Could external rotations be bad?

[michael]

I recently began working on dumbell external rotations, mainly due to an article on Tnation by Charles Poliquin about poor structural balance holding back strength gains.

http://www.t-nation.com/free_online_article/sports_body_training_performance/achieving_structural_balance

Now several weeks later, my shoulders feel more internally rotated then ever,they "pop" and "crack" when i rotate my arm from the shoulder (palms in,palms out motion) and just generally feel really loose.

Could this exercise actually be damaging to the shoulder/rotator cuff ?

(my only thoery is that the posterior capsule is overstretched along with the external rotators,which causes the loose feeling)

[Neal Winkler]

How did you assess poor external rotation in the first place? Sometimes its just shoulder protraction that gives the illusion of internal rotation.

Any exercise can be bad if its not done properly or not actually needed.

[Joshua Naterman]

Either way, one thing that Poliquin doesn't really mention in that article is the relationship between flexibility and strength across the shoulder girdle. External rotation is important, but so is scapular retraction. If your retractors are weak and your chest/anterior shoulder girdle is tight you will eventually have serious shoulder problems, virtually guaranteed. This makes the space in the AC joint smaller, which virtually guarantees impingement will result eventually. It will come on slowly for most people, but come on it will. You will also end up with a type 2 or 3 Acromiom process even if you start out with a type 1. You can google that if you want more info.

If you do not have a balanced shoulder girdle, meaning that your shoulders are rolled forward, pulled forward, or perhaps both, then you're going to have issues with external rotation for sure. You could also be CAUSING these problems by performing the exercise incorrectly. This is more of an issue with Poliquin's recommended exercise, which is an excellent one btw, than with side lying external rotations, as they hit different muscles with different intensities (infraspinatus vs teres minor) due to the different joint angle. You don't want your scapula moving very much during these exercises.

The first thing you should do is assess your shoulder and correct whatever deficiencies show up as far as postural and movement concerns go. That will cover flexibility and strength issues. The second thing you should do is make 100% sure you know how to do Poliquin's preferred external rotations correctly.

[Nic Scheelings]

You will also end up with a type 2 or 3 Acromiom process even if you start out with a type 1

This is incorrect, the shape of the acromion is the way you are and won't be changed, much like hyperextended elbows. However osteophyte or bone spur development can further narrow the space underneath the acromion.

[Joshua Naterman]

There is actually a fairly large and growing mountain of evidence at this point that suggests it is not just possible but fairly common for acromion morphology to change over time. I have just found 50 free full text articles on pubmed related to this subject. Search for Acromion Morphology. Not everything will be on topic, but there are quite a few. These three, http://www.ncbi.nlm.nih.gov/pubmed/7706348, http://www.ncbi.nlm.nih.gov/pubmed/11132273, and http://www.ncbi.nlm.nih.gov/pubmed/20065375, are a good start. You'll notice that it seems that time is the greatest factor, though the athletic activity of the subjects is not explicitly stated.

Also, according to what is being taught in the exercise science program at GSU, which is run by the guys who write most of the ACSM stuff, you can in fact slowly change from a type 1 to a 2 or 3. It is a long term thing, but you can lengthen bones with constant tension, it just takes a loooooong time. That's what traction is used for sometimes. You generally won't see something like that happen in 6 months or a year though, even with extreme stress.

I am not sure if there is anything causal, but there is a very strong body of evidence supporting the idea of changing acromion morphology over time from type 1 to 2 and 3. I believe there have been cases of people undergoing acromioplasty and then ending up with type 3 acromions again later on! I remember reading fairly recently about a powerlifter who went through this.

It is also completely untrue that elbow hyper extension can not be changed. It can not be reversed that I know of, but it CAN be advanced somewhat over time. That doesn't necessarily mean it WILL be, but it can. It seems that the same most likely goes for the acromion.

