I have a client who is trying to work on shoulder strength. He finds that when lifting a challenging amount of weight, his shoulders will give out. Once this happens, he is weak in the shoulders for the remainder of the work out. Do you have any idea what is happening here? He did mention he had dislocated the right shoulder a few years back in rugby.
A situation such as this should send up an immediate red flag to you as the fitness professional. Dealing with joint traumas like the one described here (dislocation) are well out of a "personal trainer's" realm of practice. This past rugby injury is very likely the root of the problem. Additionally, to ensure you as the professional are not causing any further damage to the injured joint and to maintain your professional integrity, I would suggest immediately referring your client to the appropriate medical professional, ideally one with a sports injury background. This is done to find out the specifics of the injury, to determine if any treatment or rehab is necessary and/or to get the OK to begin/continue training. If you have already done so, here are a few ideas to consider.
Research has demonstrated that joint damage/pain can cause muscle inhibition/weakness. This may be what you and your client are experiencing during your workouts. To simply maintain your current training methods when the joint is "giving out" within the scope of each of your workouts may be very counterproductive to the goal of adding "strength" to the shoulder.
Simply lifting larger and larger quantities of weight may not be addressing the present needs of that particular joint. ALIGNMENT and STABILITY may be the more appropriate place to focus right now. The shoulder joint has been labeled as the most instable joint in the body due to the fact that the glenoid cavity is so shallow. Because of this, the head of the humerus is basically held on by soft tissue, adding into this joint's instable tendencies.
Assess your client's static and transitional posture. Does he demonstrate any deficiencies? Research has show that those individuals who demonstrate an upper crossed postural distortion pattern (rounded and internally rotated shoulders with a forward head) are more susceptible to shoulder injuries (i.e., shoulder "weakness"). This is due to the muscular imbalances typically found present in this common posture (refer below).
So work on correcting the client's posture, more specifically in this case shoulder stability and alignment, and you will be gaining "strength" because the joint itself has now been "replaced" into a position that will allow for its stabilizers and prime movers to function optimally! This type of programming would include a proper flexibility protocol as well as a strength protocol. Here are a few training options:
- UPPER CROSSED POSTURE:
- Characterized by rounded shoulders and a forward head
- SHORT MUSCLES TO BE STRETCHED:
- Upper traps
- Levator scapulae
- Pec major/minor
- LENGTHENED MUSCLES TO BE STRENGTHENED:
- Deep cervical flexors
- Serratus anterior
- Mid traps
- Lower traps
- POSSIBLE EXERCISES:
- Cervical Retraction
- Prone Cobras: prone position, arms at side, neutral spine, abdominal draw in maneuver, squeeze glutes, scapular retraction & depression with shoulder external rotation
- Scaption: shoulder lateral raise in the "scapular plane"
- PNF Shoulder Patterns: up and outs, down and outs, etc.
I also refer you to the following highly informative and practical PTontheNET.com articles by Lenny Parracino:
- Postural Profile
- Overhead Squat: Total Body Profile
- Muscular Balance or Flexibility Profile
Good luck, and remember: when in doubt, refer out!