I’ve used ideas like this before: to fix a mess you have to lift, and to fix it right you have to do the work properly. I’m open about my potty mouth, and I’m a firm believer that strength training isn’t just a great way to get stronger—it can also help address movement blocks that hold people back.
I often work with people who complain of shoulder pain, especially when doing things overhead. There are lots of possible factors: tight lats, weak front core, tight chest muscles, and who knows what else. A coach should put on their detective hat, dig a little deeper, and try to find the root cause of someone’s discomfort.
It’s also important not to diagnose like a clinician. I avoid acting like a medical professional, and I never want to blur the line between coaching and healthcare. Assessing movement and using that information to guide programming is in our wheelhouse, but we should stay in our lane.
Back to why shoulders hurt. One often overlooked factor is how the shoulder blades move with the rib cage. Can the shoulder blades glide smoothly around the rib cage, or do they get stuck in place? A key fix is to give the Serratus Anterior muscle more attention. The Serratus helps the shoulder blade reach around the rib cage, and keeping the blades mobile is crucial. For years, some people have been told to keep their shoulder blades “together and back,” which can lead to faulty mechanics if they end up immobilized. Movable shoulder blades are essential.
Shirley Sahrmann popularized the idea of Scapular Downward Rotation Syndrome. It can stem from overactive or tight rhomboids, levator scapulae, and lats, and symptoms range from altered shoulder joint motion and instability to neck pain, and in extreme cases even thoracic outlet issues. The good news is the fix is often straightforward: allow more reaching (protraction) and better rib cage movement.
To help, we want more activation of the Serratus and better coordination with breathing. Both Serratus and upper traps play a role in upward rotation, and the shoulder blades are meant to move.
In practice, the goal is to avoid forcing the shoulder blades to stay fixed. When you reach forward, don’t lock the blades in place. As you lift overhead, think about reaching up while keeping the ribs down and avoiding a cheat with the lower back. At the top, own the position by breathing: inhale through the nose to expand the rib cage, then exhale fully to bring the ribs down and stack the rib cage over the pelvis. It’s harder than it looks.
If you want better overhead motion or just more comfortable shoulders, you need the shoulder blades and the rib cage to work as a team. Favor Serratus activation and mindful breathing over endless band-based rotation drills.
Credit to Luke Worthington and Conor Harris for the idea. I’m against using terms like dysfunction or broken when talking to clients. There’s too much fear in health and fitness, and labeling someone as broken only holds them back. Some people do need careful, corrective guidance, but empowering them to TRAIN with a plan that fits them—making them feel capable—delivers real gains.
