In the world of 2020, humanity has developed a plethora of struggles like spending long periods in chairs, looking at various screens for hours, and chronic lack of sleep. With the development of modern technology, pulling more focus forward and down to the devices in hand, humans have developed tighter, less functional shoulders than ever before. This makes one movement extremely difficult: simply putting the arms overhead and maintaining all proper alignments and positions, making certain overhead squatting, pressing, and pulling movements very difficult to achieve.
In this article, EXOS Physical Therapist Dr. Adam Fetter joins to give his perspective on joint range limitations for overhead shoulder stability and Central Athlete Coach Steven Fritsch provides exercises and drills to achieve proper joint range of motion and build a strong overhead position.
Before a client can jump right into specific exercises to train the overhead position, prerequisites must be met. Dr. Fetter describes how an adequate amount of shoulder rotation must be met in order to establish proper alignment and positions while stabilizing external load overhead:
Missing Rotation and the Misconception of Proper Overhead Stabilization
“Shoulders back and down”, referring to the shoulder blades (scapulae) being in a retracted position, is a cue often used amongst coaches and physios to improve client/patient posture and joint safety. While in many cases, this is indeed a safer position for the shoulder, “shoulders back and down” is not a catch-all cue for all upper extremity exercise.
See the below images for an understanding of the different mechanics of the scapula. In an overhead position, the scapula should be orientated in an upwardly rotated position. The reason for an upwardly rotated scapula is that this position creates the greatest contact between the humerus (arm bone) and glenoid fossa (socket part of the scapula), without allowing for excessive pinching of soft tissue (such as the supraspinatus and other muscles) in this region.
In anatomy, there is no right or wrong position of the shoulder or shoulder blade. The shoulder complex simply has the ability to move in a variety of motions. Only when external implements are loaded onto the shoulder can the conversation start about more ideal and less ideal positions.
In regards to holding an external load in the overhead position, there are some critical features to allow for more stability and safety. The most important consideration that must be taken into account is the object overhead in regards to the center of gravity of the entire body. The closer the object is to the line of center of gravity, the less force there will be required to maintain the object in this position. In more practical terms, imagine holding a barbell overhead with the bar being directly over the spine versus the bar being held several inches in front of the head. If the bar is aligned directly over the spine, the supporting musculature can stabilize the bar in place very easily, whereas if the bar is several inches in front, the muscles of the shoulders and upper back have to work very hard to stabilize and hold the bar securely in place.
In order to get the object into a position that is in line with the center of gravity, the scapula must be able to upwardly rotate without restriction and the humerus must be able to rotate freely. The amount of rotation required will depend on the individual and the limitations that could restrict the shoulder from rotating as it was originally intended.
With a better understanding of the shoulder complex, we can start to dive into how to improve the overhead position. The marriage between appropriate glenohumeral rotation and scapular upward rotation allows for the most ideal position. Experiment with rotating the shoulder inward and outward with a light object overhead. You will find that during a portion of the rotation, the shoulder will be in a more stable position with the object oriented over the centerline of gravity. If you find that you can not orient the object over the centerline of gravity, or you have to compromise the position of your spine in order to do so, you likely have a tissue restriction limiting this ability. Below are some exercises that address scapular upward rotation and shoulder rotation to improve the overhead position.
The first two exercises will address the capacity of the scapula to upwardly rotate and the capacity of the shoulder to rotate (addressing the limitations that are most often caused by having more focus down and forward). The last three exercises will force improved overhead mechanics with the newly developed shoulder complex mobility.
Serratus Wall Slides
The serratus wall slide improves the strength of the serratus anterior (the muscle involved in creating an upward rotation of the scapula) and brings awareness to the scapula position when moving into an overhead position. The client will press the forearms into the wall and slide up and down maintaining the pressure through the forearms. Notice how the scapula moves into a beautiful upward rotation position as the arm nears the overhead position.
The sleeper stretch improves posterior capsule stiffness and rotational capacity of the shoulder into internal rotation. In the side-lying position, make sure to keep your shoulder on the ground and oriented at about 45 degrees toward your body. Aim for a MILD stretch for about 2 minutes per shoulder.
After a client ensures that adequate joint range of motions are met, now is the time to start adding in specific exercises to strengthen the overhead position. Included here are the Turkish Get Up, RNT Barbell Overhead Squat, and the Sott’s Press.
Turkish Get Up
The Turkish Get Up (TGU) is probably the most complex, but arguably one of the most beneficial exercises for not only overhead stability but overall global kinesthetic awareness and coordination. The TGU requires the most coordinated series of movements in order to complete a successful repetition.
The movement starts with the client lying face up on the ground, with a kettlebell in one extended arm. The client initiates the movement with the trunk, sitting up to the opposite elbow, before switching to an extended arm for support. The client will then perform a bridge of the hips by extending the glutes fully, bringing the same side leg behind to a lunge position, then return to standing, all while keeping the extended arm holding the kettlebell pointing straight up to the ceiling. This ensures that while the cilent is going through these coordinated, independent movements, the shoulder has to constantly work hard to stabilize the extended arm to balance and support the kettlebell.
RNT Overhead Squat
The RNT (Reactive Neuromuscular Training) Squat is an advanced overhead squat variation that uses external resistance, such as bands, to improve movement quality by facilitating an automatic, subconscious response at the neuromuscular level. This can translate into improved movement patterns with less compensation.
With the overhead squat variation, the client will attach bands to either the barbell or directly to the arms, with the bands pulling from the front. Cueing “reach up, and reach out” with the bar overhead, this forces the client to use the musculature of the shoulders, upper back, and trunk to retract, and actually pull the bar back into the correct overhead position. This makes stabilizing the barbell overhead much more active for the supporting musculature, therefore forcing these muscles to contract harder and spend more time under tension in the specific overhead squatting movement.
The Sott’s Press is a great exercise for developing strength as well as mobility in the bottom overhead squat position. The traditional Sott’s Press is performed in the front rack position with a clean grip. The client will take their grip and lower down into a full front squat position. Once stable in the bottom front squat position, the client will then begin the overhead pressing motion of the barbell, while simultaneously driving hips down deeper into the squat position. Utilizing the cue “reach up, and rotate out” can help orientate the scapula and humerus into a more optimal alignment. This exercise also has a snatch grip variation if the lifter is unstable specifically in the overhead snatch position.
The overhead position is not an easy position to achieve and to maintain. It requires a good deal of joint range of motion, muscular strength and stability, and coordination of all of the different segments of the body. But, once the required joint range of motions are met, then the pattern can be trained just like any other. If you would like to be stronger and more confident overhead, or just want your shoulders to get out of pain, schedule a FREE strategy session with one of our professional coaches to see all that Central Athlete can offer inside and outside of the gym.