Understanding Cuff and Shoulder Solutions for Strengthening

SHOULDER SOLUTIONS

Question: I have been working out for about five years. My problem is that whenever I start making progress in size and strength, I end up minor injuries. My shoulder joints are quick to hurt and slow to heal. Since you have researched and written about ligaments and joints, I'd like to know your personal shoulder workout.

Answer: I train shoulders once each week, which provides ample time for rest and recovery. Safety always comes first in my shoulder workout. To prevent injury. I incorporate three essential elements in my exercise routine.

First, I begin every shoulder workout with rotator cuff exercises; second, I apply my shoulder survival rules: and third, I avoid high-risk exercises. Each of these principles is described in more detail below. Whatever your shoulder injury may be. you II find these tips useful.

My personal shoulder workout is designed to strengthen the rotator cuff and work all three heads of the deltoid muscle. A balanced overall development not only looks good, but provides better shoulder joint function.

Shoulder Strengthening Workout

1. Rotator cuff exercises (see below): 2 or 3 sets - 8 to 12 reps

2. Lateral deltoid raises (on a machine for using dumbbells): 2 or 3 sets - 8 to 12 reps

3. Rear deltoid flys on a machine: 2 or 3 sets - 8 to 12 reps

4. Front deltoid raises using dumbbells (or machine shoulder presses): 2 or 3 sets - 8 to 12 reps

5. Machine shrugs: 2 or 3 sets - 8 to 12 reps

CUFF BUILDERS

Question: I am recovering from a torn rotator cuff. My doctor and therapist didn't really explain much about rehab so I'd like your opinion. Please describe your cuff-building exercises, I would really like to know what they are. Thank you for your advice.

Answer: The training routine that I prescribe to strengthen the rotator cuff muscles consists of three exercises. It takes less than five minutes and can be done at home or at the gym.

To rehabilitate a damaged cuff and prevent future injury, perform this routine two or three times a week. Use a light weight that allows you to perform 2 sets of 12 to 15 reps on each exercise.

I recommend using the cable equipment, which most good gyms have, hut you can also use rubber exercise hands or tubing. Don't forget to build the rotator cuff on the uninjured side to ensure symmetrical and balanced cuff development.

Exercise #1 - Internal Rotation: This exercise builds the subscapularis muscle which lies underneath the front deltoid. Adjust the cable pulley to waist height, stand with one side of your body facing the weight stack and grab the cable handle. Keeping the elbow firmly placed against your waist, your forearm should he held at 90 degrees to your body and parallel to the floor. Pull the cable across the front of your body. Your hand should move through an arc of about 90 to 120 degrees. Only the forearm and hand move; your elbow is kept fixed at your side.

Exercise #2 - External Rotation: This exercise works the infraspinatus and teres minor muscles, located underneath the rear deltoid. To perform this exercise, either go to the opposite cable stack or turn your body around through ISO degrees facing in the opposite direction. Crab the cable handle with the same hand, only this time move it nut-ward to the side. Again, keep the elbow fixed at your side and your forearm parallel to the floor.

Exercise #3 - Abduction: This exercise works the subraspinatus muscle, which lies-over the top of your shoulder joint. The cable pulley should be located at floor level. Grasp the handle and move your hand upward and outward to the side. The elbow is kept fairly straight and should not bend during this exercise. The subraspinatus muscle contracts during the first 61) degrees of this motion, so you do not need to raise your hand above shoulder level.

SHOULDER RULES

Question: I am 20 years old and I partially subluxed my left shoulder a couple of times in the past playing football. An MRI scan diagnosed a "slight inconsistency in the labrum." My concern is that my shoulder is weak. Can I do anything to strengthen it or do 1 need surgery?

Answer: Your problem is shoulder instability. When the shoulder is wrenched out of joint (or subluxed). the structures that normally hold it in place are stretched or torn. As a result of this soft tissue damage the shoulder becomes loose or unstable. Minor damage causes the shoulder to feel weak, but when the damage is severe enough the shoulder can repeatedly pop out of the joint at the slightest provocation.

Whenever your shoulder is injured lite action you need to take is the same. You must strengthen the shoulder, but at the same lime protect it from further damage. To guide you, 1 have developed a set of shoulder survival rules:

Rule #1: You must perform rotator cuff exercises (see above).

Rule #2: Always keep your hands in full view to the front.

Rule #3: Keep your elbows below shoulder level.

Rule #4: Always use a shoulder-width grip.

Rule #5: Use machines rather than free weights.

By applying these rules to your upper-body workouts, the modifications will help you re-build your damaged shoulder safely. To protect an unstable shoulder the key principle to remember is to avoid overhead activities, especially the high-five position where the shoulder joint is most vulnerable.

Behind-the-neck exercises should be avoided at all costs. The decline bench press is much safer for an unstable shoulder than an incline bench press. Back exercises need to be per-formed with caution, too. As the weight is lowered, do not allow your elbow to go fully straight. A full stretch during pulldowns and rows will tend to pull a loose shoulder out of joint.

For shoulder symptoms that persist or get worse surgical repair is the best way to fix the damage. Full recovery from surgery takes about three months. The success rate is good and you should be able to pursue all of your bodybuilding goals.

SHOULDER SAFETY

Question: I have been diagnosed with shoulder impingement. How should I restructure my shoulder routine so that I do not irritate it? Should I totally eliminate behind-the-neck presses and pulldowns? Bench and shoulder presses with a regular barbell are painful. I think that occurs because I have to balance the free weight. Are there any exercises that will eliminate all my pain?

Answer: The pain from a damaged rotator cuff usually develops when your arm is raised above shoulder level. You 're in pain because the inflamed cuff tendon catches or impinges on the bony arch of the shoulder girdle. Each time this movement happens the tendon is irritated and the inflammation (or tendonitis) is made worse. It's like constantly biting the inside of your cheek - it never heals.

To avoid irritating your rotator cuff follow my rules for shoulder survival listed above. In addition, you should restructure your routine to avoid high-risk exercises. Here s a list of exercises to exclude along with some safer alternatives (see chart).

Behind-the-neck presses and pulldowns are movements that torture your rotator cuff. Avoid them like the plague. If you can't see your hands, don't do that exercise. Perform presses and pulldowns to the front, instead.

Forget those upright rows, the maneuver is not shoulder friendly. During lateral (deltoid) raises do not lift the dumbbell above shoulder level. When performing bench presses use a shoulder-width grip and keep your elbows close to your sides.

Furthermore, balancing a barbell is tricky when your cuff is weak. Do machine presses instead they 're safer. Finally, be aware that squats can also place large stresses through your rotator cuff, since your hands are placed in the behind-the-neck position to stabilize the (heavy) barbell.