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STRONGER SHOULDERS: Reduce injuries – strengthen key muscles in the upper back and shoulders

Published: Monday, May 5, 2014 3:09 p.m. CDT

Want to reduce the risk of injuring the upper back and shoulders? Strengthen them. Here’s how:

Where to start

Let’s begin with the round-shouldered position so many of us assume so much of each day as we sit at our desk or slouch on our couch. Although not necessarily a true curvature of the spine, this postural problem can lead to considerable discomfort in the upper back area.Some exercises actually can exacerbate this condition by strengthening the protraction muscles of the chest and stretching the retraction muscles of the upper back. This can occur in trainees who emphasize upper body pushing exercises such as pushups, bench presses and incline presses over upper-body pulling exercises such as pull-ups, pull-downs and seated rows.

Practice perfect posture

A simple preventive measure is to maintain proper posture as much of the time as possible, especially when sitting. Try to keep your head up, chest high and shoulders back for an erect torso position that places less stress on your lower back, upper back and neck muscles.I also recommend performing specific strengthening exercises for the retraction muscles of the upper back, namely the rhomboids and trapezius groups. These muscles are best addressed by the seated row machine exercise, the rear delt machine exercise, the dumbbell bent row exercise and the dumbbell prone fly exercise.Each of these exercises will effectively strengthen the upper back retraction muscles when performed correctly with an appropriate resistance. As a minimum, do one good set (eight to 12 repetitions) of one of these exercises, two non-consecutive days a week.

Upper back/neck pain

A related problem is upper back/neck pain that might result from a forward head position. Your head is relatively heavy (12 to 14 pounds), and poor head posture can place undue stress on the upper trapezius and other neck extensor muscles. In some cases, this can lead to the dreaded dowager’s hump, so it is important to intervene as soon as possible.While simple awareness and postural adjustment might be sufficient for slight deviations, most people will benefit from specific neck strengthening exercises.Both the neck and shoulder machine and the four-way neck machine are effective and efficient means for increasing strength in the neck extension muscles. If these weight stack machines are not available, I suggest using manual resistance as a simple-to-apply alternative.Begin the manual resistance neck extension with an erect seated posture, your head downward/forward and your hands behind your head with fingers interlaced. Lift your head upward/backward against the applied resistance of your hands in about five seconds. Return to the starting position and repeat 10 times.

Shoulder pain

Shoulder pain is all too prevalent among middle-aged and older adults. Most often, however, the visible shoulder joint muscles are not responsible for the shoulder discomfort. It is typically the underlying rotator cuff muscles that succumb to injury.These relatively small but incredibly important muscles hold the shoulder joint bones together and produce force for three aspects of arm/shoulder movements.The subscapularis muscles are largely responsible for internal rotation of the shoulder joint; the teres minor and infraspinatus muscles provide external rotation of the shoulder joint; and the supraspinatus muscle assists with shoulder abduction actions (lifting the arms upward from the sides). Explosive and repetitive movements (golf driving, baseball pitching, tennis serving, swimming) can damage weak rotator cuff muscles.Rotator cuffs

The first step for preventing rotator cuff injuries is to use proper biomechanical technique when executing throwing or striking actions and when engaging in repetitive arm activity, such as swimming. The second step is to perform specific strength exercises for the rotator cuff muscles. I recommend the following elastic band exercises for strengthening the internal and external rotators:Attach the elastic band securely to a door or stable object at waist level. Stand far enough away so the band is taut with your right upper arm against your side, your elbow bent at 90 degrees with your forearm turned outward away from your body. Keeping your upper arm stationary, pull the band across your body (counterclockwise) until your right forearm fully contacts your midsection. Perform 10 carefully controlled repetitions, then switch to your left arm. This relatively simple shoulder movement strengthens the internal rotation muscles.Next, face the opposite direction and begin with your right arm across your midsection. Pull the band across and away from your body until your right arm rotates clockwise as far as comfortable. Perform 10 carefully controlled repetitions, then switch to your left arm. This action strengthens the more troublesome external rotation muscles.

Wayne L. Westcott, Ph.D., teaches exercise science and directs fitness research classes at Quincy College in Massachusetts.

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