Biomechanics of the Shoulder and the Challenges with Addressing Shoulder Pain
Michael Hughes
Hey, welcome back to the Gymnazo podcast. I’m your host Michael Hughes with one of my biomechanical colleague specialist, friends, trainers, Mitch, and we’re going to dive into the shoulder joint. And mission I’ve had actually a lot of fun recently talking about the biomechanics and digging into, honestly, the nerdiness of what I think about movement in the shoulder joint is one of those joints as CJ spoke about last podcast or podcast or two ago about the knee joint. It’s kind of one of those like, really complicated joints, that has so many friends, so many avenues to go. And as a trainer, right, we’re really looking at how we can train a condition this shoulder, but also have it from a rehabilitation stance or a restoration stance and how we can get around as trainers, but also see if we can add more to training and conditioning the shoulder than has ever been least generally accepted from this industry. So we’re gonna dive into it deep have a lot of personal stories from clients that we’ve had, and really see how a trainer can understand or an athlete understand what this amazing shoulder joint is, and all of its 3d awesomeness. Super crazy joint, almost like the hip. And I’m excited talking about so let’s get ready to dive in and explore the biomechanics of the shoulder. Welcome to the Gymnazo podcast where you get to peek behind the curtains of what it takes to create and run a seven figure fitness facility that ranks in the top 5% of boutique fitness studios for revenue. But to be honest, that’s the least important thing about us. Founded by me, Michael Hughes, Gymnazo has created an ecosystem of services that blend performance with restoration techniques, and attracts top coaches to its facility hosted by its owners, Paden, and myself and our top coaches, this podcast shares our best practices on everything, from how to build a sustainable fitness business, to how to program for maximum results, to how to build a hybrid training module that’s online. And in person. We have marketing secrets, movement, innovation, and breaking down trends in the industry. If you’re a fitness professional, or a fitness business owner, this is where you learn how to sharpen your skills and to see maximum results. met this is a topic that we view and I have both done extensive studies on through not studies like case studies, but like, researched and looked into it in education. And through the years that we’ve been looking at the shoulder, I want to know like, is it from a ranking standpoint? How challenging is it for you? If someone comes in and says I have a shoulder problem and you’re wanting to train in conditioning?
Mitch
Yeah, we’re gonna scale this probably on like a one to 10 scale or one’s easy. 10 is pretty challenging. Okay, deal. It’s probably up in like the seventh and eighth range. And up. And definitely, depending on the population that you’re working with, you’re a little bit younger, maybe a little bit lower on the scale, but they’re a little bit older and have some wear and tear already on their body. It’s definitely going to be up on like that nine or 10 scale. Yeah,
Michael Hughes
it’s a challenging joint. Right? I mean, it’s, it’s, there’s so much complexity to it. Like, how do you how do you kind of break apart the aspects of the shoulder? Someone says, literally, I have shoulder pain on an intake? Like, where’s your mind go?
Mitch
I try and understand where they’re feeling the discomfort. Yeah, and what and with what? Is it achy? Is it discomfort? Is there a lot of discomfort just at resting? Is it with movement? Is it with simple ADLs of life? Like driving? Or, you know, cooking whatever it may be? Or is it more just gym specific and gym related? You know, does it only hurt in the gym itself when you’re lifting weights and doing other things like that, and just, and then from there, that kind of helps almost narrow it down to a certain degree. In a weird way, it’s like, it kind of eliminates certain options, I might be thinking of on that one there. And then I kind of just go from there with it, and start to take them through some assessments and other things like that, to help narrow it down. But trying to understand where the discomfort in the shoulder is coming. Is it coming from the anterior side of the shoulder, lateral back underneath or inside just to help understand what might be influencing that discomfort more. And then I always have a series, I think a checklist I would go through call. Yeah, sure that Yeah, so I mean, it really all depends. So Right.
So there’s obviously the big rocks that influence the shoulders like you have the rotator cuff muscles that will influence the shoulder you have. You had the pec muscles that won’t influence the shoulders, you have the lat that does it the subs got all of these areas that influence the shoulder and then more globally into the hips, but usually that doesn’t necessarily for me start until after I start to go more locally at an end. start to do that. Write that down. Because does it only hurt with certain motions? Which I’m really curious. We’re really excited to talk about some some clients that we’ve worked with because just literally happened yesterday with someone had an assessment with perfect, but if I can understand when the shoulder feels the discomfort and where it feels a discomfort within the motion or within whatever action they’re doing it in. I mean, me as a practitioner, I’m like, okay, cool. Like I I don’t, you know, I don’t have X ray vision. You can’t see into the shoulder unfortunately, yet. Not yet. Not yet. Phase three. But it at least helps me eliminate quite a few things. And that’s what I’m looking for when I’m looking into it and going. Okay, I don’t think it’s that and I don’t think it’s that. So let me go to this.
Michael Hughes
Right away. Yeah. Right on. So when you say the word assessment, like immediately, my mind says, well, let’s just move the shoulders in six different patterns, right, flexion, extension, horizontal abduction, and abduction, and then actual AB reduction in AD duction. Right. And since we’re on film, now, right, reach our hand up behind us, down behind us over the top to the right behind our back, in a sense, or to our side. And then across our body, rotation and opening, I’m gonna spill my glass of water, which I did in the last podcast, but it wasn’t filming across the body opening up, right, those six patterns, you can see a lot. Now, what do you look at? Like, if you I know you do that, or at least that assessment, there’s more? I’m really curious to see what more you do type one, etc. You know, what are you looking for? When you’re literally having someone extend their hand? In a range of motion? Or flex?
Mitch
Great question. There’s, there’s probably two or three things that I think I generally look at, one, is it just the shoulder independently moving, like is it just the humerus moving in that joint only got it, or is there integrity into the rest of the body is it is the thoracic spine moving with the shoulder, if you’re doing a reach behind you, like if you’re in the passenger seat of your car, or driver’s ed regarding reaching back, it’s just that joint, or just the humerus moving in there, that tells me a lot right there. That might mean that there’s not enough integration within the rest of the body. And that shoulder joint is starting to just get overworked all the time. And then that kind of helps you understand a lot more about this person in that body. So it’s like, I look at that and go cool, we need to get more more things helping you out.
