What's up, guys? Jeff Cavaliere. Athleanx.com. Here I am with Jesse's replacement, Raymond.
So much better. Today we're going to talk about shoulder pain and impingement. And the fact is,
guys, you might be doing something right now to try to get rid of the pain that you get whenever
you raise your arm up overhead or that pinch that you get. But if you're not doing it all the way,
doing everything you need to be doing, then you might still be dealing with this and you're kind
of getting frustrated and wondering why. So I'm going to show you what you need to do to finally
get rid of this once and for all. But it always starts here with a little bit of anatomy because
we want to see what we're talking about. When we're talking about impingement, we're talking
about a muscle here most almost all the time the supraspinatus, which is one of the rotate
cuff muscles, that sits in this space here, okay? It comes underneath this space, which I'll show
you over here, gets pretty damn crowded and it attaches to the arm up at the top here. All right,
so when we get impingement, when we raise it up, this structure here can-- and I can say
can get pinched-- because it's not always the cause, okay? It can get pinched in here,
which causes inflammation of the tendon, pain, and then a cascade of other things that become
problematic whenever you go to lift and push your arms up overhead. You can see how crowded it is,
as I said. You have a ligament here, the coracoacromial ligament, that creates some space.
You have a bursa that sits under there. And then the tendon's supposed to run and fit underneath
there. It's not very roomy, okay? So when we have impingement we have problems. But the second
thing-- and this is what leads to really this long term cure-- is it's not always coming from the
actual pinching of the tendon from the top down. What can also happen is you get a compression of
the tendon from the bottom up. All right, so that means that if this tendon's here, and I were to
internally rotate, you start to get this bending of the ligament over the bone. More importantly,
you can see it when you bring your arm up across your body, you see how it kind of gets bent around
the corner, okay? As it gets bent around that corner, that becomes problematic because there's
a lot of tension there. To see that better, we look at this. If I were to demonstrate this,
let's say this is the arm at the shoulder, and this is the supraspinatus tendon. And I have a
load on this, so I push my foot in it. This would be simulating a weight in your hand. The load
right here is being directed straight down. But as I go and I bring the arm across the chest, right,
or I go into internal rotation, or I do both of them, look what happens as I start to wind
this up. As I start to wind that up and across my body, you could see all the compression now
that's underneath this band at this point. That's impacting this tendon from the bottom up, causing
inflammation, causing breakdown, causing tears. These are the problems. So if you're not just
addressing creating more room, you got to be able to address getting your body more accommodated to
this stress because this is going to happen. Your arms are going to go across your body. They're
going to do it whenever you workout. They're going to do it in a way that, especially even chest work
is going to go, and become a component of that induction that we talk about all the time. It's
a good thing. But you have to be used to that or it causes this inflammation down the road. So what
do we do? So we have a couple things. Number one: if you took a band here and you wanted to work on
improving your external rotation strength, which is critical, and I build it into all my programs
because I believe it's that important to do. All of us need to be doing work for our rotator cuff
strength. All right, so if I were to go and take this band and anchor it, your progression
would be the following. You would want to make sure that you started with something very easy,
which is an isometric contraction. So I just hold this. Right, just step out just a little bit,
and hold it. I'm firing up the rotator cuff, that tendon, the supraspinatus tendon is working to
try to stabilize this position, and I go for sets of ten seconds, five seconds, ten seconds. Right,
and I work on this about three or four times aw eek, maybe three to five sets. As you're able
to handle that, which you probably will pretty quickly because that's not a really high stress,
then I would start to try to get into the concentric of it. So now I take my hand across the
body and I do these external rotation exercises. You've probably seen them before. You've certainly
seen them if you've been watching our channel. This is concentrically now shortening that tendon,
that supraspinatus muscle, and we're working on the rotator cuff strength. Now, realize,
as I improve my rotator cuff strength, I'm going to be able to have that shoulder sit in a more
externally rotated position. When your shoulder's more externally rotated, just in standing all the
time, you have more freedom to move your arm up overhead. The reason for that is the following.
