Preventing Common Shoulder Injuries in Bodybuilding

As a bodybuilder, the last thing you want is shoulder pain. Your shoulder joint is pivotal to every upper-body exercise, so an injury can quickly curtail your training.

Fortunately, shoulder pain is not an inevitable consequence in the pursuit of sculpting the perfect physique.

As a veteran personal trainer, I’ve worked with competitive and recreational bodybuilders for 35 years. The majority of my guys have remained injury-free by:

• Warming up thoroughly
• Using proper form
• Adding strength and mobility exercises

This comprehensive guide lays out a template for preventing common shoulder injuries as a bodybuilder. Here’s what we’ll cover:

• Shoulder Anatomy and Mechanics
• Proper Warm-up
• Technique and Form
• Strengthening and Mobility
• Rest and Recovery

Shoulder Anatomy and Mechanics

The shoulder possesses a greater range of motion than any other joint. Its function results from the complex interplay of:

• Bones
• Joints
• Ligaments
• Tendons
• Muscles
• Nerves
• Blood Vessels
• Bursae

The bones that feed into the shoulder joint are the humerus (upper arm), the scapula (shoulder blade), and the clavicle (collar bone). A part of the scapula called the acromion forms the shoulder roof.

Four joints make up the shoulder. The main one is the glenohumeral joint, where the ball of the humerus fits into the glenoid, which is a shallow socket on the scapula. The clavicle meets the acromion at the acromioclavicular (AC) joint.

The sternoclavicular (SC) joint connects the clavicle to the sternum on the front of the chest. The scapulothoracic joint is a false joint formed when the shoulder blade glides against the rib cage. For the socket of this joint to be correctly aligned during shoulder movement, the muscles surrounding the shoulder blade must work together.

The ends of the bones that feed into the shoulder joint are made of articular cartilage. It has a rubbery consistency and is very slippery, allowing the bones to slide against each other with minimal friction. It also absorbs shock in the joint.

Ligaments connect bone to bone. A joint capsule is a water-tight sack that surrounds the joint. In the shoulder, it comprises several ligaments connecting the humerus to the glenoid. These ligaments are the shoulder’s primary source of stability.

The rotator cuff muscles are situated just outside the shoulder joint. They lift the arm and rotate the shoulder in all directions, keeping them stable.

The deltoid muscle lifts the arm up and out to the sides. It comprises three heads, each with a separate function. The lateral, or side, head raises the arm sideways until the humerus is nearly perpendicular to the torso.

The deltoid’s anterior or front head participates in any action that pulls the humerus forward and upward. This includes pressing movements, such as overhead presses and chest presses.

The posterior, or rear, deltoid pulls the humerus back and down. It also helps with the external rotation of the humerus.

Proper Warm-Up

By running through a targeted warm-up routine for your shoulders, you activate the muscle tissue around the joint to help stabilize it and improve mobility during shoulder exercises.

You’ll also increase blood flow to the muscles, tendons, and ligaments and warm up the synovial fluid inside the shoulder joint. This helps the bones glide across each other more smoothly.

Here are three warm-up exercises that will prepare your shoulders for the work to come:

1. Internal/External Rotation

1. Grab a light dumbbell and lie on the floor on your back with your knees bent.
2. Hold the dumbbell in your right hand and bring your right arm out so the elbow is at shoulder level, resting on the floor. Bend the elbow to 90 degrees so the lower arm is perpendicular to the floor.
3. Place your left hand on your right shoulder and press down gently.
4. Lower your forearm to go down as far as you comfortably can. This provides internal rotation.
5. Now reverse the motion, taking the forearm back as far as you comfortably can. This provides external rotation.
6. Do ten reps on the right side and then repeat on the left.

2. Resistance Band Pull

1. Grab a light resistance band with an overhand grip. Your elbows should be at shoulder level, and your arms extended in front of you so they are parallel to the floor.
2. Pull the band apart until your hands are in line with your shoulders. Keep your elbows locked so the entire movement comes from the shoulder joint.
3. Slowly return to the start position, maintaining tension the entire way.
4. Do 10 reps on this exercise, switch your grip to underhand, and do another 10 reps.