The pec minor attaches to the coracoid process which is connected via ligament to the acromion, and the pec major is directly connected to the clavicle, which is also connected via ligament to the acromion. If you do not stretch these muscles to maintain muscle length they can absolutely cause the acromion (and shoulder in general to be in a bad position, causing short term problems as well as long term problems ( Reference: http://www.ncbi.nlm.nih.gov/pubmed/8956588), and the constant tension can certainly cause traction effects that seem to lead to development of type 2 and 3 acromions. Longitudinal studies suggest that this is simply a natural occurrence that most people will experience over time and perhaps not a direct function of training, though powerlifters may be at increased risk due to intense focus on bench pressing. That is based on lifter experiences and the results in the referenced study. Internal rotation, 60+ degrees of flexion, and 60+ degrees abduction are all where impingement was seen most. This is where powerlifters spend an inordinate amount of their time, especially shirted lifters who do lots of board presses, and perhaps goes a ways to explain the unusually high rate of shoulder problems in this population.

However there are MANY athletes with type 3 acromions that have zero shoulder issues. These athletes most likely have a healthy balance of flexibility and strength across the shoulder girdle and by maintaining correct posture they keep plenty of space between the humerus and the acromion. The same process that allows for proper rehabilitation of the shoulder issues athletes often experience will also allow us to avoid the problems altogether. I believe this is especially important to consider in light of evidence that acromioplasty does not prevent the progression from impingement to tear. reference: http://www.ncbi.nlm.nih.gov/pubmed/10463757

I somehow feel like this isn't complete, but my tired mind can't make this post any better than it is at the moment! Please let me know if I'm screwing something up!

[Nic Scheelings]

I will spend the time to read this through properly when i finish exams

[michael]

How did you assess poor external rotation in the first place? Sometimes its just shoulder protraction that gives the illusion of internal rotation.

If your retractors are weak and your chest/anterior shoulder girdle is tight you will eventually have serious shoulder problems, virtually guaranteed.

So what your both saying is that basically weak retractors lead to a damaged rotator cuff

To be honest though my shoulders weren't overly hunched/rolled forward and had decent flexibility (mainly due to doing barbell pullovers when i was younger) before i started the exercise. My main reason for doing the exercise was to see if it was holding back my strength ,and also for some "better safe then sorry" type work.As far as the retractors go i do pleny of chin-ups,handstand pushups and overhead presses. The majority of reading i found about weak retractors generally associated it with a "bench and curls" type program design.

Not to sound lazy or ignorant,but as far as the "clicking and popping" goes can any one suggest anything?

i've asked around aswell as searched online and the only advice i can get is to do exercises very similar to the one my inital post was about.

*Sorry if this posted about 5 times i had to keep re-typing it for some reason

[Cole Dano]

@ the OP: Can you post a video doing the exercise, and anything else you might feel relevant?

@Slizz- Very interesting, it certainly makes sense to me. I have to read the studies over as well. Do they state apx. how long the transformation takes?

[Joshua Naterman]

OP: Video of external rotations will definitely help us. One thing that I noticed was that if you are really pushing your strength limits with external rotations you will sometimes notice more of what you are describing. When you're performing them you should be working well within your ability, and higher volume work is more appropriate. Even though Poliquin suggests 8 reps, keep in mind that those 8 reps are taking a full 48s of constant tension to complete as he likes 4s down 2s up tempo. That's volume work. Also, you should never go up more than 2% per workout. That means you may need fractional plates or a water bottle!

As an example, even though I know I can do 32 lbs with 7-8 reps because I've done it before, it didn't feel perfect. I prefer to work with 25 lbs at the moment, as it feels right. It is very difficult to assess shoulder problems without knowing training history and being able to watch you perform upper body work. Without being able to walk around you and watch what's happening with the shoulders we are limited. Video of such things could be very, very helpful!

Mr. Brady: There is a very high rate of occurrence of type 2 and 3 acromion in the over 50 population, with a very low occurrence in the under 25 population. That suggests that the constant tension on the bone causes slow but steady growth in many people. Of course, it could also just be something that grows on its own, but based on knowledge of how traction affects bone I would think it is reasonable to lean towards the tension being the primary cause of the growth.