At Body By Design we often follow up the work of physiotherapists working with clients recovering from shoulder issues, especially rotator cuff injuries. I also see a lot of clients developing shoulder problems, usually in conjunction with the rotator cuff, sometimes as a result of activities out of the gym, sometimes as a result of their exercise regime. Depending on the client and the nature of the problem we may deal with as part of our client’s workout out program, or refer the client to a physiotherapist or an orthopaedic doctor. However what I want to deal with here is how to exercise safely to avoid these injuries in the first place.

Shoulder injuries are some of the most common problems faced by sports people, athletes, even just fitness enthusiasts who go regularly to the gym. I encounter them on a weekly or even daily basis during my work.

This can be the result of over training, certain exercises or exercise technique or excess loading of the shoulder joint.

However after the age of 40 years, 30% of all of us begin to suffer from rotator cuff tears due simply to general wear and tear and by the time we reach 60 years old it has risen to 80%.

So whether we are regular exercisers or not, these muscles located in the shoulder joint are something we need to take care of. In the gym it is just as important for those with healthy shoulders as those going through rehabilitation to focus on this small group of muscles. If you are a novice to strength training (whatever your age) or to any sport which involves taking the arm higher than shoulder height in a forceful motion or loaded with weight (for example, tennis or golf, baseball or squash or swimming)  then the rotator cuff muscles need to be prepared. The job of these four muscles, two behind the shoulder on the scapular (Teres Minor and Infraspinctus), one on the top of the scapular (the supraspinatus) and one coming across the front of the body from the shoulder, (the subscapularis) is to stabilize the shoulder joint and control the movement of the arm. We are only as strong as our weakest link however and when you place your arm and thus shoulder in a position where they are not strong enough to do the required job (either due to weakness or an anatomically unsafe position ) they ae put under stress.

Thus beginners need to prep their shoulders for future training but also those of us who have worked out for years must not neglect keeping these particular muscles strong too as when lifting the heavy weights we focus the major shoulder muscles but not always the rotator cuff group.

We also need to remember it is not just shoulder exercises which challenge the shoulder muscles. When exercising the chest (push ups or bench press for example) the shoulders are being used to assist and support the work performed by the chest. The same when we exercise the back complex (eg pull ups or rows). Even when performing arm exercises the shoulders are under tension working indirectly to keep the shoulder joint from moving while the elbow joint performs the exercise. So it is very easy to simply over train the whole shoulder complex including the supporting cuff muscles.

Correct technique of all upper body exercises is also vital to prevent injury in the shoulder joint. Bringing down a weight too low in a chest pressing movement or equivalent, results in excess stress for the shoulder joint. Incorrect pulling or rowing movements can also lead to shoulder issues. Pressing or throwing movements above the head (or even just lifting to above 90 degrees) with force or weight can typically lead to shoulder impingement (a common shoulder injury related to the supraspinatus)

So your exercise selection and technique for your workout is paramount for an injury free workout. It is a good idea to get an experienced personal trainer to put together a sensible routine and ensure you have injury-free technique.

In addition most of us need to perform regularly simple rotator cuff exercises even if you don’t’ visit the gym regularly. If you google there are many variations using dumb bells at various angles. Some are more effective than others. The most simple and effective method however is to use bands or tubing attached to a door handle (and for the third variation you can stand on it). Adding a folded towel under the armpit as we demonstrate ensures perfect technique.