April 26, 2011


One of the most gratifying and mind-expanding aspects of this project is in talking with other health providers, health professionals, out of the traditional medicine realm. I have talked with probably 500 chiropractors and have spoken with dozens of athletic trainers, and one thing I have really come to appreciate about their input is that it is coming from a framework of wellness. I am a traditional medical doctor, and we fix problems when they arise. We do give some, what I would call, lip service to wellness, but it is not our outlook, frankly. We are trained to fix disease, which is a fantastic and great talent to have. Coming to learn about wellness and keeping people well is something that has given me insight into a powerful tool.

With that in mind, I would like to think about the shoulder and the muscles of the shoulder and how people might be able to get stronger and remain more functional with their shoulder by exercising in the right way. One thing that I see a lot of people do is basically get stronger, get bigger in the upper chest and the back. This is, of course, great. I think that muscle mass is, generally speaking, good for your health. I think there is overall a deficiency of muscles in the population, particularly the aging population, but even when we are talking about young and healthy people, I am definitely supportive of getting stronger. One problem I see is that people are trying to get stronger without a great understanding of muscle balance.

In particular in how it relates to the shoulder, muscle balance is critical. Keep in mind that the muscle balance will allow the shoulder to function. The shoulder is a remarkably complex joint with a 270° range of motion. When you move your shoulder, you need complex interactions between muscle groups; some muscles moving your arm and the other muscles working in the opposite direction trying to keep basically the ball in the socket. What I see a lot of people doing is essentially working on the overlying muscles including the pectoralis, the deltoid, and the trapezius without appropriately exercising the rotator cuff. Let’s think about this. It’s like building on sand. If you do not have a sound underpinning for your shoulder in the form of a very strong rotator cuff, several things are going to happen.

Firstly, the overlying muscles are going to outstrip the counterforce of a relatively weak rotator cuff.

Secondly, you are going to have pain because the easiest way to think about it is that the shoulder is going to start to slip out of its joint because the rotator cuff dynamically stabilizes the ball on the tee, if you will.

Thirdly, your shoulder won’t get as strong. To get a stronger shoulder, and all the muscles of the shoulder girdle, you should first have a strong rotator cuff. How does one get a strong rotator cuff? I think this is trickier than most people think. I think that people are doing the wrong exercises that engage the wrong muscles. I would take a look at the RotatoReliever and consider that as the gold standard, the best form of dynamic stabilization. If you want to get really strong in the upper body, start with a strong base. Start with a strong rotator cuff and then you will be able to bulk up much easier, much faster, and with much less pain.


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