Shoulder health is common to hear in the gym, many exercises (if done improperly) can cause shoulder pain, through impingement causing inflammation and/or compression, and tears. Many people will come across a shoulder issue in their exercise journey, but we want to eliminate that from happening or from continuing to happen.The goal is to have shoulder range of motion without pain, and then adding a weight to the equation, we need to be able to keep position to ensure no issues.
The shoulder is different from the hip joint, the hip is more stable than the shoulder and we have to remember that the scapula part of the shoulder sits on the ribcage, so we have to take into consideration of what the ribcage is doing first before we start to address what the scapula (shoulder blade) and humerus (arm) are doing. This is a big thing that I have seen when talking with people about their shoulder physical therapy routine and the exercises they are doing. Not to say that physical therapy is bad, I look at how the therapist is addressing the pain issue, and if it is working. Some shoulder exercises may work for one individual but not another, and/or the pain goes away but then comes back. My big point here is that strengthening muscles is good and all but if we strengthen muscles in an incorrect position or posture we are actually aiding the joint to be influenced. It is easy to strengthen muscles, you add resistance and contract but being aware of where your body is in space is crucial, it can make an okay exercise a great exercise.
So for the shoulder we need to have control of the rib cage underneath first before we go and move the arm and scapula everywhere. Ribs out of position underneath the blade can push the scapula into a winging position or tilt it, these positions will affect how the muscles that attach to the shoulder function and that's what we want to attack.
The muscles are what will help keep the stability of the shoulder in check, and the ones we want to focus on engaging are the serratus anterior, lower trapezius and the triceps. The serratus anterior and low trap will influence the thoracic spine and rib cage underneath the scapula and help influence the shoulder blade as well, the triceps will help stabilize the scapula in place.
This group of muscles will help shut down the influence of the upper trapezius. In people with shoulder impingement syndrome and glenohumeral instability, they show an increase in upper trap activity and decrease in lower trap and serratus activity, showing that if we are too upper trap dominant that it can cause shoulder issues if not already present.
Adding in exercises that target the serratus anterior, lower trap and tricep is gold for healthy shoulders, two of my favorite exercises are alternating tricep pull downs, and long seated press downs. When doing these exercises the focus is bringing the shoulder blades down and together and feeling the triceps engage while maintaining that position. For the tricep pulldowns do 3 sets of 12-15 reps 3 times a week and the long seated press 3 sets of 15 second hold.