Tips from performance expert Dr. Zaki Afzal

If your shoulder is bothering you and you aren’t sure why or how to find relief, you’re in the right place!

We’ve teamed up with a performance expert doctor for a really cool 6-part blog and video series called FIX YOUR BODY!

Today, we are focusing on SHOULDER PAIN!

If you do a lot of manual labor or hit the gym hard, you most likely have at least one part of the body that causes you some sort of discomfort.

Even if these pinches, aches, and pains seem minor or come and go —  it’s important to not brush them off.

Getting to the root of your muscle or joint pains and correcting them can not only prevent injury but can also make your workouts more effective! 

If your pain is muscle or joint related, you probably won’t need to see a doctor or therapist in most cases.

With the right expert guiding you, many body pains can be pinpointed and fixed at home!

We may know a lot about health and fitness here at V Shred and Sculpt Nation, but we aren’t doctors specializing in muscle and joint pains. So we called in performance physical therapist Dr. Zaki Afzal to help us out with this 6-part series.

Each week, Dr. Afzal offers his expertise as we work our way down the body to address the most common reasons people experience body pains and how you can correct them at home in an educated, safe, and simple way!

In Episode One, Dr. Afzal went over a few reasons people have neck pain and how to find relief at home! If you missed it, you can watch it HERE!

It was interesting to hear him explain why the source of most neck pain isn’t even in the neck! Everything is connected, so it makes sense that WHY you hurt isn’t always WHERE you hurt. 

The same goes for pain and stiffness in the shoulders. As you will learn today, when your shoulders hurt, the issue probably doesn’t even originate in the shoulder itself. 

Before we go over 3 reasons you could be experiencing shoulder pain and give you some easy at-home solutions, keep in mind that sometimes you need a one-on-one assessment from a professional.

DO NOT attempt any of the corrective exercises we are showing you if you have severe pain, accompanying issues such as numbness or tingling, or if you feel that your pain is not muscle or joint related. Speak to your doctor or a trained medical therapist.

3 SOURCES OF SHOULDER PAIN AND HOW YOU CAN FIND RELIEF AT HOME 

1:  RIB CAGE MOVEMENT
If you have shoulder pain when bench pressing, your ribcage could be the issue.

Because they are attached, if the ribcage doesn’t move the way you want it to, the shoulder blade will have a hard time experiencing full range of motion. 

Typically, this occurs because of internal rotation limitations, which generally happens due to the inability for the ribcage to move up toward the chest. 

In some instances, the issue could also be your sternum, which should move like a pump handle. If it’s not moving that way, you could have limited internal rotation, leading to shoulder issues.

To determine if either of these limitations are the source of your shoulder pain, you need to first test out your internal rotation range of motion. 

How To Access Rib Cage Internal Range Of Motion

• Lay on your back on a flat surface.  
• Bring the elbow of your right arm straight out to the side to form a 90-degree angle between your torso and arm. 
• Take your left hand and put it on top of your right shoulder to hold your shoulder blade down from the front, so it doesn’t move. 
• Lower your arm to see how far you can get your hand toward the table without the right shoulder blade coming off the table. You should be able to get to about 70-90 degrees. 

While you are in this position, go ahead and repeat going in the opposite direction to test external rotation. You don’t have to hold your shoulder down; just allow your arm to go back as far as you can without your shoulder lifting.

You should be able to go 90-degrees (flat/parallel to the ground) or further. If not, you could have limited external rotation. This is usually an upper back issue that manifests as neck pain, not shoulder pain, which we talked about last week in our neck pain video.

If you notice your external rotation is limited when doing this assessment, check out the 2nd corrective exercise demonstrated HERE. 

Corrective Exercise: Full Exhale Breathing
Getting the air OUT is what really unlocks the full shoulder and rib motion you need for healthy shoulders.

Something as simple as FULL exhale breathing can be the easiest fix. Yes, just breathing! But when done correctly, it’s a little more complex than it sounds!

• Lay on your back.
• Bend knees, with feet still on the ground. 
• Place a foam roller upright between your knees and squeeze with about 10% pressure. 
• Lift your toes and dig your heels into the ground (also about 10% effort.)
• Make sure your back remains flat on the ground/table.
• Take a deep breath in through your nose and then blow out ALL the air through your mouth (like you are blowing out candles.) 
• Two sets of about 5-6 reps should do the trick!

Helpful Tips
** Most people aren’t fully emptying their lungs. For this exercise to work, you need to get out every single drop of air.

