Four
Exercises to Modify or Avoid
(also
see Rotator Cuff Tendinitis
and What Goes
Wrong)
Certain
exercises are commonly performed in ways all but guaranteed
to traumatize the rotator cuff. These exercises should be modified
to reduce their potential to induce cuff injury. In some cases
that means eliminating them entirely!
1. RISKY
BENCH PRESS VARIATIONS
Prime Mover:
pectorals
Secondary Movers: front deltoid, triceps
The Bench
Press targets the pectoral (chest) muscles but also makes heavy
demands on the triceps and front delts. All three muscles—pecs,
front delts, and triceps—act to lift the bar. Along with the
rotator cuff, all three also stabilize your shoulders during
the exercise.
In an effort
to ``work different areas of the pecs" and to decrease the involvement
of the supporting muscles, athletes have come up with a number
of Bench Press variations. Some are O.K. Some are potentially
harmful. Let's look at two variations especially likely to produce
shoulder injuries:
- using
too wide a grip
- touching
the bar to the chest too high up
Using too wide a grip
On the plus
side, bench pressing with a wide grip does increase the intensity
of pec contraction during the exercise. The position places the
pecs on a greater stretch than a shoulder-width grip does, and
the greater stretch causes more muscle fibers to be recruited
during each rep.
On the minus
side, though, is this: Imagine you are holding up a 10-pound
weight on the end of a stick one foot long.
Now imagine
you are holding up that same weight on the end of a 10-foot
stick. Obviously, it's harder. The longer lever increases the
force necessary to hold up the load.
The same
thing happens when you use a wide grip during the Bench Press,
only the stress isn't increased just on the pecs—it's also increased
on the shoulder joint itself. The rotator cuff is left holding
the bag: the stage is set for injury.
Some athletes
are told to use the wide grip early in their athletic careers
when many of them don't have sufficient shoulder-girdle strength
to withstand the strain. In fact, few athletes are ever able
to withstand the torque of the wide grip, and many suffer rotator
cuff injuries as a result of using it.
The safest
grip for this exercise is a medium grip, which allows all the
prime movers to work together, minimizing the strain on the
rotator cuff.
Touching The Bar Too High
Many bodybuilding
books recommend lowering the bar to a point high on the chest
during Supine Bench Press to focus on the upper pecs.
Don't do
it. The higher you drop the bar on the chest, the greater the
stress on your shoulder. High placement may overstretch the
joint capsule, the muscles, or the tendons.
If you want
to focus on the upper pecs, use the Incline Bench Press instead.
Touching the bar high on your chest during a Supine Bench Press
can cause more damage than will ever be offset by the yield
in development. When doing the exercise, lower the bar to approximately
the nipple line or slightly below.
2. DIPS
Prime Mover:
chest or triceps, depending on body position
Secondary Movers: triceps or chest, depending on body position;
front deltoid
Some athletes
just shouldn't do dips. Several factors determine whether you
are one of those, including your body weight and whether you've
ever suffered a shoulder separation.
A shoulder
separation occurs at the acromio-clavicular (A/C) joint, where
the shoulder blade and collarbone come together just above your
front delt. The degree of separation can range from barely perceptible
to a complete rupture of the ligaments, requiring surgery and
pins or screws to hold it together. Major trauma to the A/C
joint can come from falls, car accidents, motorcycle accidents,
skiing, and so on. Less-traumatic separations can come from
weekend softball or football games. If you played football in
high school, you might have had a slight separation that you
thought was just a sore shoulder.
The top,
or lockout, position during Dips puts vertical stress directly
on the A/C joint. This can increase a separation, further aggravating
the problem (fig x).
Our advice
on this exercise: If you have ever separated your shoulder to
any degree, don't dip. If you have pain at the top of your shoulder
when performing dips, don't dip (this is not something you can
``work through"). If you have gained a lot of weight, and this
exercise does not feel as comfortable as it once did, don't
dip.
If on the
other hand, you have always been able to dip without pain, you
can continue to do so, but allow one set for a special warm-up:
Do the first rep barely lowering yourself at all. With each
subsequent rep, lower yourself a little further so that by the
final rep you are moving through the full range of motion for
the exercise.
3. DUMBBELL
PULLOVERS
Prime Mover:
lats and triceps
Secondary Movers: pecs
Now here's
an exercise with problems!
Pullovers
are supposed to ``expand the rib cage." This assumes that ribs
will somehow lengthen, or that cartilage will change to allow
expansion to take place. Bone just doesn't work that way.
Training
of various types can change the vital capacity of the lungs—the
quantity of air that can be exhaled by the fullest expiration
after making the deepest inspiration. However, much of this
change results from the learned ability to use available lung
space and from improved control of the diaphragm. Neither factor
translates into a larger rib cage. Despite the tremendous vital
capacities of opera singers and trumpet players, for instance,
they, as a group, still possess normal sized rib cages.
Pullovers
won't expand your rib cage; but there's a good chance that,
in time, doing them will cause shoulder or other injuries. One
example: The exercise can stretch the connective tissue that
forms the vertical ``midline" between the abdominals. If that
tissue tears, you have a hernia of the median rectus, which
produces a slight bulge in the center of your abs that increases
in size when you strain. A hernia of the median rectus is of
little clinical significance, but it's certainly not what you
were trying to develop! (If you have such a bulge in the center
of your abs, don't attempt to diagnose it yourself. Several
conditions could be responsible.) Pullovers also put tremendous
stress on the posterior aspect of the shoulder; even before
you sustain a clinical injury, they can cause a great deal of
pain.
The bottom
line: Pullovers won't enlarge your ribcage, and their high potential
to injure the rotator cuff and other structures far outweighs
whatever minimal muscular gains they may promote.
4. UPRIGHT
ROWS
Prime Mover: lateral and anterior delt
Secondary Mover: upper trapezius
One exercise
you should eliminate from your weight training program is the
Upright Row. This exercise places the shoulder in internal rotation
as the arm is raised, a position that does not allow sufficient
space for the greater tubercle to clear the acromion.
Supposed
``proper form" requires pulling the elbows as high as possible.
This simply increases the degree of internal rotation and magnifies
the danger of impingement.
The onset
of pain from Upright Rows often is not immediate, although it
may be. Usually the inflammation in the tendons and bursae increases
with shoulder motion after the workout is over. Pain may develop
hours or days later, making it difficult to associate the pain
with a particular exercise. People with this inflammation usually
feel pain during any stressful shoulder exercise —such as Bench
Presses, Incline Presses, Behind-the-Neck Presses, Behind-the-Neck
Pull downs, Pullovers, and Military Presses.
Upright
Rows accelerate rotator cuff degeneration. If you do them, you
risk developing chronic tendonitis or bursitis.
-
Also see Rotator Cuff Tendinitis and What
Goes Wrong with Your Rotator Cuff
