Clearing Up Shoulder Pain


If you’ve ever had a client with shoulder issues you know how tricky they can be. And, if you’ve suffered any shoulder injuries or pain you know exactly what I’m talking about. But the worse thing of all is that there is so much information out there, with conflicting opinions that it’s hard to figure out who and what to believe.

So with all this information out there I decided to give you some great articles to help you understand the shoulder a bit better. These aren’t the easiest reads around, but I think if you take some time to read and digest them you’ll really take your game to the next level with understanding how the shoulders work.

One thing that I would strongly recommend for you to do with all your clients is to look at these 3 things before you start training them.

1) Clear for acromioclavicular impingement

2) Clear for Sub acromial impingement

3) Check thoracic extension

Obviously you want to know if there is any impingement before you start training a client. If there is, you should be sending them out to get checked by the appropriate health care practitioner. This way they can do an in depth assessment and give you directions on exactly what your client can and cannot do.

Acromioclavicular impingement typically causes pain in your client when they take their arm into abduction, around the top of the movement. The pain is caused when the rotator cuff and bursa get pinched or impinged underneath the acromion, so the simple test is to see if there is any pain when the client takes their arm across their chest.

A simple clearing test for subacromial impingement is to have your client place their hand on their opposite shoulder and imagine they are holding down a $20 bill on it. Now have them lift their elbow towards the ceiling. If they get any pain before they get to at least 120° that’s a positive sign that there may be some impingement.

Checking that your client can extend their thoracic spine is the most common one of the three that trainers check. If your client is unable to extend their thoracic spine and pick up their first rib angle then we should not be asking them to do any overhead lifting. The reason for this is that the head of the humerus won’t sit properly in the glenoid, which will cause wear and tear over time.

So there you have 3 quick and easy clearing tests to do with you clients to determine if there are any underlying issues that need to be further investigated.

If you want to go a bit deeper, here are 8 great articles that will take your knowledge of how the shoulder works to a whole new level.

The Truths About Shoulder Impingement Pt 1 by Eric Cressey

The Truths About Shoulder Impingement Pt 2 by Eric Cressey

All Things Thoracic Spine Pt 1 by Dean Somerset

All Things Thoracic Spine Pt 2 by Dean Somerset

All Things Thoracic Spine Pt 3 by Dean Somerset

So Your Shoulder Hurts……by Tony Gentilcore

Shoulder Packing by Joe Sansalone (via Bret Contreras)

And for the super trainer geeks:

Current Concepts in the Scientific and Clinical Rationale Behind Exercises for Glenohumeral and Scapulothoracic Musculature