Help, my shoulders are too high!

We see this plenty in martial arts, fencing and, well, normal life. People who keep their shoulders up too high, kind of bunched up or tense, but all the time. Or maybe just while they are training. For training it's most common in new fencers. Recently somebody asked about it on the HEMA Alliance Facebook page and here's my long response.

Let me get technical for a moment. I'm talking about excessive tension in the upper traps that elevates the shoulder joints. If you're actually looking at something else, then this won't help.

I'm going to address the common advice and suggestions as well as my own thoughts.

Stretching

A lot of people will suggest stretching for something like this. But stretching is seldom the answer, though it can be part of it. Here's why:

1. Go stand in front of the mirror.
2. Depress your shoulders, that is shove them towards the ground - see the third picture
3. If you can get them to normal posture (the second picture) then muscle length isn't the problem.

Hunched posture - the problem we are correcting

Normal posture - the objective

Depressed posture - should be able to get the shoulders this low

Stretching solves problems when the muscle is short. And such is seldom the case for this particular problem.

If stretching feels good then that's good and go ahead and do it.

If stretching helps relieve tension then that's good and go ahead and do it.

So, by all means, include stretching if you like, but also know that it won't solve the problem.

Yoga

Yoga for what?

If it's stress reduction then go for it. Lots of people are stressed and any kind of meditation activity that they find stress relieving is a good thing. Stress can be the primary contributor to the elevated shoulder problem. You've probably heard, or are, somebody who says, "I carry my stress in my shoulders".

Finding a good way to reduce your stress is quite important in life. But it's outside the scope of my blog.

If the yoga suggestion is based on the idea that certain of the yoga postures will cure the problem then I want to know which ones. All too often there is just a generic suggestion for yoga as if the whole of it is some cure-all, without looking at the specifics of individual yoga postures.

A quick google search on yoga poses for shoulder problems came up with a whopping zero poses useful to this problem. This does not mean that they don't exist. But it illustrates that a simple suggestion of yoga in general is not sufficient.

Strengthen the Upper Back

Well, we might expect me to be all over a strength training solution!

But the upper back strength isn't the solution to this problem. It's probably the cause, or at least an accomplice.

The upper back muscles are primarily the trapezius and rhomboids. You also have the top part of the spinal extensors, but they don't attach to the shoulder blade or joint.

The traps are a big muscle group that primarily elevates and upwardly rotates the scapula, so that's a possible culprit. And by possible I mean almost certainly it. Though with a possible contribution from the levator scapulae.

So strengthening the already overactive or tight muscles won't help!

The rhomboids downwardly rotate and retract the scapula, so we can rule them out. Strengthening the rhomboids might actually help us, but the upper traps are much bigger, and so we can't win that tug of war with just reverse flys.

Strengthen Other Things

Farmer's Carries - I love farmer's carries. I just spent good money buying equipment to do heavier carries. But that's an exercise where gravity pulls the shoulder down, so they won't help keep the shoulders down in other actions.

Indian Clubs - I'm not a big fan of these, because there is nothing they do particularly well, they're really just a conditioning tool. And they don't have a way to work the muscles to pull down the shoulders. Whether or not they help is entirely dependent on how good you keep your posture while using them. And that's true of a lot of options. So it's really independent of a solution.

But it does indicate something useful. Being mindful of posture during all strength training, especially standing exercises, will help.

Bodyweight exercises - Which ones? Most of them are simply not relevant to the problem. The only relevant one, really, is pull-ups. And so if you are capable of pull-ups then they should benefit this particular problem. But pull-ups are really hard for a lot of people, so they are usually not a good general purpose suggestion.

Posture

We are moving progressively closer to the best understanding and solution to the problem with this. Better posture is better. Work to increase the amount of time in good posture and your awareness of your posture - in every part of your life. In particular here is getting the shoulders back and down. If you have a desk job this is a challenge. And addressing that challenge is it's own big topic.

There is also your posture when you are on-guard. When you are in guards with the arms and sword above the level of the shoulder it's natural to also hunch up the shoulders. But you don't have to do that. You can get your arms overhead and keep your shoulders down.

Shoulders hunched high guard position

Shoulder neutral high guard position

You may also have your shoulders elevated in a lot of your guards. In which case switching to pflug or Fiore won't help. Sean Hayes talks about it in this video.


One of the cues for getting your scapula into the right position for overhead guards is to think about sticking your shoulder blade into your back pocket.

* Side benefit of this: it's healthier for your rotator cuff!

Tension

Are you tense while you are training? If you're new you probably are. I see this problem an awful lot. And it's understandable. When you start you don't understand any of it, it's all new. There's a lot to concentrate on. And many people naturally hunch up their shoulders in this situation.

I tell people to relax. I then I tell them that relaxing will take a while. You have to get better at the actions to be able to think about relaxing while doing them. When it's new you have too many things to think about to be able to also think about relaxing.

I'm really relaxed while doing the things that I've been doing with a sword for years. It's easy for me at that point. I'm sure a video camera would show more tension in the brand new stuff. But I've also got, at this point, 17 years of martial arts training, so I've got a habit of being relaxed while doing this stuff. And that took time i.e. don't expect a quick fix. This is a long-term project.

The take-away is spend more training time on the stuff that is not super challenging. That's doesn't mean spend it all on the easy stuff. But spend most of your time on the actions that you get mostly right, most of the time. This is actually my general advice to all my students, just based on learning theory. The advanced stuff, that may be stressing you out, should be practiced with a coach who can provide feedback.

Good Strength Training

Of course I'm going to conclude that strength training has a role to play in addressing this! But it may be a much smaller role than the above about stress and tension, depending on the person.

