Standing lateral raise, side-lying unilateral horizontal abduction, standing bent-arm pull-back and seated press overhead.
||Standing Lateral Raise
||Middle Deltoid Emphasis, Muscle Balance in Shoulder.
Generally, your client will execute the standing lateral raise in a fairly erect standing position. In anatomic position, the anterior deltoid is the primary muscle region used. When your client is standing, the middle deltoid is usually positioned posterior to the top of the shoulder, with the anterior deltoid positioned on top of the shoulder. When the exerciser is using free weights or elastic resistance, the line of pull of the anterior deltoid directly opposes the resistance provided.
This is not necessarily "bad", but the anterior deltoid gets a lot of attention in chest work or any pressing work. Working the middle to posterior deltoid is often more effective in bringing balanced strength to the shoulder joint.
To challenge the middle deltoid and avoid emphasizing the anterior deltoid, instruct your client to lean forward about 30 degrees (the angle will vary with each client) so the middle deltoid is positioned on top of the shoulder and its pull "apposes" the resistance provided.
Encourage your client to note how the middle part of the shoulder is now farther forward and "parallel" to the floor. If the client experiences any discomfort with or concerns about unsupported forward flexion (usually of no concern until the body is leaning forward more than 45 degrees), suggest a unilateral variation. This allows the opposite hand to support the body.
If middle deltoid emphasis is the goal, the usefulness of this positioning will hold true whether the participant is seated on a step platform during group exercise, performing cable work on a pulley system with selectorized plates or using free weights.
Performing the Exercise
In the exercise demonstrated here, the effects of gravity and free weights combine to provide the overload. Inspect your client's position for neutral posture of the lumbar and cervical spine in this forward-leaning position. A neutral posture of the lumber spine will necessitate a cocontraction of the abdominal and low-back musculature. Neutral position of the cervical spine occurs when the head is comfortably balanced (not tilted forward, back or to either side) and the natural existing curvature of the spine is maintained.
Stabilization may allow for more effective muscle contraction and targeted results. Scapular retraction transforms the upper back into a rigid, solid platform and allows more deltoid isolation. The midtrapizius and rhomboids - key postural muscles - are often ineffectively challenged if scapular stabilization is not initiated prior to shoulder joint movement.
To stabilize the movement, your client should slightly elevate and retract the scapulae. To determine the amount of scapular elevation, have the client perform the lateral raise and note the amount of elevation that occurs in the movement without pre-exercise stabilization.
After stabilization has been ensured, the client should maintain the position throughout the movement. (Note: In all the exercises described here, some clients may prefer to release stabilization between each repetition instead of between each set
An important aspect of correct techniques is an emphasis on what feels natural to the body. As you client's arms move naturally forward from the body, make sure the client keeps the scapulae retracted and slightly elevated, and the elbows slightly bent. Avoiding "long lever" positioning of the arms (i.e., straight arms) will relieve potential stress on the elbows and allow the arms to fall naturally into the line of gravity. The arms should purely abduct and remain forward when the movement is complete.. An important aspect of correct techniques is an emphasis on what feels natural to the body. As you client's arms move naturally forward from the body, make sure the client keeps the scapulae retracted and slightly elevated, and the elbows slightly bent. Avoiding "long lever" positioning of the arms (i.e., straight arms) will relieve potential stress on the elbows and allow the arms to fall naturally into the line of gravity. The arms should purely abduct and remain forward when the movement is complete.
If the client initiates external rotation early in the movement, the emphasis shifts to the anterior deltoid. If he or she uses excessive internal rotation, the range of motion can be limited to 60 degrees or less and shoulder impingement may occur. Experiment with these variations yourself and you will fee the difference.
For proper exercise execution, verbal or touch cues must communicate what should occur at the joint. Cues such as "Dump the soda cans" or "Pour the pitcher" may encourage poor technique, excessive rotation at the shoulder and movement at the wrist. The wrists should remain neutral, or straight, throughout the exercise. For proper exercise execution, verbal or touch cues must communicate what should occur at the joint. Cues such as "Dump the soda cans" or "Pour the pitcher" may encourage poor technique, excessive rotation at the shoulder and movement at the wrist. The wrists should remain neutral, or straight, throughout the exercise.
Cuing the client to maintain a slight elbow bend and move the elbows out to the sides of the body and then up is more likely to produce the proper joint action at the shoulders. This position also creates shorter levers from the elbows to the shoulders and makes it easier to maintain proper speed of movement, correct movement path of the arms and a stabilized position in the rest of the body.
As the elbows move to the side, the lower-arm bones (radius and ulna) should move into a position that places the flexor muscles of the wrists parallel to the floor. If the client attains 90 degrees of shoulder abduction, but does not attain this positioning of the lower arms in relation to the floor, he or she may be "leading" with the elbows (causing internal rotation at the shoulders) or with the wrist (causing external rotation at the shoulders).