3. Shoulder Dislocator

1. Grab a light resistance band with an overhand grip and hold it at arm’s length with the band against your thighs.
2. Without bending your elbows, bring your arms up over your head and behind you until the band touches your butt.
3. Perform 10 repetitions of this exercise.

This three-exercise routine takes no more than three minutes to complete. Yet, it will fortify your shoulder joint so it’s ready to perform heavy work without compromise. You should build this warm-up into every upper-body workout.

Technique and Form

Due to its complexity, the shoulder joint is the most vulnerable to injury when working out. Perfecting your form to avoid excessive internal or external rotation is critical to injury prevention.

In my experience, the three exercises that are most likely to cause shoulder injury are the bench press, the overhead press, and the lat pulldown. So, let’s zoom in on those three and lay out the proper technique to avoid shoulder pain.

Bench Press

If you do the bench press correctly, you should not feel shoulder pain. However, if you do it incorrectly, all sorts of problems can result. These include the bursae that lay over the shoulder, the biceps tendon, and the rotator cuff.

Here are five form tips to prevent shoulder pain when bench pressing:

Line Up the Bar

The bar should be above your mid-chest when you lie on the bench. You risk excessive external shoulder rotation if your head is too far from the bar. Conversely, if your head is too close to the bar, it can also lead to excessive external rotation.

Grip the bar with an overhand grip about one and a half times your shoulder width. A wider grip than that will put too much strain on the rotator cuff and the long head of the biceps in terms of stability.

Do Not Bring the Bar too Low

You should not lower the bar beyond a point where your upper arms are at 90 degrees. Going lower than that can strain your shoulders, especially when pressing heavy weights. Alternatively, you can switch to floor presses to limit the range of motion. 

Focus on the Flat Bench

Different bench press angles affect your shoulders differently. The flat bench involves a neutral arm position and no external rotation of the rotator cuffs. However, when you perform an incline barbell, you introduce external rotation. The greater the bench angle, the more external rotation you will experience.

This external rotation puts a lot of strain on the ligaments that run over the front of the shoulder joint. Anterior shoulder stability could result, especially if you’re doing a lot of heavy incline pressing.

When it comes to shoulder health, the decline bench press is a better option than the incline version. That’s because it places the shoulder joint in slight internal rotation. This does not strain the ligament the way the incline press does.

Overhead Press

If you have been overhead pressing behind your neck, you should stop immediately. This puts the shoulders into an extended external rotation position, which creates anterior shoulder instability.

Doing a lot of heavy lifting in this position will overstretch the ligaments and cause instability, which may make your shoulder joint pop. The behind-the-neck press also forces your neck forward, which can strain the cervical spine.

You should do the overhead press from a front rack position while using a shoulder-width overhand grip.

Whether you’re using a barbell or dumbbells, grasp the weights with a shoulder-width forward-facing grip. You will be strongest (and safest) when your hands are directly above your elbows. In the beginning position, the weight should be at the upper chest level.

When pressing, your arms should travel directly up. Do not allow them to come forward and up in an arcing movement.

The final piece of advice with the overhead press is not to use a weight that you can’t handle safely. If the weight is too heavy, your arms will drift back over your head, and you’ll probably end up with a failed behind-the-neck press.

Lat Pulldown

I’m often asked whether the lat pulldown should be done to the front (pulling to your upper chest) or to the back of the neck. From a shoulder health point of view, the front pulldown is a better option because it reduces external rotation. However, there is an even better option.

Next time you get on the lat pulldown machine, lean your torso back to a 30-degree angle rather than assuming an upright position. Now, pull the bar down to your sternum.

This position will engage your lats more while also reducing shoulder strain.

Dumbbell Flyes

Dumbbell flyes allow for an awesome pectoral stretch and contraction. But they can also cause excessive external rotation of the shoulder joint, resulting in strain, pain, and possible impingement.