There is a reflex in the body to keep the muscles safe by turning down the activation of opposing muscle groups when activating a particular muscle. So an overactive upper trap is turning down the activity of the opposing muscles that pull the shoulders down.

And so we can use that to our advantage. As we train up the muscles that pull the shoulders down we increase their resting tone. This will have the effect of turning down the resting tone in the opposing muscles. And thereby reducing the tendency to hunch up those shoulders

What exercises pull down the shoulders? Lat pulldowns. And pull-ups.

You may think of these as primarily latissimus dorsi exercises, and they are. The lats are a big muscle that pulls the shoulders down - amongst other actions. Your rhomboids will also be helping with these exercises. As well as the lower traps.

And that's pretty much all the muscles that pull your shoulders down. So make sure you are including vertical pulling exercises in your complete strength training program.

Does it Hurt?

If yes, then see a medical professional. I am not a doctor.

If you aren't sure yet then ask following questions:

1. Has it hurt for more than 2 weeks? If so, see a doctor.
2. Does it hurt even when you are not training? If so, see a doctor.
3. Does the pain interfere with any other part of your life? If so, see a doctor.

Specifically, see a physical therapist or orthopedist.

Conclusion

In my experience, the most common cause of this is being new. And that can go on for a very long time. The next most common is generally carrying tension in your shoulders. As such, strengthening, stretching and other exercises have only a small role to play in this type of problem.

However, it's not a self-correcting problem. If you do this when you are new then you will do this always. That's what coaches are for, to spot your errors and remind you to fix them.

Back Pain and Strength Training

My mother posted this article from NPR and asked for my comment: Pain In The Back? Exercise May Help You Learn Not To Feel It

There's a lot of good in this article. Though the specific exercise recommendations in it are dubious in my mind.

 

The Good

The basic premise is that strength training is good for back pain. I have no doubt about the accuracy and helpfulness of this recommendation. A lot of back pain is caused not by structural defects but by movement defects. Pain and movement defects form a positive feedback loop. A little bit of pain causes a person to avoid certain movements and move differently. These modifications end up contributing to more pain - and so the circle goes round.

Many pain-free individuals have MRI scans that look like a back problem with herniations and similar structural abnormalities. The correlation between these scan results and actual symptoms are fairly poor. But these kinds of scans encourage the prescription of surgery and injections to treat the problem even though the success rate is only middling in some patients.

I don't want to give the idea that I'm discouraging surgery. I had back surgery myself and it was an amazing improvement for me. However, I had a severe herniation and it was possible to see on the scan that my disc was actively pressing against the nerve related to my pain. And I had sciatica. These are the kinds of problems for which surgery is clearly indicated.

 

Non-Surgical Treatment

Strength training and movement training will help correct many kinds of back pain. And I firmly recommend physical therapy referral for minor back pain. (I just wrote an essay for my Simmons application explaining my philosophy on how PT can better deal with back pain)

Joints are primarily stabilized by the muscles and not by the passive bones and ligaments. As such strengthening will improve joint stability and address some kinds of pain. Additionally, strength training will improve range of motion, which helps to address other causes of pain.

Movement patterns need to be fixed in people with pain. A good physical therapist or strength coach will be able to spot these movement errors and fix them. Creating new grooves for correct movement patterns. It takes time, skilled supervision and a lot of conscientious practice. So the 'boot camp' approach discussed in the article makes sense. I would gladly take this kind of approach with patients when I complete my DPT.

Personally, this is what I have done for my back. After the surgery I was back to the ACSM recommended amount of exercise within 2 weeks. I endeavor to place as few limits on my activity as possible. With ongoing back pain I still strength train, do conditioning work and martial arts training. The primary limitation I accept is on sitting. Sitting too much is bad for my back and I know it.

 

Pain-Killers

The article poo-poos pain-killers. And I disagree. But I disagree in the context of a complete program to address back pain which includes the above kind of training. If the only thing you are doing about back pain is pain-killers and avoidance then that is a problem. Pain-killers to improve quality of life and facilitate movement and strength training are a positive thing.

 

The Dubious

There are several specific exercises recommended in the article that I'm dubious about. This comes in part from recently reading Stuart McGill's "Ultimate Back Fitness and Performance", as well as my own personal experiences and martial training.

As I've said before the primary role of the trunk (or core) muscles in most activities is to hold the torso stationary. Not to move it. Our back is well designed from this perspective. It can move but it is not well designed to move under a load. As such we can look at two categories of back movement:
1) Loaded and stiff
2) Unloaded and mobile

The combination of motion and high loads seems to be a primary mechanism of injury for the back. Exercises for the back should instead focus on holding the back stiff and stable while under a load. For instance planks. Weight or other challenges can be added to the basic plank exercise to increase the difficulty as you progress.

But the torso rotation machine that combines twisting with moving weight is probably a bad idea. Same with the back extension machine. Yet both of these exercises are included in the 'boot camp' program.

Stretching is also mentioned. Flexibility in the back is unrelated to back pain and it is mostly useless or even counterproductive to stretch the back. There are a few exceptions but they aren't the norm.

Alternately I could be suffering from a limited point of view based on what I've read and experienced so far. Time and a three year graduate degree program will afford me the opportunity to gain a more complete picture.

That being said I doubt that the kind of program Stuart McGill describes is bad for you. It just may not be the only kind of program that works.

 

The Bad

Like any popular science article it relies on personal stories and anecdotes instead of good research findings. Well done science reporting would look at literature reviews and meta-analysis as well as positions stands from reputable organizations (like the ACSM and NSCA). This is unfortunately typical and frustrating to me.

 

Conclusion

Strength training and movement training are more useful for typical back pain than surgery, injections or other invasive procedures. Get thee to a physical therapist!