Michael Hughes
And I think that’s a gold nugget, we just hit it with him. Like now that,
Mitch
you know, it’s kind of like that traditional style of training looks like you’re just going isolation. And I think a lot of people are so used to that isolated type of exercising, or you just do like an overhead press or a lateral fly or whatever it is. And it’s like that shoulder joint is only learns how to work independently of everything else. So I’m definitely like when you’re going through different reaches is like, great. Like if you reach behind you, how have you seen that thoracic spine rotate? If I don’t, that tells me one big thing right there. If you’re reaching overhead, am I able to see good thoracic extension? Not just through the spine, but even through the thoracic through the ribcage as well. That’s a big, big thing that I look at as well. Yeah, do I, you know, and then also, like the traps play factor, I just look at the traps, like are you shrugging? Like, I think most people just shrug. But, you know, that tells me it’s like, maybe they don’t have enough integration into the, the core muscles for the lat or anything like that. And that’s also a big sign. You know, it’s, it’s really interesting. And going back to what we’re talking about earlier, it’s like, is it gym related? Like, do you only feel pain when you’re exercising in the gym? Like, say you’re doing a row? Like, you might just be gripping that thing with your hand and it’s all forearm and bicep? Yeah, interest? Yeah. Right now, and you don’t get any of the bigger muscles in the back to help you out like maybe the rhomboids traps, flats, you know, even the core muscles as you go into them. Like are those contributing or is it just purely dominant? Isolated? arm exercise, like you probably love the exercise because you feel like you’re getting great pumping a great workout your arms look good. You know you go wine tasting on the weekend, you grab that glass and you look shredded.
Michael Hughes
Doesn’t like holding that 90 degree bent elbow, exact colic beverage. Exactly. But like having that polo shirt just right over the custom of the bicep. Exactly, exactly. But like, I don’t speak from personal experience.
Mitch
But so, but so like, like, I look at that and go okay, well, you know, once again, like, it’s just too much on that joint itself. And benchpress would be the same thing on there, too. So it’s like you’re just using those delts to push that bar out and some triceps and stuff like that and you’re just hammering that joint itself. You’re not using anything else like the pecs
Michael Hughes
biggest muscles Right. Yeah.
Mitch
Right. But like you want those
Michael Hughes
to assist you? Yeah. And a term that we share that the green student taught us is Pell Trunki law. And it seems like some, like Frankenstein type of word, but Pell, pelvis, trunk, thoracic spine, and scapula. You know, are those three working in the in? Are they assisting? Are they friends? Are they in the motion pattern? And that’s exactly what I thought of when you’re saying like is, is everything moving together? Right. Are you seeing the thoracic spine, the ribcage open up? Because if you’re not it, yeah, I think that that perfectly it’s by itself.
Mitch
Right. And if you think about most people in their habits and lifestyles these days, even active people, but like, you know, cyclists and stuff like that would probably suffer from similar things like a person that would sit down all day, because you’re in that flex position all the time. And it’s like, you’re just compressing the front end of your body or limiting your your movement, you’re not getting access into those tissues, and then you want to go work out and do the same things, but it’s just not you’re not using it as well as you could. Yeah.
Michael Hughes
Gosh, I think there’s like seven thing I apologize. 1617 different muscles that connect just to the scapula about 17. So what is 17? Yep, we’re gonna say some 17 We’re gonna say 17. Awesome. So what kind of dysfunction? Let’s let’s bring up that that client of yours. Would you see? Yeah,
Mitch
this was interesting. So she had I’m not gonna name any names at all. But yeah, client a, my client that she came in with a lot of shoulder and neck tightness, history of CrossFit, which I don’t necessarily think is bad if it’s programmed correctly, but it certainly tells us the type of program that they do. But it tells me a lot about what they’ve been doing vertical overhead pressing with high load and high reps. Recovery. And tissue maintenance isn’t quite there, like it needs to be. And so they’re doing an online WOD like a mobility WOD. And I believe his left shoulder, both arms were back with like a stick mobility or some type of stick they were using. And they’re holding a position for a period of time. And like the shoulder just kind of like, I think what ended up happening was, in the moment, it felt really good. But I think it was almost too strenuous on the tissues. And then the next day or the day after they went and did some kind of wide grip overhead claimed by pressing motions, and then just kind of just went on her. Not not a pop, not like a I don’t think it was a pop, or anything like that, where it’s like, oh, like, you know, a drastic snapping thing that would be like, that’s like, you’re like you’re going in? Yeah, exactly. But it was more like, that doesn’t feel right. And now it’s hurting. And I was on one shoulder. And then the other one I can’t exactly remember, off the top my head, but the other shoulder I think was just starting to get overworked and fatigued. And then that one started to go out a little bit more. So like, it’s a simple thing of just reaching behind your back. You know, it’s like, big backpacker. And so she couldn’t even get her backpack on because she couldn’t get the arms on the straps to pull over to her shoulders. So she had to help with that. And that’s like one of the things we’re like, Okay, now, your training is limiting the things that you like to do, which is the exact opposite of what training shouldn’t be doing for you should make it easier for you. Like your training should
Michael Hughes
hypothetically funny concept, right? Yeah. Right. Yeah.
Mitch
So it’s like, okay, well, that wasn’t helping you. Like to a point it was and then it wasn’t. And so now we have to kind of have all these behavioral resets, in the sense of trying to build trust back, right. And yeah, so I’m sorry, please, please can so I basically took her through, we did our normal, what we call 3d maps assessment. And then dhondup some really great things. I just basically took her through like a single arm or a bilateral arm swing matrix, and then a single arm swing matrix with different reaches and other things like that. Starting off with motions that I knew would be super easy and not discomforting for her.
Michael Hughes
Kay, how’d you know that? Right. I mean, that’s what I love it, we are ingrained in this. So like, how do you know what motions would have been successful?
