If you missed Part I of Dr. Licameli’s guest post, you can read it here. Today’s post distills yesterday’s ideas, but you might miss some fine details. It’s a bit like watching Blade Runner 2049 without the original film—you lose important context.
This is where you’ll see what points 1–4 were about.
5) Don’t push through pain…not all the time, anyway
There’s good pain and there’s bad pain. Telling the difference is crucial when you train the shoulders.
We’re not talking about delayed onset muscle soreness (DOMS), which shows up 1–2 days after a workout. We’re talking about pain felt during training.
These are general guidelines. If you have pain, see a qualified healthcare practitioner.
A qualified professional will explain all this and offer options to keep training while you recover.
Not every physical therapist has spent a lot of time under a bar. Some have, some haven’t. You deserve care that respects your goals and doesn’t suggest irrelevant solutions like stopping squats for weeks or doing basic band work to “strengthen” the rotator cuff—only to find those ideas don’t fit your needs.
Characteristics of good pain:
– How it feels: Muscle burn, usually similar on both sides.
– Onset: Builds gradually during the set.
– When it stops: At the end of the set.
Characteristics of bad pain:
– How it feels: Sharp, numb, or tingling; may be uneven between sides.
– Onset: Quick; can appear after only a few reps.
– When it stops: It can linger for days, weeks, or longer, even after the set ends.
If you feel bad pain, it doesn’t have to be the end of the world. Be flexible with your training. If pressing overhead with a barbell hurts, try a landmine press. If you can’t do a reverse fly, try a face pull. You can keep the same exercises and adjust training volume to make it work.
6) Don’t overdo the classic “rehabilitation” and “injury prevention” exercises. Some classic moves still have value.
Physical therapy has a reputation for piling on rehab exercises. The idea that pain relief or injury prevention requires a long list of “therapeutic” moves is common, but not universal.
In my view, the line between therapy and regular training should blur. You don’t need a half-hour block just for foam rolling and selecting isolation moves. Look for what your existing routine already provides for healthy shoulders. Examples:
– Face pull: Builds scapular retraction and external rotation; supports scapular stability and the rotator cuff.
– Farmer carries/Overhead carries: Great for posture, scapular control, and overall shoulder stability, plus core and total-body strength.
– Plank on a ball with protraction and/or the ab wheel: Dynamically trains the serratus anterior, core, and scapular stability.
– Plank with a band around the wrists with protraction: Targets external rotation and serratus anterior, plus core and scapular control.
– Landmine press: With proper scapular movement, strengthens the serratus anterior and improves scapular neuromuscular control.
– Pull-ups/pull-downs: If you initiate the movement with scapular depression, you target the lower traps and improve scapulohumeral mechanics. A full range of motion and a long eccentric can help lengthen the lats and improve shoulder mobility.
– Squats/deadlifts: Teach shoulder packing. A proper warm-up should include thoracic mobility work.
Seek guidance from experienced professionals like Tony Gentilcore, Andrew Millett, John Rusin, Jeff Cavaliere, Quinn Henoch, Mike Reinold, Mike Robertson, Eric Cressey, Dean Somerset, Zach Long, Joel Seedman, Ryan DeBell, Teddy Willsey, and others. But if you have pain, see a qualified healthcare practitioner first.
7) Symmetry…don’t forget external rotation and thoracic mobility
Weightlifters often rely on internal rotation, for good reason. Muscles that internally rotate the shoulder include the pec major, lats, subscapularis, teres major, and front deltoid. External rotators include the infraspinatus, rear deltoid, and teres minor.
Because the internal rotators are larger and stronger, simply matching presses with rows won’t fix rotation symmetry. Even though rows and pull-downs are “back” work, they still train the lats and internal rotation.
Favored ways to train external rotation include face pulls, W raises/pulls, reverse flyes with an external rotation bias, wall slides with a band, and planks with a band around the wrists.
Adequate thoracic mobility is essential for shoulder function. If the scapula is the foundation of the shoulder, the thoracic spine is the ground on which that foundation sits. Include thoracic mobility in almost every warm-up, regardless of the body part.
One of my go-to thoracic mobility moves is a kneeling protraction sit-back into a lat stretch with deep breathing. There are lower-body warm-up routines that incorporate this as well.
8) Don’t pin down the scapulae
The idea of keeping the shoulders “down and back” can become an extreme. You’ll see suggestions that dynamic stretching is better than static, or that foam rolling should be done for long, obsessive periods. The bottom line is that the scapulae must move, and they must move correctly. The scapula is the base and foundation of the shoulder; dysfunction here can lead to injury.
Note from TG: I’ve written another article on how this relates to performing a dumbbell row correctly.
In general, the scapula remains fairly still during the first 30 degrees of shoulder abduction (as you lift the arm to the side in a lateral raise); the movement mostly comes from the glenohumeral joint. Once abduction goes beyond 30 degrees, the scapula begins to move, and the glenohumeral and scapulothoracic joints work together in roughly a 2:1 ratio.
At about 120 degrees of abduction, the glenohumeral joint contributes roughly 80 degrees and the scapula about 40 degrees. If the scapula stays pinned down and back, range of motion is restricted, and the shoulder joint has to compensate, increasing injury risk.
Along with upward rotation, the scapula also needs to protract (move forward) during overhead and pulling movements. The serratus anterior is a key muscle for protraction and for keeping the scapula against the ribcage. Pinning the scapulae down and back isn’t what we want—we need controlled, functional scapular motion.
I’m done
If even one person benefits from these tips, I’ve achieved my goal. Keep these ideas in mind and work toward stronger, healthier shoulders.
