brinded. He is learned in reflexology and is one of the first people to teach you how to stretch on several different planes. A majority of the times when we stretch we are only stretching on 1 plane, once you are able to hit 2-3 planes your flexibility increases dramatically which in turn promotes stability.
The exercises you recommend are awesome. I also like to do hand stand push ups after air squats. Get the blood rushing from your legs into your shoulders, this really allows you to build the stabilizing muscles you need to lift efficiently.
Keep the info coming!
Christopher Stella
Fitness as a Lifestyle
Scott,
Thanks for the reply, what you said makes a lot of sense. I’ll try incorporating rehab before the press like you suggested. I hadn’t previously thought of that with being so focused on max lifts always, which like you say, probably isn’t healthy in a rehab situation.
Thanks a lot man,
Sam
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hey i injured my shoulder in november of 2008 playing basketball. My shoulder felt sore for around 1-2 weeks and after that it seemed to stop hurting me. i figured i was healed so i started playing basketball again, around once to twice a week. it started hurtng me again and i figured its not that big of a deal, after a while (late february) it was still hurting me and this time the pain was extensive. I am in high school and it was hurting me to write notes and stuff which never happened before. i went to see a physiotherapist and she told me my shoulder is out of position and its kind of in front (where as the left shoulder is in proper position). She gave me all these different exercises to do. I started goingto the physiothereapist in March and it is now May. I have seen results but at a minimum. My shoulder still aches every now and then and i have a hard time sleeping because of it. Whenever I go back to her she just gives me new exercises which i do to the best of my ability. I was wondering is my shoulder supposed to take this long to heal and is there anything else i can do besides these exercises to heal my shoulder?
Christopher, I need to start incorporating more static handstand holds into my workouts. I’m also checking out Rob Brinded’s stuff…thanks!
Arsal,
I wouldn’t think it would take that long for your shoulder to return to stability. Even after a dislocation, I’m back into form and pain-free in far less than six months. What kind of exercises does she have you doing? Have you tried the exercises that I posted above?
Cheers
Scott
Great Article!
I have only come across some of this stuff a few weeks ago and the change has been amazing. I injured my shoulder in a rugby game a while back and this info has been like gold dust to me..
Christopher,
Thanks for the heads up on Rob Brinded’s stuff, I have been doing some of the exercises he has on the blog..
Skustes,
I had the same issue with my shoulder, went to the physio for a while but stopped. I now know the exercises they give are so outdated, or not specific to the actual problem area. I now look online more for information myself, and like I said before the material has been awesome…
Mark.
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People tend to ignore shoulder problems until it is too late. People need to take action sooner.
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