Mitch
We sat down for the first 10 minutes and she just described to me what hurt Okay,
Michael Hughes
so you listened. Yeah.
Mitch
I love it. Yeah, so she was just like, X y&z Hurt reaching down my back going overhead. I can’t do this and that and I was like, okay, cool. So I know you can’t do that. Which means those motions probably used to cause you pain, maybe just more restrictions and less pain at this point. Because it’s been a couple of years. But I knew those things at one point did cause pain. So let me take you through the ones that didn’t cause pain, just to build a little competence. And then let me start taking you into the ones where I know you didn’t want to go originally. And then from that point, I was like, oh, yeah, now I can really see where it is. That was interesting was it The thoracic spine in the communication with the hips during that assessment was really fascinating. almost zero, thoracic spine flexion was it extension, zero thoracic spine axis extension on her. When her legs were in a lunging position, you eliminate the lunge. And then there’s much better thoracic spine flexion extension, which I mind spinning on this one, which starts to relate to more shoulder flexion and extension to once you take the legs out, you’re like, Oh, that looks a lot better. Now, there’s still a lot of local areas that you need to go and address with soft tissue work to help address some of the damage that was done in those areas.
Michael Hughes
So I have to interject, I have an idea. And I have a thought process on when you say into a split stance or a lunge or XXL like this lunch? What happens to the legs, pelvis tissue, that they’re fed into the shoulder? What do you think about
Mitch
I immediately go into the anterior hip complex? Yeah, right on right into that so and then that diagonal fashion line, or even just the same lateral chain, essentially. So it’s like left hip left lateral core, left shoulder, right, which is also something that I took her through a test and it seemed more of like, kind of more that anterior diagonal line from left hip to right shoulder was really gunky. So it’s like, I’m looking at those things, and then I take the feet out of it, and it looks a lot better.
Michael Hughes
So it was tension, the anterior pelvis, right? Yes. So remove the tension, and up and a thoracic spine can go where it wants to go. At too much tension. It robs the thoracic spine of motion, too much tension in the pelvis, front anterior hip, as you said, then it robs the threat thoracic spine, therefore, yeah, I’m spilling this out. Because I’m, you and I have been talking about this stuff for what? How long ago? Did you go through? I mean, just before? I mean, you’d get right. I mean, five, go on five years.
Mitch
The conversation has been much better since I went there.
Michael Hughes
But it’s but but I guess the point I’m making is it’s been pretty much daily. Yeah, at least weekly. You know, although once week meetings, you know, but yeah, okay. Got it. Okay, perfect. Okay. So,
Mitch
yeah. So I basically found that out. And so in my mind, I kind of looked at and go, okay, like, I know, there’s some influence in the hips right now. Now, there’s a lot of stuff between the hip and the shoulder to that needs to be addressed. So she’s a professor, she sits down a lot. Now she has a standing desk, but that doesn’t necessarily reverse all this sitting down that she’s done in that flex position. So I’m looking at, you know, how does the hip and the ribcage associated with each other? You know, is it just kind of, you know, that bottom rib to the top of the hip and anterior part of your body just really short and condensed? And does that need to be opened up to help with the shoulder? You know, yeah, if we were just to follow up the chain, this is kind of just my thought process. I did it keep on Yeah. And then into the pecs. That’s an excellent. looked into that. And you can basically just start to kind of see the bigger influences. I think I’m losing my train of thought on that.
Michael Hughes
But yeah, but you’re following the chain reaction? Yeah. Um, you’re going you saw the road? It’s the anterior diagonal, which is, it’s a left shoulder, right? Both shoulders, okay. Perfect. So we just so we can pick pick one. So let’s go right anterior hip, iliopsoas, hip flexor, literally, to left PEC. And what? And what’s in between me what you got, I mean, everything, you know, the entire anterior part of the entire ribcage, you know? So yeah, that’s about it. And then. Now, this was just a movement assessment, right? It wasn’t necessarily a session a treatment. Right? You’re just assessing? Or did you have an opportunity to be like to like, let me get in there a little bit. Let me see what I can do.
Mitch
Now. We ended up spending about an hour and a half together. Okay. Yeah, a little of time, then. Yeah, I didn’t have I had a little, little nice gap. And it was one of those things where it’s like, a bleeding heart moment. I can No, I can help you with this. And it’s also one of those things where like, let me show you the value as well, too. So I basically just put it on the table, and I went to two places, one pec minor, and sub Scott. Right away.
Michael Hughes
So your strategy was to start local.
Mitch
More behaviorally?
Michael Hughes
No, I know. Yeah. I know. I totally get i Yes. Love that.
Mitch
Right. And primarily because there’s a backpacking trip at the end of this month. So it’s like, you need to get the backpack on. I can go to the hit right now. But like, you know what, that’s not necessarily being a problem with your day to day stuff. Like you can still hike, you can still do all the things that you want to do. That’s fine, man, I’m writing down. I’m gonna come back to this. Yep, go for it. But you know, ultimately, those will have to be addressed and integrated within the shoulder too. But I think just more behaviorally speaking, like, just being frustrated and having those issues constantly, like let’s just let’s just try and solve that. Let’s just try and get you to a point where you’re like, you’re fed up at like nine out of 10. As usual, I guess Six. Yeah. Right, because you at least go on to backpack trip. Right? Yeah, let me just at least be able to get you to get a backpack on easier. And so like the strategy, so saw great results, just in like 2025 minutes of soft tissue work in those four areas if you do left and right side, some light stretching. And, yeah, I mean, it was really interesting too, because even going into the true stretch, and just putting her into some simple positions that wouldn’t necessarily load the tissue that much, you can see the binding, just the holding of tension, behaviorally in that area. And then, you know, I’m a big fan of breath work within stretching, you know, especially when those situations like teach the tissues to calm down, like, I feel like it’s like localized, sympathetic nervous system like sympathetic system like in that localized tissue. So it’s like holding on to that trauma. So if you can get that breathwork to just kind of teach it to calm down and relax in that position, and just be like, Hey, it’s okay. Like, we can do this, like, you can be in this position and not freak out. Now, she or her mind, she’s not freaking out, she just got us really tight. But that tissue has his mind of its own. And like, we’re not, we’re not used to doing this. So it was like, just hey, hold that position, there doesn’t feel like much of a stretch. But once you don’t feel the stretch, turn a little bit more. And then hold and breathe, turn a little bit more hold and breathe. And over and over time, I love this too, just like starts to work. Yep. Now that’s just working right now, of course, but, you know, we just need to get to a point where we can start to move without the discomfort, and then start to kind of progress out of that.
