I’ve used that kind of slogan in other ways: “If you want to fix shit you need to lift shit.” “If you want to fix shit do shit right.” “Shit, shit, shitty, shit.” There’s a T‑shirt somewhere in there. Needless to say: one, I have a potty mouth, and two, I believe strength training isn’t just a great way to get stronger—it can also help address movement blocks or what some call dysfunction.
Owning position(s)
I work with many people who complain of shoulder pain, especially during overhead movements. There are lots of possible factors: tight lats, weak front core, tight pecs, and plenty of other things that can go awry. I think any coach should put on their detective hat, dig a little deeper, and try to find the root cause of someone’s discomfort. A quick note: be careful with scope of practice and don’t diagnose. It frustrates me when trainers pretend to be physical therapists or doctors and diagnose clients. We can assess movement and use that information to guide programming, but stay in your lane and avoid diagnosing.
Back to why the shoulder hurts. All the factors mentioned can play a part, but one often overlooked aspect is how the shoulder blades and rib cage move together. Can a concave shoulder blade work well with a convex rib cage? One way to help this is to give the Serratus Anterior muscle a lot more attention. The Serratus is a reaching muscle that helps the shoulder blade move around the rib cage. For those told to keep the shoulder blades “together & back”—which is important for lifting heavy things—it can sometimes lead to faulty mechanics where the blades become too stationary. When the shoulder blades don’t move, that’s not good.
Renowned physical therapist Shirley Sahrmann popularized the term “Scapular Downward Rotation Syndrome” in Diagnoses and Treatment of Movement Impairment Syndromes. Downward Rotation Syndrome can arise from overactive or tight rhomboids, levator scapulae, and lats. Symptoms can range from altered shoulder joint motion and instability to neck pain, and in extreme cases, thoracic outlet syndrome. It can sound intimidating, but the fix can be quite accessible. Anything that promotes more reaching (protraction) and better rib cage expansion can be very helpful.
You can see both concepts in action in what’s probably the most boring video on the internet. First, as I press my hands forward, I’m thinking about reaching as far as I can in front of me (not keeping the shoulder blades still). Hello, Serratus. Second, as I progress overhead, I reach upward toward the ceiling while keeping the lower back honest and ribs down. Both Serratus and upper traps play a role in upward rotation—the shoulder blades are meant to move.
At the top, I own the position by breathing: inhale through the nose to expand the rib cage all around, then a full, deliberate exhale to pull the ribs down and establish a canister position with the rib cage stacked over the pelvis. It’s harder than it looks. Pants optional.
If you want to improve overhead motion or simply help people’s shoulders feel better, it’s essential to get the shoulder blades and rib cage working together and owning better positions. Favor Serratus activation and positional breathing over endless band external rotation drills.
Props to Luke Worthington and Conor Harris for the idea.
For the record, I avoid using words like “dysfunction” or “broken” when talking to clients or athletes. There’s too much fear-mongering in health and fitness, and we do no one any favors by making them feel like a walking disaster that needs to be fixed. This isn’t to say some people don’t need more attention to detail and a corrective approach. However, letting people TRAIN—finding their trainable options and feeling less like patients—yields huge improvements.