Here are three hacks to make this exercise shoulder-friendly:

1. Keep the weight manageable: If you go too heavy, you’ll be forced to engage the shoulders and biceps rather than isolating the pectorals. You’ll also force your shoulders and elbows back, causing excessive external rotation.
2. Don’t go below parallel: In the bottom flye position, your hands should align with your torso. Going any lower than that will overstretch your shoulder ligaments.
3. Don’t roll your shoulders forward: Keep the shoulders back and down to minimize deltoid involvement.

Strengthening and Mobility

Performing shoulder strength and mobility exercises will increase the shoulder joint’s stability, flexibility, and overall health. By strengthening the deltoids, rotator cuff muscles, and scapular stabilizers, you improve joint stability and reduce the risk of excessive movement or instability that can lead to injury.

Adding mobility exercises to your routine will increase shoulder flexibility, reducing joint strain during movement.

Here are five key shoulder strength and mobility exercises you should build into your routine:

Seated Cable Front Press

1. Place a back-supported bench about three feet before a cable pulley set at waist height. Connect two D-handle attachments.
2. Grab the handles with an underhand grip and sit on the bench,
3. In the starting position, your hands should be at your sides with your elbows slightly forward and palms facing forward.
4. Press your arms up in a scooping motion so that your hands meet in line with your chest,
5. Lower and repeat.
6. Do four sets of 20, 15, 10, and eight reps. Increase the weight of each set.

Cable Side Lateral Raise

1. Set the cable pulley at hip level.
2. Stand with your side toward the machine, about two feet away from it.
3. Grab the cable handle with your outside hand.
4. The arm closer to the pulley should be at your side in the start position.
5. Without bending your opposite elbow, bring your arm up to just short of shoulder level.
6. Lower under control and repeat.

Cable Rear Delt Fly

1. Set the pulleys on a double cable pulley machine to their highest setting and remove the handles from the end of the cables.
2. Grab the ends of the cables in a cross-over grip so your left hand is holding the right cable and vice versa, and stand about two feet from the machine, facing it.
3. From the starting position, where your hands are in front of your chest, bring your hands down and to the sides of your waist.
4. Return under control and repeat.

External Rotation Lift

1. Lie face down on the floor with your arms by your sides and your palms facing up.
2. Move from the shoulders to bring your hands up and down in a rhythmic motion. Keep your head on the floor throughout.
3. Perform 20 reps of this exercise.

Internal Rotation Lift

1. Assume the same start position, except that your palms are facing down this time, and your arms are extended at a 45-degree angle.
2. Lift your arms up and down in a rhythmic motion. Keep your head down throughout this exercise.
3. Perform 20 reps.

Neutral Lift

1. Lie face down with your arms out perpendicular to your torso.
2. Keep your head down as you bring your arms up and down in a controlled rhythmic movement.
3. Perform 20 reps.

Rest and Recovery

Your shoulders are involved in virtually every upper body exercise. So, if you’re hitting your chest on Monday, your back on Tuesday, and your arms and shoulders on Wednesday, your deltoids are getting hammered daily. Unless you schedule in time for rest and recovery, you’re likely to suffer an overuse injury like bursitis or tendinitis.

Your recovery plan should include having at least one day of no weight training per week. On that day, you should do some active recovery. This involves light activities that you can do while carrying out a conversation. Examples are walking, recreational cycling, and playing golf.

Ensure you get seven to nine hours of uninterrupted sleep each night. When you’re sleeping, your body undergoes most of its recovery, maintenance, and rebuilding work. Make your bedroom a tech-free zone, and keep it cool, dark and quiet.

Conclusion

Taking care of your shoulders starts with educating yourself about your shoulder joint’s complex and intricate make-up.

This should inspire you to take a few minutes at the start of your workout to warm up and to check your technique on pressing and pulling exercises to ensure your form is on point.

The five strengthening and mobility exercises described in this article will help develop joint stability and reduce the risk of excessive movement or instability that can lead to injury. And don’t forget the importance of rest, recovery, and listening to your body to keep those shoulder injuries at bay.

Read also: Common Bodybuilding Injuries and How to Avoid Them

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