Michael Hughes
Yeah, and we’re gonna take the whole thing like, so like, going going locally, like, you saw how the hips were directly influencing this shoulder, right in one plane of motion, right, at least at least with the anterior positioning right, forward and backwards, you put forward stress on the pelvis, right through his stride stance, our execs right foot in front left, left foot in front of right lunge position hold, and then fast spine couldn’t do what it wanted to do. So I’m kind of thinking in my head here, and then the shoulder couldn’t get that overhead position. Okay, got it. And you knew that if you went after the hip, you could get more thoracic spine then, and therefore get more shoulder motion. Because last time I checked, the glenohumeral joint is connected to the clavicle. And the clavicle is literally the only thing that connects the entire shoulder complex structurally to the body. And that connects to the ribcage. And the ribcage is connected to the thoracic spine. I’m just gonna jump over the lumbar spine. And if you get extension through the thoracic spine, you’re probably gonna get extension or good extension through the pelvis, or through the hips, rather, excuse me out the pelvis. But but the hips. So therefore they’re, they’re directly connected, not even mentioned this scapula. And instead of going after the, what I would call the big dogs, you and after the smallest ones possible, but you did so because they have shoulder pain. And if you start doing some alias, so as abductor work, when they come in or assessment for shoulder discomfort, you have to fight a much bigger behavioral battle. Right? Right, they have to trust you a whole lot more know that you’re starting way down at the at the at the pond, the stream, and they’re screaming about a waterfall, you know, you got to follow that stream all the way up. So you went right into the direct muscles that control or limit or restrict the overhead motion. subscapular be one and then you said the pec minor definitely is another one. And there’s several others that do that too. And you went in there, and therefore treating that person in a way like I’m going to go right after your shoulder. You know, you didn’t touch the deltoid, right, but you went in to those areas. And then you position them in a position that was comfortable. And then let that inner connective web of fascial tissue literally spread itself out just by breathing. Because the fascia is literally connected to the shoulder. And every time you move your diaphragm, you there you therefore move your shoulder.
Mitch
That’s pretty awesome. It’s just micro movements. Yeah, right there.
Michael Hughes
I did I yeah, that’s, that’s really cool. That’s really cool.
Mitch
And she’s an extremely intelligent person. So it’s like I even kind of broke down like, hey, look, these actors, these right hip muscles, this hip complex, like, it’s influencing it, but and she’s like, look, I totally get that. And so she’s totally on board with understanding that so it’s awesome. But, you know, once again, it was like, We need to get you to a point where you could do this.
Michael Hughes
It’s not solving. It’s like, it’s like for a lot of athletes, right? A lot of athletes do. They play injured, they play with pain, and that’s kind of especially professional sports and NBA Finals. Uh, gosh, I’m gonna really show myself here. I apologize. Either just finished, or are in the last few games here don’t yeah, this is not dated here, this pack is not dated. So when’s it gonna know, when it’s posted is not when this was recorded. But they’re hurt. They’re definitely hurt. They’re definitely hurting. Right. And they make it happen, right? Hence athletic tape on ankles with basketball players, right? What, uh, what I’m bringing this up is that, like you said, as, at least what I would say like, I want to give you perfect motion, you know, 90% motion back. But that’s not going to be possible in three and a half weeks. But so that’s get you as much as we can. So you can do the task, you can play the sport. I’m going to tell you the roadmap after that, but let’s get you to play the sport, the hike the trip, and then we’ll come back and we’ll dive deeper. And I think that’s kind of like understanding that understanding that we’re here to serve them. We have obviously, our education and our experience. And we want to make things right. I mean, I think as a trainer, or as any sort of person who works with therapeutics, you want to fix it. You want to and you want to fit in like, at least for me, like I’m like, I am definitely a perfectionist. And I will definitely go to like, I’m going to make this thing as dialed in as possible. And do nothing until this is fixed. That’s where my heart that’s where my mind goes where my heart because like that’s it that’s idiotic, because the shoulder has so many influences. Literally, inversion and E version of an ankle joint can limit the range of motion of backwards reaching or forwards, reaching over shoulder, like it’s, that’s that deep, it’s that deep. So fixing a shoulder and we use word fixing, putting it into an environment where it can heal itself through training and conditioning is very challenging for a shoulder because you cannot not use it. Right. It’s it’s so it’s so important to the it’s like fix a car engine while the engine is running. That’s what pretty much brain surgeons doing heart surgeons do. That’s pretty awesome. But a joint it’s physically in movement all day long, or prepositioned. Like even me sit at this desk right now, like me holding this pin. Like it’s, it’s in a position for me to write, it’s ready to go. I’ve kind of just work with us this morning. Nasty ski accident, fall, no surgical requirement needed, but sling for a long time. And though the connective tissue close to the ligaments are now healed, the doctor says you’re good, you’re good to go, literally was the phrase, go for it, you’re free. She’s now has to recover from the sling. Like we’re not even treating the ski axe anymore. And in fact, we never were we’re just literally getting her out of her shoulders position for the sling. And how that muscle memory like you like I think it’s so fast that when we move our shoulders, we move it in such a pattern that we think it’s just like, oh, that’s just the way the shoulder should move. It’s literally going through a pattern. Like for the most part in our day to day lives that is you is unique to us. And it’s so interesting that it becomes that muscle memory path, you have to literally break that muscle memory path and form a new path. And we have tools and ways to to do that. But it’s really challenging. I find it to be the shoulders the hardest joint for me to work on. I understand it a lot. But it just like expect slow growth. That’s just my that’s my thought process on it.