It is sometimes amazing what happens to correct mechanics when exercise equipment or resistance is added to the equation! Remember that technique should not change simply because resistance is added. Resistance - whether in the form of metal free weights, machines, tubing or water - simply "goes along for the ride" and should directly oppose the movement pattern.
Your client should "push" the elbows out and maintain:
- A correct body position (without raising or extending the spine)
- Scapular stabilization
- Neutral positioning of wrists and arms
- Arms positioned in front, rather than moving back
Caution: Shoulder Impingement.
Shoulder impingement typically occurs because of either excessive internal rotation or shoulder abduction that goes beyond 90 degrees (when the humerus is parallel to the floor). Shoulder impingement may affect the hyaline cartilage. Additionally, tendons, ligaments and bursas may be irritated. If this condition persists indefinitely due to repetitive exercise performed incorrectly, it may lead to tendonitis or another chronic, inflammatory condition.
To lessen the likelihood of shoulder impingement syndrome and create effective, safe overload, keep the movement pure. Avoid excessive internal rotation and limit shoulder abduction to 90 degrees or less. If more than 90 degrees of shoulder abduction occurs during the movement, a smooth transition into external rotation of the shoulder is advised. However, at this point the emphasis of the exercise switches to the anterior deltoid, upper trapezius and levator scapula muscles. Shoulder abduction beyond 90 degrees is not necessary to effectively challenge the posterior deltoid through a full range of motion.
||Side-Lying Unilateral Horizontal Abduction
||Shoulder Horizontal Abduction (Extension)
||Posterior Deltoid Emphasis, Muscle Balance in shoulder.
Emphasis on and isolation of the posterior deltoid is crucial because of its role in balancing the strengths of the anterior deltoid and pectoralis major. Proper execution of this exercise can lessen the contribution of the latissimus dorsi and teres major, thus more effectively challenging the posterior deltoid.
The average participant cannot easily perform the side-lying unilateral horizontal abduction exercise. While it is an excellent exercise, achieving proper positioning and execution is complicated. However, this exercise serves as a very good model for other exercises that use horizontal shoulder abduction as a joint action.
Proper positioning requires that the body maintain neutral alignment in the lumber and cervical regions of the body. Before your client initiates the movement, stabilize the exercise with scapular retraction and a cocontraction of the abdominal and low-back muscles.
The lower arm must be able to reach the floor, preferably with the palm flat and in full contact with the floor. The top arm should bend slightly at the elbow and be positioned across the body in horizontal shoulder adduction. The slightly bent arm creates a shorter lever, reduces mechanical stress on the wrist and elbow and more effectively loads the posterior deltoid. The movement is initiated from the shoulder. There is no movement at the elbow.
Performing the Exercise
Cue your client to lead with the little finger or the elbow. The neutral body position, retracted scapulae and slight bend of the arm must not change until the set is complete.
The path of motion the client must maintain is pure horizontal shoulder abduction in the horizontal plane; no rotation should occur at the shoulder. This motion is referred to as neutral rotation, meaning that throughout the exercise the arm position remains the same with regard to rotation.
Determine range of motion actively. Have the client find his or her active range of motion with no resistance challenge. The elbow will lead the motion.
When the motion is complete, the elbow will be about 10 to 20 degrees behind the shoulder joint. Note that the hand and wrist may be in line with or slightly in front of the shoulder joint, depending on the amount of elbow flexion used.
The elbow of the top arm should remain oriented toward the ceiling. If this exercise is performed in a seated position (i.e. reverse chest fly or back fly using tubing or steel cables attached to the wall), the arms remain parallel to the floor to maintain this same horizontal plane. If elbow flexion is added, as in a seated high-elbow row, the same principles and horizontal plane orientation apply, ensuring that pure horizontal abduction occurs at the shoulder.
||Posterior Deltoid, Latissimus Dorsi
||Standing Bent-Arm Pull-Back
||Posterior Deltoid Emphasis, Muscle Balance in Shoulder
The posterior deltoid is also important in full shoulder extension. Placing your client in a supported, forward leaning position challenges a greater range of motion (anywhere from 20 to 45 degrees) with overload. This positioning starts the exercise in shoulder flexion (arms in front of the body), and the tubing continues to effectively resist the movement as the hands pass the midline of the body and the shoulder joints fully extend. (This movement is also known as shoulder joint hyperextension.)
Stabilize the movement with scapular retraction. Maintain a slight bend in the elbows, and drive or lead with the elbows moving toward the ceiling.
Performing the Exercise
This movement is similar to a pull-over movement performed on machinery.
