The shoulder complex is the functional unit that allows for movements of the arm with respect to the trunk. It is comprised of the clavicle, scapula (shoulder blade), and humerus as well as various muscular and ligamentous structures. The shoulder complex has four joints: (1) sternoclavicular, (2) acromioclavicular, (3) scapulothoracic, and (4) glenohumeral.
The glenohumeral joint is the most mobile joint in the body, which presents challenges with regards to the joint’s inherent stability. The glenohumeral joint is supported by both static and dynamic stabilizers. The static stabilizers of the joint consist of the labrum, other capsuloligamentous structures, and the joint surfaces. The dynamic stabilizers are made up of the rotator cuff and long head of the biceps as well as the scapulothoracic and periscapular musculature. The goal of this blog is to provide exercise and movement options to help strengthen the muscles that influence the dynamic relationship between these joints in order to build a more robust shoulder complex. The best way to increase resiliency of the shoulder is through both compound and rotator cuff-biased isolation exercises.
Compound movements are exercises that utilize large amounts of muscle mass and are typically multi-joint movements. In this case, we will focus on exercises that challenge the musculature of the shoulder complex through pushing and pulling movements at various angles. These exercises are beneficial for building a solid strength foundation and improving load capacity and tissue tolerance. While the list of upper body exercises that improve shoulder strength is expansive, I have compiled a few of my favorite movements for both the gym and the rehab setting.
Pushing or pressing movements are a great way to train the muscles of the chest, posterior rotator cuff, and the serratus anterior, which is an important muscle for scapular protraction and upward rotation.
- Set up on a bench or box. Make a 45 degree angle between your arms and torso and lower yourself until your chest makes contact with the surface of the bench/box.
Body weight – Flat
- A progression of the previous exercise into a more horizontal position. Make a 45 degree angle between your arms and torso and slowly lower yourself. Try to take movement through a full range of motion.
#2 Dumbbell Bench Press
- Squeeze your shoulder blades at the bottom position and keep the dumbbells at the midline of your chest. Press up through a full range of motion.
#3 Incline Press
- Keep your elbows at 45 degrees and slowly lower to just below the level of your collarbone. Press up through a full range of motion.
#4 Overhead Press
- Press dumbbells up overhead from shoulder height. Keep the weight in line with your ears.
Pulling movements should be included as well to emphasize the muscles around your scapulae, the upper back, the anterior (front) portion of the rotator cuff, and the biceps, which assist the rotator cuff with various movements.
#1 Standing Row (Band or cable)
- Pull the band/cables backwards and try to squeeze your shoulder blades together. Let your shoulder blades move forward as you work back into the starting position.
#2 Inverted Row (TRX)
- Set up with your weight on your heels and keep the TRX at mid-chest level. Squeeze your shoulder blades together at the top and slowly lower yourself down to the bottom. You can make this exercise more difficult by making yourself more horizontal.
#3 Single-Arm Row at bench
- Set up in a split stance position with one hand stabilizing at the end of the bench. Pull your arm up and back towards your hip pocket and squeeze at the top. Slowly lower back to the starting position and let your shoulder blade move forward.
- Start with your hands just outside of shoulder width. Engage your shoulder blades to initiate the movement and try to go through full range of motion with your chin at the top of the bar.
Rotator Cuff-Biased Isolation Movements
The muscles of the rotator cuff provide dynamic stability to the glenohumeral joint and assist with various movements of the shoulder. Although these muscles are highly active with different movements of the shoulder (external and internal rotation, abduction, and adduction), it is difficult to isolate them since they act in conjunction with other muscles of the shoulder complex. However, if we want to preferentially bias the rotator cuff muscles with less contribution from other muscles of the shoulder, these exercises are good options.
#1 Banded ER
- Place your hands about shoulder width apart and pull the band outward. Can be performed with your palms up towards the ceiling or down towards the floor.
#2 Sidelying ER
- Place the top arm at your side with a towel in between your elbow and rib cage. Keep your elbow bent to 90° and rotate your arm up towards the ceiling while keeping your arm at your side. Slowly control the weight back down to the starting position.
#3 Cable IR
- Position a towel in between your elbow and rib cage. Rotate your arm towards your stomach and slowly control it back to the starting position.
#4 Cable Y’s
- Pull your shoulder blades back and bring arms up into a “Y” shape. Keep your palms facing forward.
#4 Scaption at 90°
- Raise your arms to about shoulder height with your thumbs pointing up. Do not raise your arms straight out to the side or directly in front, but rather an angle in between the two.
Movement of the shoulder requires synchronous and coordinated actions of the various structures that comprise the shoulder complex. The function of the complex as a whole is reliant on adequate strength of the muscles that act upon it. While having strong shoulders does not absolve us of shoulder pain or injuries, strength plays a pivotal role in injury risk reduction and overall resiliency of the upper extremity. By incorporating various compound movements and more isolated rotator cuff exercises, we can develop a more robust shoulder that is capable of handling our activities of daily living and helping us participate in the things we love to do.
If you are experiencing any shoulder pain with movement or have sustained an injury, please come in and see one of the excellent physical therapists at IronHealth so that we can help build a program to meet your individual needs and specific goals.