Mitch
I’ve dislocated my left shoulder twice. And I’ve also like sprained my knee. When I was a kid a couple of times due from skateboarding. I would rather go through a knee injury than a shoulder injury every single time.
Michael Hughes
What happened with the shoulders just fell
Mitch
dislocated like the first time I ever went snowboarding.
Michael Hughes
The first time bummer was on a birthday trip. Oh
Mitch
gosh. Yeah, that was pretty. That was pretty painful. But like, that was the moment where and this is years before I even started here and doing any of this and that was just one of the most uncomfortable things I’ve ever had an experience like half on going in a shower happens sleeping happen. Getting out of a car helping trying to do anything and clothing putting on deodorant. Yeah, like anything like a knee. I’m like, I gotta mobilize that I can just put weight on it. I can easily walk that thing. I’ll just done it before. Yeah, true. Yeah, but the shoulder. Yeah, you get some crutches. You’re fine. All right. Shoulder. Can’t move without it. Without it moving.
Michael Hughes
Yeah, right. Exactly. Yeah. You can’t take a breath. Sometimes he will say I’m breathing in hurts my shoulder. Yeah. Which tells me a whole lot about where the problems coming from. But yeah, you know, but yeah, it’s, that’s gosh, yeah. Frozen Shoulder is probably one of the most the more challenge same ones that I’ve, that I’ve come across. And I’m curious what what your answer is to. Because the way I look at a frozen shoulder is, it’s been there in hiding for a long time, the shoulder has been moving improperly, for years, slowly, just like a car tire slowly wearing away a little bit faster than you should be turning to sharp accelerating tool to do to sharp, and then you go do and clean the house. And you just rock and roll and you’re cleaning some ceiling fan. And the next day, your shoulder is literally in like, I can’t move mode. And it’s so surprising to clients when when they see us because like, it came out of nowhere, you know, and like, are they slept wrong one day and their shoulders just locked down. And it’s really fascinating how like a frozen shoulder how the, how the capsule literally becomes, like solid. It’s like plastic. It’s really fascinating. And the treatment some treatment for this is, you know, besides the physical therapeutic side of it is literally let me put you under, let me put you in, in literally knock you out. And then manually as you’re literally knocked out on a table in a surgery center. Let me just forcefully move the shoulder to you know, feel it to break up the capsule, like I get the concept. You know, it’s not it’s not a bad strategy. But man, it’s pretty invasive. So, what’s your strategy on a frozen shoulder? I honestly I’ve never worked with one. Okay, then let’s dive into what the possibilities are then. Right. Most of
Mitch
the damage is like it’s usually like some impingements you know, some soft tissue restrictions. I think the probably the most challenging one I’ve had to deal with is not challenging. But one of the more extreme ones for someone who was 70 was just recovering from a broken humerus. That was that was probably it. Yeah, yeah. But never frozen shoulder quiet.
Michael Hughes
Well, it’s to me what I look at. It’s like the extreme of all the shoulder injuries just manifested into an shoulder, it really just says no, I’ve been, I’ve been pissed on so often, I’ve been overworked so much, that I’m really at my limit. And until you get all my friends to help out first, on the kind of move at all. And then some people wake up like one day and it’s gone. It’s really this I don’t know, like there’s a whole level, we’re talking to a colleague of ours, Lenny, like, he’s like, Oh, it could be dietary to you change anyways. So to stay into the biomechanics of it all. With a with a versatile because it hurts so much just to like, just get that lateral kind of motion that that AV duction up. It’s like you got to go after the hips, you got to make sure that you can move purely there, you got to go off the thoracic spine, make sure they got amazing thoracic spine, lateral flexion and rotation extension, then you go to the scapula and that scapula is gotta be just loose. Well, it hasn’t been so stable joint, but has to be very capable to move in all the different ways. And it’s a lot of manual work, a lot of manual work and so much of like behavioral unraveling, because they want to move their shoulder and it’s so apparent, you just, it’s just all trap. It’s like they go to raise their hand up and the trap goes first. And like oh, man, okay, like, how do you unwind that? And it’s really just training and conditioning, right? That’s the name of our job, train it and condition it over and over and day after day, you’re going to eventually win. But that’s been that’s been the hardest one to my taking. Because it is such it’s it’s like the it’s the ultimate manifestation of unmad. And I’m not going to do nothing. When I get mad, I just do. Don’t look at me, don’t talk to me. Don’t even stand next. So I imagine that’s what the show was going going through. What do you see training ammunition because you’ve worked in the traditional gym? Interesting story about merchandise that we both come from essentially the same background in the industry, we both worked at Big Box gyms first, right? And then found our way into Gymnazo I certainly found my way into it and so did mentioned we both worked literally worked at the same big box gym. So we have a lot of fun fun stories about that one. What do you see a lot of Gen pop a lot of people just gonna go to the gym that isn’t good for their shoulders. And let’s get kind of detailed.
Mitch
I actually I really appreciate coming from box gym a lot because you get to really understand two different sides of the training world you get understand that the isolated muscle building side of things, all you do is concentrated bicep curls and tricep grows and benchpress and and you live it to so you get it you experience it. And so it’s like with the shoulders and particulars like and I’ve definitely been at fault in this my younger like younger years of training guilty. It’s just overload and isolation. So like how many anterior dumbbell rows ACS can you do? How many lateral flies? Can you do? How many overhead presses can you do? How many narrow grip bench presses can you do? And they’re gonna do it over and over and over and over again. And then, you know, Monday, Wednesday, Friday, every exactly like, seriously. And then it’s, it’s not only that, but it’s also, well, there’s only one way to improve your shoulders, and that’s by it progressively overload. Oh, great, okay. And then you do that over and over and over again, months, months on and years on end, most likely doing the same routines with slight variations from a dumbbell to a cable to a resistance band, well, great, you’re still stressing the same tissues in that same joint the same way over and over and over again, with very little tissue maintenance for most people. So I mean, you know, if you’re professional athlete, you can probably get away with it a little bit more, because you’re going to spend a million million a half on your body to be able to get the proper recovery. But that’s what Jen, Bob’s not gonna be able to do that. Nope. So you just, you just end up seeing all of this isolated cotton and concentrated work just on the delt muscles, some of those just localized tissues in there. And you’re just like, just looks like it hurts every time but
Michael Hughes
the Delta, it looks so good. It does that nice softball right on top of your shoulder. I mean, you can see it in your shirt right now, man, it’s it’s a good looking, good looking piece of tissue.