** If you are doing this correctly, you should feel your lower abs come “on” pretty strong at the end of the exhale.

** If you don’t have a foam roller, you can also use a soccer ball or basketball. You just need something that is somewhat firm to put between your knees to squeeze.

2:  ISSUES WITH YOUR ROTATOR CUFF
If you feel pain in the front of your shoulder, it may be because of your rotator cuff.

To understand why it could cause your shoulder pain, it is important to quickly tell you what the rotator cuff is and what it does. 

The goal of the rotator cuff is to stabilize the shoulder ANYTIME it moves. 

If your rotator cuff doesn’t have control over your shoulder, it can lead to compensations that result in shoulder pain. 

One thing to keep in mind when correcting this issue is that the rotator cuff isn’t one muscle. It’s actually a collection of four muscles – the supraspinatus, infraspinatus, subscapularis, and teres minor. Three are located on the back of the shoulder blade, and one is underneath the armpit. 

You’ve probably seen similar exercises to the one we are showing you. However, there is a very unique way that you need to perform the movement if you want to isolate the correct rotator cuff muscle that will help keep your shoulders happy and healthy! 

Corrective Exercise:  Side-Lying Rotation
This exercise is a great way to target the infraspinatus – the small rotator cuff muscle that needs to be strengthened to possibly help correct the root cause of your shoulder issues! 

You’ve likely seen this exercise performed standing. But the best way to perform the movement, especially as a corrective exercise, is lying down.

Dr. Afzal explains why and shows you how to do it in this video, but here is a breakdown of how to do it.

• Lay on your left side.
• Pin your right elbow to your side. It should NEVER come away from your body at any time during this corrective exercise. 
• Relax your shoulder blade. 
• Make a fist and rotate your arm up and back (again, keeping your elbow pinned to your side at all times) as far as you can without letting your shoulder blade move. You only want your infraspinatus muscle activated.
• Try doing a few sets of 10-12 reps a couple times a week or on your upper body training days.

Important Form Tips
** If you are doing this exercise correctly and targeting the part of the shoulder we are looking to isolate (the shoulder/rotator cuff muscle), you should feel some fatigue in the back of the shoulder even with 10-12 reps with NO weight.

** If you start to feel fatigue toward your neck, you are probably shrugging your shoulders too much and not using the shoulder itself. 

3:  FOREARM DIRECTION WHEN PRESSING
The key for proper form with pressing (whether it’s overhead or in the front) is in the direction of the forearms!

The direction your forearms are pointing is where you are applying force. You always want your forearms pointing straight up and down. 

How To Correct Your Forearms During Chest Press
When benching, be it with a barbell or dumbbells, any deviation in any other direction other than perpendicular is wasted energy because you are pushing your force in the wrong direction!

If you are using positions like this, you may not instantly feel pain, but you are in a much less efficient position.

For a good visual, check out this video.  

How To Correct Your Forearms During Shoulder Press
This same thing applies when doing a shoulder press.

You don’t want your elbows too far back. This limits your shoulder motion and puts your body in a position where it requires a lot more strain to lift the weight.

If your forearms are pointed too far back, you won’t be able to bring them all the way down to your torso when you lower the weight down.

You certainly do not HAVE to go all the way down when pressing. There are many times you should not use full range of motion. We are just saying you should be ABLE to. 

An easy fix is to just bring your elbows forward into a natural plane of motion.

You will know you are in a proper plane of motion if you can lower your elbows down to your side.

In short, whether you are performing a bench press or shoulder press, if you want to keep your shoulders healthy and get the most out of your lift, you’ve gotta pay attention to your forearms! Make sure they are always straight up and down from start to finish!

We filmed a video that goes over each problem and solution in little more detail…. 

If you are serious about fixing your shoulder pains, we suggest you watch it before trying any of these corrective exercises!!

ALSO, DON’T FORGET ABOUT THE MOST IMPORTANT THING YOU MUST DO BEFORE TRYING ANY OF THESE SHOULDER PAIN SOLUTIONS!!

You need to consider the root of your pain! You should not attempt any of these exercises if your pains are extreme or not related to joints and muscles.

Please talk to your doctor, or if you are in the Las Vegas area, feel free to click here to contact Dr. Afzal. He would love to help you! 

Next week we are moving down the body. Make sure you check back; we will be talking about back pain! 

In the meantime, if you have any questions about this shoulder pain article and video, you can leave them in the comment section HERE.