Because this bony structure that that tendon attaches to, when we're in internal rotation, and
I raise it up, it actually gets stopped. There's a bony block. And I've shown you guys how to do that
before, literally turn your arm in like this, and then raise it up over your head. It's only
going to get so far. Turn your arm into external rotation, it's going to get much further. Because
you're clearing this bony bump from instead of banging it into the stop here, you turn it out,
now it can go all the way up, and the arm can come way up over your body. So that is in and
of itself going to help to create more room, but that's not why we're really doing this. Why we're
doing it is because we have to get accommodated to that overload, that tension and compression
that's happening that I talked about on that bar. So, from there now we're like, All right, let's
start getting it into that internally rotated position under load, under eccentric stress,
okay. So what we do is now we take it here we take a little bit of a step. So now it wants to pull me
back here. Eccentrically I have to control that. All right, and I come back, and now this is the
level that I'm working at. And I still do this in my three to five sets three times a week. Then I
say, All right, let's get that heavier eccentric load. Let's go a little bit further than that.
Because ideally we want to introduce heavy, even dynamic loads eccentrically, to be able
to be able to accommodate those tendons to the stress. So now I take a bigger step and I let
it kind of go here slowly. And I take a bigger step. Again, not allowing it to simply whip me
into internal rotation, I'm controlling it into internal rotation. And the final step is you go
for those plyometric type loads, and these apply to a lot of different tendon issues. Down in the
Achilles tendon, other places in the elbow, we want to make sure that what we do is we
get ourself to the point where we can accommodate more dynamic ballistic loads. So I have it here,
and then I step out that way, and again, I slowly bring it back. In here and back. In here and back.
Set it in here and back. So that's where you get to. When you're able to get to that level
two things happen. Number one: you will experience a lot less pain and discomfort in your shoulder.
Number two: you won't have to do that three times a week. You only have to do that, let's say,
one time a week. And the other two days a week that you're doing your rotator cuff work, you can
go back to more of the concentric work, or some of the isometric work to kind of prevent a little
bit of overloading of that, but that's where we want to get to. Now, one final progression
here. If you wanted to go a little further for the induction component with internal rotation,
there's an exercise called a sword raise. So you have your band and you're starting in this
position basically, right? So what you could do is we can get ourselves into this position and just
isometrically hold it out here. Right, just being able to control this out in front of my body,
not letting it take me al the way here, but just a little bit of isometric force. Then I could take
it, it could do a concentric version of this. And now I'm in here and I'm trying to get to the top
position. Down here, top position. If I wanted to, I could take the eccentric exercise and not hold
it here, but hold it a little bit further up here. Okay, as I got stronger. But now I'm working this
concentric exercise here. Down and in, we call it a sword raise. Thumb down, like I'm taking a
sword out of this pocket, and I externally rotate up to the top to here, okay? Now I want to get
eccentric. So I'm in here, now I take the step over here, and I slowly control the eccentric.
Okay, now I want to take it a little further than that. Heightened eccentrics. So now I'm up here,
I take a larger step, and I have to control that all the way down to that opposite pocket. And then
I want to get to that ballistic portion of it, that end range here, that end goal where I have
it up here and I jump out, and I control it down. In, it's up here, down, and I control it down,
up, out, and control it down. And the same rules apply. So the fact is, guys, maybe you're doing
some rotator cuff strengthening. You need to be. We've covered it so many times, and like I said,
we build into our programs for a reason. It's that important for shoulder health. And it
doesn't matter what your overall strength level is. It doesn't matter what you're doing in your
program right now. Your shoulders can benefit from more strength in your rotator cuff. It's
going to lead to stronger movements in everything else you do. So you can't ignore this, it's not a
baby exercise, it's not a remedial exercise, it's a corrective exercise that we all can benefit
from doing. But maybe you stop it just doing the concentric. Try to add these other components in,
especially if you got pain, start at the bottom, work your way. And I promise you, ultimately,
the pain that you've been dealing with here. Whether it's being stretched from the top down,
or from the bottom up, the repositioning of the arm and the shoulder joint, and the relief of some
of that tension underneath and the accommodation to that compression tension is something that's
going to help you in the long run. If you guys are looking for our programs where I said,
we build these into all of the things we do because it matters, you can find them over at
Athleanx.com. In the meantime, if you found the video helpful, leave your comments and thumbs
up below. Let me know what else you want me to cover. I'll do my best to do that for you. And if
you haven't already done so, guys, make sure you click subscribe and turn on your notifications so
you never miss a new video when we put on out. Jesse, you only wish, buddy. You only wish.