Mitch
Sometimes you got to walk sideways through the door.
Michael Hughes
I love it. Yeah, I started in fitness by literally reading Arnold Schwarzenegger Encyclopedia of Modern bodybuilding. And I get it. And it was fun, because it looks good. I mean, yeah, there’s amazing shots of Arnold, leaning over a bench, his arms crossed. And he’s he’s just two softballs. Actually, they’re bigger than that. Be quite frank with you. So if you were to go back, let’s say Gymnazo got transplanted into that big box gym? I want to have it, how do I make this like realistic? And your client hired you? Right? What would be a few minutes? Like wouldn’t be a few things. You’d say like, Hey, you know what? I’m glad you’re working on. But here’s what to do instead?
Mitch
Yeah, that’s a great question. I think a couple of the myths? My, it’s a great question.
Michael Hughes
Because I think it kind of comes down to the word cheating. Right?
Mitch
I mean, one is like, I would have to integrate the rest of the body into it, and use the hips a little bit more to help the shoulder out. Like, if you want to lift an 80 pound weight overhead, I’m probably going to put you in an upright position. And have you at least do a little bit of a squat to get that overhead.
Michael Hughes
sounds right to me,
Mitch
you know, I might have you do more of like a hip drive, you know, a frontal plane hip drive weapon, right lateral to help get that weight out to to the sidebar, you know, for horizontal abduction, you know, but I’d have to convince the client that that this is what we’re going to do, because it’s so unnatural for people to go into a box gym and be like, you want me to do what you want me to push my hips with it? Yeah, I do. The weights gonna go to the same area, but you’re gonna be more efficient at it. And now we got to learn how to control mass momentum, rather than just trying to just muscle that up, right, all your effort ever you’re going to do it with a trapper with whatever, you know.
Michael Hughes
Yeah. It’s it’s really, it’s a facet like don’t isolate, don’t stick your elbow next to your ribcage and do an external and or interlayer rotated bandit or cable move. Don’t sit down in a chair, and rester dealt your dumbbells on your shoulders and press overhead. In fact, do move your pelvis, do cheat. I remember I bring that up often as I want you to cheat. Meaning I want you to squat and press. I want you to shove the hip over and do a dumbbell fly. And it’s fast how I’m gonna go look at me and be like, that’s not what you should do. I’m like, for what reason? Like what’s the purpose is there’s so much ingrained pneus of isolation to the shoulder. It’s it’s like from it’s I think it really starts like high school even maybe not sooner. You know, like, we don’t throw a baseball in isolation. We don’t throw anything in isolation. Maybe at darts, we think throw darts a little bit of isolation, a
Mitch
lot of restart. Yeah, a little bit there. Yeah,
Michael Hughes
I will give those Dart
Mitch
players that guards beer pong. You know, I’m
Michael Hughes
not growing up in college and you say that more appropriately. When we’re 20 really grown up. There’s so much of those things go on. And that really leads into a lot of like, to me, I think the most common thing we see is a good old fashioned impingement where the humerus is going somewhere faster than the scapula or the glenohumeral joint can take it Right, and it’s like, the way I can look at is like if a, if a door and a wall could both move, right and the door and the door is attached the hinge hinge attached to the, to the wall, if the wall could go towards the door and the door could go towards the wall, that door would close a lot sooner. And I found on this one, I want to make sure if you’re following me, then at least someone else’s, okay, and then of the wall went away from the door, as fast as the door went away from the wall, the door would open a lot sooner, because both things are moving away from each other. And that’s kind of how the humorous and at least the scapula works. So it’s like a teeter totter. You want them to be moving, one goes up, the other one goes down, one goes down, the other one goes out. Right. So if I’m gonna take my arm overhead, then my shoulder blade, my scapula has to go down. If it doesn’t, then I’m going to have a problem eventually. And if I will take my arm behind me that my scapula has to go relatively wrap over the top in front of me. And if that doesn’t happen, then we’re probably gonna have a problem in another 150,000 reps, or our motion matters.
Mitch
And there’s also you know, it’s so crazy how much of it you see, but you see people just grab a screw band resistance band and just like internal external rotation, so the whole time it’s like, now that not saying that’s wrong, like there’s a time and place for it for certain people. Like maybe that’s the best way that you need to recover from an injury or so right? Yeah, it’s not wrong. It just benefited. Yeah, you know, I think one of the bigger myths is is like, it always needs to be strengthened. Ooh, nice point. Yeah. Like, yes. Like, it’s, uh, you haven’t you have a shoulder injury? Oh, we have to make it stronger. Yeah, oh, gosh, I actually think we can deal decompress everything around it more to open it up. I think you’re actually putting too much tension into it. And that’s why you’re experiencing so much discomfort. Now, you may feel great during the workout, because now you’ve just lubricated the joint a little bit with some motion and blood circulation in that sense, you know, to phrase it easily. But, you know, in the long run, like when your body cools down, like, there’s still a ton of compression within that joint itself and around it. You know, what are you gonna do? Just go back and do more? You’re just exacerbate? You’re just making an exaggerated issue, just making it worse. Yeah. And then what like, then you’re going to go overhead one day and next thing you know that that PEC tissue, that lat doesn’t move, and then she’s pure pop or snap, or whatever it may be?
Michael Hughes
Yeah, because it’s because it’s such a mobile joint, right? In the grand scheme of things, we go through the joints where the shoulder grabs that lands on a mobile joint, the scapula is more of a stable joint. So stabilize the scapula, right and mobilize the shoulder and therefore move the shoulder with strength. But strengthening when it’s done creates more tightness, more compression. By definition, it should do that. But you overdo it. And so therefore, you have to mobilize the shoulder. And this and cash haha, don’t want to say this. You have to make the shoulder more mobile.