Mental imagery of the elbows leading the movement with a driving but controlled force may be useful to your client. The shorter levers created by the flexed elbows help ensure proper technique and less mechanical or orthopedic stress transfer to the wrists, elbows and shoulders.
The exercise begins with and maintains scapular stabilization, neutral lumbar and cervical posture, slightly flexed elbows, neutral or "quiet" wrists and "soft" or flexed knees. Note the torso remains pressed into the incline bench and the feet are placed on the bench to keep it from sliding.
Determine range of motion actively. Have the client perform the movement with no resistance. A slight tension or resistance to movement in the anterior region of the shoulder will indicate the limit to the client's active range of motion. Forty-five or more degrees of full extension is not uncommon.
Combining external rotation with full extension in this exercise may compromise both joint actions. Although external rotation of the shoulder is a natural movement when the arm passes the midline of the body and enters into full extension, placing force in opposition to external rotation is all but impossible without applying manual resistance.
The combination of external rotation and full extension will negatively affect the range of motion that can be attained in full extension, as well as the fiber alignment of the posterior deltoid and its relation to the force resisting the movement. Consider training each function separately.
||Anterior Deltoid (Triceps, Clavicular Pectoralis Major)
||Seated Press Overhead
||Shoulder Flexion, Scapular Rotation Upward, Elbow Extension
||Anterior Deltoid and Chest Emphasis
Any pressing or pushing movement away from the body places the emphasis almost entirely on the anterior deltoid and chest musculature, rather than challenging the entire deltoid musculature. Specifically, while the middle deltoid may be somewhat active (depending on the individual's structure or body position), the posterior deltoid is inactive. This is important to note if one of your goals is to promote muscle balance throughout your clients' body.
Performing the Exercise
Performing the press overhead on a slight incline is preferable to pressing overhead from an upright posture, which can be uncomfortable. If an incline bench or position of incline support is not possible, have the participant "sit tall" or upright, maintaining neutral posture in the lumbar and cervical spine. In addition to spinal stabilization (scapular retraction and neutral posture), a slight elevation of the scapulae may enhance the movement and overload challenge to the anterior deltoid.
To determine the proper amount of scapular elevation, have the client press overhead and note the amount of scapular elevation that occurs. Prior to the press, the client should retract and slightly elevate the scapulae, then maintain this elevation throughout the set. (Note: Some clients may find it difficult to keep the scapulae elevated).
Position the arms so your client is pressing "from the front" of the body. This position is functional, as it carries over to daily lifting activities, such as removing or replacing items in cupboards or shelves.
By splitting the difference between having the elbows extremely flared, or opened, in the frontal plane and positioning them in front of the body (in the sagittal plane), you decrease the likelihood of shoulder impingement. If the hands come up near the shoulders or ears, the shoulders externally rotate, reducing the potential for shoulder impingement. Also, maintaining a midposition between the frontal and sagittal planes reduces the chance of pure abduction.
I call this the "Mickey Mouse position". With the arms properly positioned, the hands - were the exerciser to open all 10 fingers - would resemble the ears of the famous mouse. (Participants tend to enjoy being cued into the "Mickey Mouse position".)
Have your client finish the press overhead by bringing the hands or thumbs toward each other. The hands may or may not touch. Since no resistive force opposes this movement overhead, the most important criterion is that the client feels no discomfort.
If your client finds this finishing range of motion uncomfortable to the shoulder area, instruct him or her to add a small, additional amount of external shoulder rotation and scapular elevation. Rather than bringing the thumbs together or toward each other, the client should bring the palms together. This position orients the thumbs toward the wall behind the participant and creates additional external shoulder rotation, which may avert impingement syndrome or discomfort. Emphasize that the movement is shoulder rotation, not a token supination movement at the elbow.
Presses behind the head are generally not recommended for several reasons. They do not work the anterior deltoid any more effectively, and they may put considerable stress on the ligamentous joint capsule of the shoulder. Additionally, your clients are more likely to experience shoulder discomfort and accumulative joint instability, especially if a bar is used.
Because they allow you to adjust to and work with the individual physical nuances of each client, tubing, cables, water resistance or dumbbells have a great, though not always consistent, advantage over straight bars and traditionally designed machines. Many machine manufacturers are now turning their attention to developing more versatile machinery that will allow work in several planes of motion, mimicking the options already available with conventional cable and dumbbell equipment.
Keep in mind that lifting technique rarely offers exact "right or wrong" interpretations regarding correctness. Many commonly made assumptions regarding technique are not scientifically proven. However, based on logical conclusions, a wealth of electromyographic studies and what we know from the sciences of kinesiology and anatomy, we can establish a solid foundation from which to select exercises and guide their execution.
Ultimately, your clients' physical responses and verbal feedback will dictate the best approach to use.
Reproduction by permission of IDEA © 1995