Sword Shoulder - A Response to Jess Finley

Recently my friend Jess Finley posted some video commentary about shoulder injuries in Longsword and Messer. There are some good points, and I want to flesh out some of the things you can do to prevent the common issues that she describes.

This post will make more sense if you watch the video first.

I disagree with one wording choice. A forward shoulder position is not pulling the shoulder out of it's socket.

The primary issue Jess describes is an overextension of the arm which can stress the shoulder.  She notes this in particular for women. I don't doubt the association between this problem and women. In part because she makes a good observation that the shoulder blade wings out. Given that our society discourages women from engaging in actual strength training, especially for the upper body, it is not surprising that this is more common for women.

An extreme example of scapular winging ("Wingingofscapula". Licensed under CC BY-SA 3.0 via Wikipedia.)

The most common cause of this is weakness of the serratus anterior muscle. The serratus anterior has it's major role in keeping the scapula pinned to the ribcage. The muscle attaches to the underside of the shoulder blade, on it's inner edge and then to the ribcage around the sides. The muscle's action is to protract the scapula i.e. slide the shoulder blade forward and also to upwardly rotate the scapula.

Secondary to this is strength of the rhomboids and middle trapezius. These muscles attach to the inner edge of the scapula and then to the spine. As such they retract the scapula, that is slide it towards the spine. Therefore they can help stabilize the scapula, but only by preventing it from moving forward also.

Our focus then needs to be on the serratus anterior development. There are two basic exercises for this:

1) Push-up plus (scapular push-up): set-up for this exercise in a push-up position. Your arms will stay locked out during the exercise and the torso needs to be kept in neutral posture. Then squeeze your shoulder blades together and then push them out. This lowers and raises your whole body (which you are keeping locked into good posture.

2) Incline presses: any kind of exercise where you are positioned on an incline bench and pressing upwards will make good use of the serratus anterior. This can be done with dumbbells, barbells and other tools. Make sure to fully extend the arm upwards to get full motion forward of the scapula. And make sure to use enough weight for strength gains - that means enough that you can only do 12 or fewer repetitions.

The rhomboids and middle trapezius will assist the serratus in stabilizing the shoulder blade and so exercising them will also be of benefit. Exercises for these can start with basic upper back exercises like rows: one-arm, barbell, cable etc. Single joint exercises like reverse flyes can be added if more is needed; but usually it is not.

Forward, Rounded Shoulders

Jess also talks about having forward, rounded shoulders, which is common with folks who work at a desk job. People who have had this for a long time may have shortened there chest muscles and so stretches may help those folks. However, it's frequently more about attention to posture and ergonomics. Additionally, strengthening the back, as I just described, will help.

Jess also makes a good point here about making sure that when you are strengthening the pecs you also need to work the back, otherwise you end up with your shoulders pulled more forward.

That's only a brief look at rounded shoulders and I'll likely get back to it in another post.

The Rotator Cuff

The rotator cuff also plays a role in shoulder health and pain, but it will be covered in future posts.

Conclusion

Ultimately, a basic strength training program using intensities that actually develop strength (as opposed to the way most magazine's describe resistance training for women) will be sufficient for most people with this type of problem. The additional exercises here can accelerate the improvement or cover when a basic program is not working.

More on Shoulder Health

To add some to previous advice about overhead shoulder exercises. If the doctor told you not to do overhead presses there are other ways of working the muscles similarly.

First, there's upright rows. As far as the shoulder is concerned it's basically the same exercise. With a history of shoulder problems it is generally advised to avoid lifting the upper arms past parallel

Second, there's incline presses. Again, similar muscular involvement, but less stress on the usual suspect in the shoulder i.e. the acromion.

Third, ask if the prohibition against overhead presses applies to all such exercises or just the barbell and machine versions. Dumbbell overhead presses allow the shoulder joint to move more 'naturally' and so are less likely to aggravate a shoulder problem.

Further, there's some variety in rotator cuff exercises that can be useful supplements to the above.
Lying face down on a bench you can do 3 external rotation exercises. With the elbows tucked at the side; with the upper arms straight out from your shoulders; and in-between, so that your arms look like a 'W' from above.
The other rotator cuff exercise is called an 'empty can'. Do lateral raises except with the hand turned with the palms facing backwards, like you would if you were emptying a can.

Lastly, scapular stability exercises will contribute to shoulder health and function. These are usually called something like 'YTI' because the three positions, viewed from above, look like a Y, T and I. The T is just a standard back fly exercise, they can be done lying on a (incline) bench or similar to make the whole set convenient to do*. The Y is the same exercise but your arms extend forward at an angle instead of straight out to the side. The I is done by extending the arms straight back/down, so that the weight is brought from a hanging position to up by your hips. With these three exercises it is important to make sure that your scapula is moving - the scapular movement is the entire point of these since doing so increases the stability of the shoulder joint. Rotation at the head of your upper arm is not helping the scapular stabilizers.
* Alternately they can be done in the same kind of position used for a bent over row, either one arm at a time with the other on the bench or both arms at the same time.

All the supplemental exercises involve small muscles* and should be done with smaller weights and for more reps, typically 12-15.
*The I exercise uses your rear delt and so can be done with larger weights.

Overhead lifts

"Another common mistake is lifting weights higher than shoulder level or bringing weights behind the the plane of the body." P. 188 Complete Conditioning for Tennis, E. Paul Roetert & Todd S. Ellenbecker.

This is a quote from a book on tennis. But the similarity in movements between tennis and longsword are relevant . This is also common advice for baseball pitchers.So, for longsword guys the overhead lifts are a potential problem. Due to the high stress on the shoulder from doing overhead sport actions the overhead lifts should be avoided. This is also common advice for baseball pitchers.

So do an incline press instead of the shoulder press (and do a vertical pull exercise as well e.g. lat pulldown, pull-ups, dips etc.). And only do cleans for Olympic lifts, not the snatch or jerk.

To explain, a little anatomy first: the head of the humerus rests in a socket, the glenoid cavity. Above the socket is the acromion, a projection off the scapula. In between these two is the subacromial space, which has to fit tendons, muscle and bursa.

Lifting the humerus above about 90* tends to compress the subacromial space. This can be lessened by strengthening the rotator cuff muscles. Healthy, strong rotator cuff muscles will help the head of the humerus move correctly, so that it doesn't impinge.

However, strengthening the muscles that pull the humerus upward will not reduce the upward compression of the humerus against the arcomion.

Overhead work, like house painting, and overhead sports, like pitchers and tennis, involve much more upward movement of the humerus. Most people bodies can't tolerate a large amount of overhead movement of the arm. There is variation in this characteristic; differences in acromion shape, glenoid cavity health, rotator cuff health and strength, and history of injury will all effect the likelihood of developing impingement.

Motion at the edge of a range of motion increases the likelihood of chronic injury. So overhead athletes have a much higher likelihood of impingement. Even with correct form for pitching or serves in tennis, the stress is still high. Professional athletes frequently subject themselves to predictable injury because of their drive to compete.

This blog post also does a reasonable job of discussing it.

To produce the same strengthening of as an overhead press you can do an upright row and a shoulder shrug. Same muscles, used the same way, but each avoids excess abduction of the humerus.