Mitch
We have to integrate it. Yeah. So you have to make it mobile but integrated into the rest.
Michael Hughes
Right, exactly. And the scapula needs to start flying around. Yeah. A lot of times I literally put like, I’ll say, hey, client, feel my scapula, put your hand on my scapula and I’ll move my my my arm around actually move my hand around, said you feel how move how much my shoulder blade moves, to try to get back to what you’re told, but needs to needs to actually actually do. And remember going through like soft tissue edges as soft tissue education. There it is. And realizing that the scapula can like adhere itself to the ribcage through the subscapular you know, like all that fascia right there and to have someone dig their fingertips into your armpit so deep that it goes behind. And inside your, your your shoulder blade. That’s a unique feeling. Kind of like unique getting your, your your soul as deep tissue. Yeah. Like it’s like where are you?
Mitch
That’s client B right now. Yeah, no shoulder blade motion. You go overhead. Trap. Elbow all? Yeah, trap elevates. elbow bends. Put the hand on the shoulder blade. Where’s this is literally glued to it. Once you get a little shoulder FMR, a little soft tissue work. You move it. Yeah, there’s still clicking, but we only did 10 minutes.
Michael Hughes
The clicking is a good thing. work because this is there’s movement now. Right? Right. Yeah, I would say like click is a good thing from no clicking. Then we want to go back to no
Mitch
clicking. Oh, no, there was a lot of clicking. Yeah, there’s less clicking. Oh, you’re on that spectrum. That was Yeah, exactly. But it was so interesting. I was like, fuel my shoulder blade. You feel how that moves in these different directions? Yeah. Like no, fill yours as you go through reaches? Nothing was fascinating.
Michael Hughes
Yeah, that was probably that was one of the biggest takes like is that you if you want to fix it, if you want to enable an impingement to go away. It’s just got to balance the teeter totter. And that to me, that’s the relationship between the shoulder, humerus and the scapula. And anyone that’s been that’s been kind of that’s been kinda cool. Okay, this was this was pretty, pretty cool because, you know, I like to call myself pre grad school. PT trained, right? That’s like all my education was all about physical therapy, physical therapy, and the bandage rotator cuff muscles, right, those those drills are like Staples. I don’t think I’ve done one of those drills in 10 years. Truly, I’ve done them, but not even close the way that it’s looked. So like, what what would you call like, what would you call some like interesting shoulder exercises, but the traditional person be like, That’s a shoulder exercise. Like, just kind of dive in it like, you know, let’s go to like the integration. Like think like think about like a plank, is that a shoulder drill? Like how many ways that you can train the shoulder, but if someone has to has shoulder to so think about someone’s in a workout? And they have shoulder pain with a viper overhead press? Give me some tweaks? I know it’s general, right? Because it all depends. But like, you know, typically say oh, just go ahead and just go do some, some rubber band. internal external rotation, you know, tea cup that not tea cup, but you know, those kinds of things, tea cups, a whole different story, which we should probably end on that one in a few minutes. But so talk about some like some like tweaks, you know, if there’s a trainer listening is like, gosh, well, what do I do about it?
Mitch
It’s actually been interesting to do, since we’ve, since we’ve been integrated in meses. A lot of mace work lately, and a lot of wraparound work. Yeah. So it’s like me as a practitioner, I’m like, oh, I need to get good at this. So I don’t look sloppy for the clients. I want to do 100 of these. But it’s what’s really interesting is my left shoulder doesn’t integrate well on this, I actually do some like just some single arm pull downs, isolate a little bit more. And so I noticed like my shoulder almost wants to like cellblocks when I go into my left arm goes over my right shoulder wrapper
Michael Hughes
makes sense, because you’ve literally just look at it twice, right? Yeah.
Mitch
And so it was really interesting. I was like, well, this isn’t right. So I was like, Okay, well, let’s think about this, it’s acting alone. It’s not getting help. So I was like, oh, let’s just do some simple pull down. So I just went to the cable machine, did some pull downs, and went right back to and I was like, wow, that’s 100 times better. And so just kind of going in that flow of things. You know, it’s like, some of the one on ones and semi private clients, I’m working with him like, Okay, you want to get better at this. But it can’t be purely shoulder dominant exercise, oh, we’re going to fatigue you out, and there’s gonna be an injury down the line. And it was more so just teaching the body, how to work with the other parts. Like let me get the core to work, I need to get to go through extension, thoracic extension. And it needs to be integrated into the bigger muscles surrounding the shoulder. And that was a big game changer for myself and a couple other people and they just felt more connected, just more integrated. And that was pretty fascinating. In terms of training, other aspects, like overhead press or something like that. Sometimes it’s like I look at it and go, Okay, well, you’re doing an overhead press. Like we talked about really let me do have you do squat. Good, I helped you. Okay, cool. Maybe you’re going to heavy or maybe, you know, squat to overhead press squat. Every press, I find a lot of times is especially you know, like through the obliques and the serratus muscles. All those muscles that encompass the thoracic spine in the ribcage are just glued to if you can create some more mobility with that, and be able to get a little bit more traction coming from from below the shoulder and helps a lot. So it’s almost like it’s a really weird cube. It’s like I almost tell people like lift up their ribcage when they’re going overhead. Yeah. And it’s like Yeah, well, that’s a big game changer.
Michael Hughes
Oh, I gotta sorry about that one. Yeah, yeah. I got a for those listening. I got a two year old and shirt was off his shirt, and he has permission making this diaper most of the time. And I was teaching him our warmup literally, I was like they brush your teeth every night we should probably stretch every night to and if you’re gonna start on that this young, you might have started this.
Mitch
So it’s good better be an athlete when he’s older.
