A Quick Look at Preventing and Treating Shoulder Instability

 Jeff Barnett

If you perform strength training, then you’ve probably experienced shoulder pain. You’re not alone. About 36% of injuries in the weight training population occur at the shoulder, and many of these injuries occur because of instability in the shoulder joint.

The shoulder is a relatively fragile joint compared to its lower body cousin, the hip. The shoulder only attaches to your skeleton via bone in one place: the clavicle. All the other connections via your upper arm and scapulae are floating in a sea of muscles, tendons, and ligaments. Many of the stupid things we do in life and the gym contribute to shoulder instability - when you can’t effectively keep the humeral head centered in the shoulder joint.

A recent study from the Journal of Strength and Conditioning Researchasked, “What causes shoulder instability? What can be done to avoid it? Can anything be done to prevent it?” The study examined 123 participants who trained recreationally about three times per week. The average participant had about nine years of weight training experience and was about 28 years old.

The study identified two movements in particular that accompany shoulder instability: military press and behind the neck pulldowns. The frequent use of both movements together was also particularly correlated with instability. But the study also found some good news. Strengthening the external rotators of the shoulder makes the shoulder more stable and can help prevent the above problems.

To get some practical advice from these findings, I reached out to Dr. Ryan Davis, a doctor of chiropractic and a rock star manual therapist. Dr. Davis says, “Too often rehab professionals confuse strength and stability. Strength is simply one component of stability. Just as important for stability are timing and neuromuscular control.” He goes on to describe how rhythmic stabilization drills, such as the one in the video below from Eric Cressey, can aid someone recovering from shoulder pain. For advanced patients he prescribes functional movements that can strengthen the external rotators such as Turkish get ups, pull ups, and deadlifts.

If you suffer chronic shoulder pain, shoulder instability could be part of the problem. My advice is to lay off the strict presses for a while and work on strengthening the muscles that externally rotate your shoulder. I also recommend seeking out a therapist who can help solve the problem at the root of your shoulder pain, and not a family doctor who will simply prescribe two weeks of rest and Ibuprofen.

References:

1. Morey Kolber, Melissa Corrao, and William Hanney. Characteristics of Anterior Shoulder Instability and Hyperlaxity in the Weight-Training Population. Journal of Strength & Conditioning Research. May 2013. Vol 27. Issue 5. p1333-1339. doi: 10.1519/JSC.0b013e318269f776