Should You Push That Shoulder As Far As It Will Go?

Start by figuring out your range of motion. If you've never tested for shoulder range of motion before, you'll need to use your uninjured side as a model but don't expect identical effects. Most people are quite significantly lopsided, so don't think your right arm's not working because it doesn't work like your left. 

 

 

Ideally take your shirt off and look in a mirror to test your shoulders. You'll be watching the head of your shoulder to check that you're not "inventing" range of motion by borrowing it from scapular tilt. Press out overhead and slightly in front of your head. Watch to see that your elbows are facing the same direction. Try pressing out to the sides and then doing internal and external rotations on both arms with your elbow at your ribs, and finally with your elbow at shoulder height. 

 

If there's no pain most of the time but you get pain in a certain axis of motion (for instance, if you can do everything except externally rotate) then you should see a professional about what could be nerve or serious tissue damage. 

 

If you have range of motion stoppages or sudden slips and glitches in movement you probably have a stability problem arising from motor patterning. If toward the end of your range of motion, you're halted by pain, or by a feeling that you've reached the natural end of something, not dysfunction, read on and we'll talk about how to deal with it.

Every joint has an end point, where it stops moving. For instance, when you extend your arm, it won't extend past a certain point because the elbow stops it. That's a bone end point. And when you bend your arm it won't bend any further because your upper and lower arms are pressing into each other. Then you have a "leathery" feel, which is the feeling of ligaments or the joint capsule not allowing any further movement. It's likened to the feel of stretching a piece of leather and it's the normal way shoulder motion stops. If yours stops in an acceptable range of motion, without pain or dysfunction, and the end point feels like this, you might have just found your natural shoulder range of motion. 

There are other ways you can hit an end point before you reach the natural end of the joint's range of motion. One is spasm, when the muscles seize up to protect an injury. The other is pain that you can't move through. When that happens, stop. With painful end feels you can get someone else to move you slowly into it so you're dealing with passive movement, which can help relax and realign tissues. But with a spasm, stop. 

 

 

If you're getting a spasm end feel, or a spasm around the whole shoulder when you move it certain ways, which isn't that uncommon, then you should primarily concentrate on reducing the protective spasm so you can work on other mobilization techniques. If you continually trigger spasm you're going to find the problem gets worse, not better. Methods that can help reduce spasming include anything that's relaxing, like a hot bath, as well as seeing a sports masseur who will know how to reduce spasm by manipulating tissues safely.

 

When you take your injured shoulder to the gym you're better off working within the range of motion you have. Safety first! 

 

If you have gaps in your active range of motion it's a good idea to explore them under professional guidance with minimal or no resistance. If they occur during your bench press, guess what? Don't bench press. At all. Not a bit, not light, not at all. Tissue that's spasming will spasm harder; tissue that's inflamed will be chronically irritated. Replace things like the bench press or overhead press with landmine presses, or with something like standing band pullovers. It's also a good idea to train the uninjured side unilaterally; studies indicate that unilateral training can result in a bilateral training outcome, essentially because training outcomes are centrally controlled.

 

Finally: consider that your orthopedic issue might not be your shoulder. If you're working through a shoulder injury and a professional you trust says, "it's your shoulder," well, then it's your shoulder. But if you're encountering pain or dysfunction in your shoulder when you do certain movements, your shoulder might not be the problem. You could have a neck issue or a problem with your upper back musculature and it's not unusual to have both at once, creating a perfect storm of nerve compression and scapular instability. To address this look at spinal posture first. 

 

See what happens to your shoulder pain when you stand will your back flat against a wall, from hips to skull, for about 30 seconds, about five times a day. 

 

Most people can't get into this position at all, so if it feels hard, don't worry: that's just because it's hard. But if back and shoulder pain falls when you do it your problem might be postural. If not you can look at the possibility that your injury actually arises from poor motor patterning that throws the weight of the movement onto smaller, weaker muscles and it's that that's creating the pain and dysfunction. If you address the root cause the peripheral symptoms often improve on their own. See a movement specialist like a physical therapist who's got a good track record in this area. The news no-one wants to hear: you might have to give up your sport while your shoulder heals, at least initially. Because it's probably something you're doing in your sport that's damaging your shoulder in the first place.

 

I'm indebted to Mike Reinold for his work on shoulder treatment when writing this piece.

 

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