Michael Hughes
You’d be very efficient mover. I always say that. He may like drawing and you know. But long story short, and he did not tell them. I said okay, read your hands overhead. And he said the stage where he understands everything but says nothing. And literally he reached his hands overhead. And what did I see? What’s his ribcage go? All sucked way up. Yeah. And I’m like, da da. Like why wouldn’t the ribcage help out? And this is I mean, this is like this is only if this is like a year ago. I’m like I’ve been missing that I haven’t been actively focusing on that with my training and conditioning to my clients. And I was like, as I say it probably 14 times a day now, just like when I’m talking my shoulders like lift your ribcage. And as a game changer, it’s all active tension thing to like taking a mope stick and pushing them up stick together and doing it overhead press. Is that holding it apart as the irradiation? That it’s so many more muscle groups? Yeah, it’s it’s like your lat pulldown to get the isolation going to kind of get that triggering happening. positive one. Yes, super fascinating. But there’s so much shoulder use that is constant. But so many other muscles of the 17 that attached to just a scapula that aren’t doing much. Turn them on, get him going, get the juices flowing, and see how you know, instead of using just for muscles constantly, at get to eight, I’m sure is going to be better use from eight you almost have double, you know, actually you do have double, you know, go to 16. It’s so there’s so many, like there’s so many possibilities of how the shoulder actually works in integration. I think that’s pretty, pretty, pretty, pretty sweet. teacups, I think I want to end on the teacups. Yeah, describe that to somebody.
Mitch
You are a caterer at an event like this, you’re holding a tray overhead, and you have to bring it down onto a table type of situation. And you have to use one hand and you can only use one hand. Yeah. So it’s like you have to go from an overhead position. Keep the food on the plate as you bring it down onto a table without spilling anything on it. Yeah. But then also add a reach behind you. Behind you, yeah, and then pass it to someone behind you. So you know, your overhead. You bring it down and around. Yep, super complicated. And it’s really interesting, too, because you can see bailouts right away. But then once they start to do it a few times, and then once you start to see the fluidity in it, and then you sort of go okay, and
Michael Hughes
and actually put like a 10 pound plate in their hand. You know, load it now. Exactly. It’s crazy. And it hits extension flexion internal, external AB ad reduction. It hits the entire shoulder in every aspect. So way to go servers. Way to go bus bus boys and girls email
Mitch
is like the most like relatable thing I have here is like yeah, like you have to hold something over and you have to bring it down. You can’t spell it. Yeah. And what a great shoulder assessment that is. And we use rubber discs to start, right. Don’t drop the disc, but you can’t grab it though, right? And then I don’t think ever I don’t think I’ve ever seen anyone use like a 20 pound plate yet or 25 pound plate. But going up like five pounds. That’s about it. Yeah. Maybe that’ll be a new challenge for us. I’ve been even using like a lot of cars. lately. Concentrated particularly articulated rotations. Okay, yeah, where you just isolate the joint, just so you can move the humerus within the joint itself, just to create some walk motion, because sometimes I’ve noticed with tea cups, too, it’s like, oh, you’re not ready for that. You might say I do feel a little discomfort. Yeah, I don’t want you to go through that for 20 reps while you still feel a pinch in a certain part of that. So you’re able to just isolate, you know, of those three different things are six different motions, really, you’re able to just isolate them out a little bit more, and just hone in and practice a couple of those skills. And then go back into the teacups and see how it works. Particularly. Yeah, just so you can refine that line of movement, and then refine it even more with all the other motions.
Michael Hughes
Yeah. So I liked that one, like ending this podcast on the biomechanics of the shoulder, do a teacup move, test yourself out? And then posting the comments, let us know what what Yeah, and we’ll keep going from there. Hey, Mitch, thank you very much. I love these. I love the conversation of the banter, love the back and forth. Probably listeners out there, we have an understanding about biomechanics. That was not something that we that we created. But we created a course around it called the multi dimensional movement course, coaching course, excuse me. And it’s allowed us trainers to really have a deeper understanding not only from the movement, asset aspect of our practice, but from the operations in the systems and the backgrounds and the programming and all those things that really make what we think as a whole as a well rounded coach. So if you’re curious about that, check out the show notes. There’s a link in there. But it really dives into the inner workings of exactly what we’re talking about. Because we believe trainers shouldn’t just be those people who just give exercises but can master exercises master movement, and we haven’t mastered it yet. But we’re in that process and we’re having fun with it. So we want to join you in that in that that journey. So check out you can apply for it and it has changed certainly our lives as we were practitioners and continues to do so with a lot of other coaches that we coach. So once again, thanks for being with This, Mitch, thank you so much. Thank you. Cheers. And see you guys next time. All right. Hey all. I hope you guys enjoyed today’s episode. And if you did, please share it with your fitness obsessed friends and peers who are also navigating this world of fitness and trying to succeed the trends and misinformation. As you guys can see, this podcast is basically a masterclass for trainers wanting to level up in their coaching skills, and their fitness business model. We launched this in 2020. Because you and your fitness tribe deserve to see an unfiltered look at all the aspects of what it takes to stand out as a next generation coach, and build a successful fitness business sell, share far and wide. And please, when you do, do me a favor, take a screenshot of this screen and share it to your social media accounts and use the hashtag Gymnazo podcast that’s hashtag Gymnazo podcast that way we can see you and share your post with our audience. And finally, when you’re ready to go to the next level as a coach, or in your business, and to reach more people, please go check out gymnazoedu.com. We have put together the best 90 Day coaching program on the market for trainers wanting to become a masterful practitioner and build a business that gives them the freedom and impact. So let us help you do just that. We have online training and one on one coaching to guide you through a full 90 Day certification. We even get you training our clients live because it’s always better to work out your kinks on someone else’s clients than yours. But we promise you this, your clients will be blown away by the transformation our program will help you make you’ll be masterful at a whole new level and part of an incredible community of coaches worldwide, taking their skills to the next level. So if you thought so this episode had some fire to it, and inspired you to take action, wait until we see what we’ll deliver on this program. So just go to gymnazoedu.com. And we’ll see you on the other side. Remember that turning your passion for fitness into transformation and sustainable business is critical to reaching the people and lives you were put on earth to help it matters and truly can make an impact in other people’s lives. So, hope you do that. Keep sharing your passion and we’ll talk to you soon.
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