You Can’t Just Balance Push & Pull (Part Two)

When we parted last time out we were stuck with a programme the fuelled the internal rotators at the expense of the external rotators. The second part of this double header will look to explain why this becomes problematic and, of course, how to go about solving it.

 

A little recap on the anatomy of the shoulder joint

Why Is IR/ER Imbalance A Problem?

Imbalances are never a good thing, but what’s so bad about this little couplet in particular?

  • Loss of joint centration – the external rotators can’t match the pull of their adversaries and the head of the humerus is wrenched out of its normal resting position.
  • Shoulder impingement – excessive internal rotation of the humerus narrows the subacromial space and is a common source of shoulder pain.
  • Impaired proprioception – as demonstrated by Machner et al (2003), impingement and lack of centration reduces the kinaesthetic awareness and the ability to stabilise the shoulder.
  • Increased injury risk – unsurprisingly, weak external rotators, a loss of centration and impaired proprioception is a great combination if you’re looking to injure yourself.
  • Impaired strength and power – if your body thinks that a particular component is weak then it will effectively cut off the power supply and limit muscle activation as a protective mechanism.

    You know it's bad when it starts glowing

Guidelines For Balance

Before you start any journey it’s a good to where you want to get to. No specific references for these, I’ve compiled them from a few different sources and come to some sort of consensus with them.

  • Strength Balance – concentric strength of the external rotators should be at least 80% of the internal rotators
  • Training Load – a training volume of between 1:1 and 1:2, dependent on the level of imbalance, in favour of the external rotators

Shoot for these goals and your shoulders will thank you in the long run.

Modifying Pressing Exercises

As they are often the bane of the problem, we’ll start by addressing the compound movements. Pressing will never be fantastic for external rotation, but let’s look at some substitutions and alterations we can employ to make them little more shoulder-friendly.

  • Swap barbells for dumbbells or kettlebells – barbells keep you locked in a pronated position so, as pronation feeds internal rotation, the potential for supination that is offered by DB’s and KB’s makes them a better choice.
  • Supinate as you press – just as pronation feeds internal rotation, supination feeds external rotation.
  • Abduct the shoulder as you press – I wouldn’t advise supinating and adduction together, however, abducting the shoulder creates an external rotation moment on the humerus and increases activation of the external rotators (Southgate et al, 2009).

Here are a few specific exercise substitutions:

Modifying Pulling Exercises

Last time out we identified that pulling exercises were a problem predominately because of the emphasis the place on the lats (due to their insertion on the humerus the lats are internal rotators of the shoulder). Here’s how we will adapt the pulling exercise to help meet our goals.

  • Use rings or suspension trainers instead of straight bars – same rationale as for using DB/KB’s, these will both let the shoulders rotate as you pull.
  • Supinate as you pull – same as with pressing, supination feeds an external rotation moment as you pull.
  • Chose pulling exercises that take the emphasis off the lats – the rhomboids and traps attach on the scapula, and therefore don’t pull on the humerus, whilst the posterior deltoid is an important external rotator.

Here are a few specific examples:

Isolated Strengthening

Makes subtle changes to the compound exercises is all very well, but if there is a substantial deficit in external rotation strength then compound exercises won’t be enough to cut the mustard (Giannakopoulos et al, 2004). Going through a comprehensive summary of external rotation training goes far beyond this article but here’s a selection of good exercise choices to get you started.

Isolated exercises should be performed at the start of the session, prior to compound exercises (Malliou et al, 2004).

Dynamic Stability (Proprioception)

In the majority of athletic circumstances shoulder stability is our number one concern. Strengthening in the conventional sense is of course important, but we need to get everything working in synergy too. For stability we must centrate the head of the humerus within the glenoid fossa – this is known as ‘packing’ the shoulder – and be able to maintain this position in the presence of perturbation. Here are some examples:

 

Whilst this double header has highlighted importance of balancing your internal and external rotation in your upper body training, it’s not the only factor. The scapular is complicated beast with a whole host of different articulations; all of these motions need to balanced too if we are get on top of things at the shoulder. That, however, is a topic for another day!

Stay strong, stay healthy!

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5 comments


  1. Darren

    This is the best article I have seen about balancing the shoulder movements. Many articles instruct us to balance pushing and pulling, but do not address the internal rotators vs. external rotators enough.

    A question? Since balancing pushes and pulls genearlly hits the internal rotators more, what is a better reccomendation? Should a certain number of external rotation exercises be done to balance internal rotation exercises?

    Should we stop thinking of push vs. pull? but instead think of IR vs. ER? Thanks for the great article!!

    • Maloney Performance

      Hi Darren.

      Thanks for your comments! No clear cut answers really so I’ll just give you my two cents worth. Strength wise I aim for a push-pull ratio of 1:1 with most (would change either way depending on sport – i.e. powerlifter vs rower) and IE-ER of 1:0.7-0.8 in pretty much all athletes. Volume wise 1:1-2 for both.
      I think both are important. However, I think we can get too obsessed with balance. Given that so many big muscles IR, and so few small muscles ER, I don’t think we’re built for balance. If we look at things from an evolutionary standpoint, it would make sense that the pushing muscles are more powerful (to push away things) and the pulling muscles more resistant to fatigue (to pull things in and hold them) but there’s not really a movement that would balance a throw. Would perhaps suggest that eccentric strength is the key for ER’s and maybe indicate that concentric IR to eccentric ER ratios are actually more important??

      Best wishes,
      Sean

  2. Dr. Robotnik

    Good article again Sean, as always.
    I really enjoy reading your tips and scrutinies of the scientific literature.
    Top lad. Good luck for your PhD

  3. Pingback: Free Range CrossFit | CrossFit in Tempe, AZ » WOD 6/7

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