Video: 4 Physio Exercises to Keep Your Shoulders Safe
Ever wonder if your shoulders are going to hold out through the next crash? Have some thoughts of weakness?
Crashing in mountain biking is inevitable, but there are some things you can do to see if your chances of getting injured are higher.
As a physical therapist, who does online movement assessments for strength programs through, The Ride Life, I use exercises to help me assess the strength and control of specific joints. I’m going to show you 3 self-assessment exercises, that I use, to see if you are at risk if you crash. These exercises are not to clear out everyone, but to speak directly to the people who are more at risk for shoulder injuries.
These exercises are chosen to show the stability of the shoulder joint and its ability to stay together if an impact occurs. Part of the exercises are mobility, but stability is the main focus.
These videos walk you through as I walk Daniel, an avid mountain biker, through the exercises.
Assessment Exercise 1: Hands and Knees: Arm Raise
Perform 20 reps
Looks for:
- Shoulder blade Muscles Working (shoulder blade stability)
- Neck Strain/Tightness
- Full shoulder Flexion (parallel with the floor)
Looks for:
- Shoulder blade Muscles Working (shoulder blade stability)
- Neck Strain/Tightness
- Full shoulder Flexion (parallel with the floor)
Assessment Exercise 2: Knee Push Ups
Perform 15 reps
Looks for
- Shoulder Blade Stability with Pec Muscles
- Core with Shoulder Complex
- Back of the Shoulder Joint Stability
Looks for
- Shoulder Blade Stability with Pec Muscles
- Core with Shoulder Complex
- Back of the Shoulder Joint Stability
Assessment Exercise 3: Arm Raise to the side
Perform 25 reps
Looks for
- Deltoid with Shoulder Mechanics
- Neck Strain/Tightness
- Rotator Cuff Muscles Working with Shoulder Blade Muscles
- Overuse of Pec Muscle
Looks for
- Deltoid with Shoulder Mechanics
- Neck Strain/Tightness
- Rotator Cuff Muscles Working with Shoulder Blade Muscles
- Overuse of Pec Muscle
Did you pass?
- No Pain with the exercises
- Completed the exercises using the correct regions for muscles
- Felt strong at the end of the set
The Exercises!
Do you need to add some strengthening to your life? Are your shoulders at risk?
Here are 4 exercises that focus on stability of the shoulder joint, motor patterning of the shoulder complex, and neck to shoulder function.
Exercise 1: Hands and Knees – Arm Raise to the Side
Objective
- To increase Middle Trap Strength and Activation
- Help Support Rotator Cuff Muscles
Perform:
- 1 time a day
o Before Riding to warm up for a ride
o With Workout
- 2 sets 10-20 reps, can add weight when needed
Things to Note:
- Lead with your thumb
- Don’t raise hand higher than level of trunk
- Goal is shoulder blade movement
- To increase Middle Trap Strength and Activation
- Help Support Rotator Cuff Muscles
Perform:
- 1 time a day
o Before Riding to warm up for a ride
o With Workout
- 2 sets 10-20 reps, can add weight when needed
Things to Note:
- Lead with your thumb
- Don’t raise hand higher than level of trunk
- Goal is shoulder blade movement
Exercise 2: Bent over Row with “W” (Shoulder External Rotation)
Objective
- To increase Shoulder Blade Strength with External Rotators of Shoulder (helps keep ball of shoulder in socket)
Perform:
- 1 time a day
o Before Riding to warm up for a ride
o With Workout
- 2 sets 10-20 reps, can add weight or use band/cable when needed
Things to Note:
- Don’t bring elbows back too far
- Try not to move elbows when moving hands
- Neck should stay loose
- To increase Shoulder Blade Strength with External Rotators of Shoulder (helps keep ball of shoulder in socket)
Perform:
- 1 time a day
o Before Riding to warm up for a ride
o With Workout
- 2 sets 10-20 reps, can add weight or use band/cable when needed
Things to Note:
- Don’t bring elbows back too far
- Try not to move elbows when moving hands
- Neck should stay loose
Exercise 3: Knee Push Ups
Objective
- To Increase Shoulder blade stability with Pec Muscle and Deltoid
- Strengthen Back of Shoulder Joint
Perform:
- 1 time a day
o Before Riding to warm up for a ride
o With Workout
- 2 sets 10-20 reps, when you can do 20 in a row move to regular push up and back reps down
Things to Note:
- Keep elbows out and shoulders away from ears
- Don’t forget the importance of using your core with a push up
- To Increase Shoulder blade stability with Pec Muscle and Deltoid
- Strengthen Back of Shoulder Joint
Perform:
- 1 time a day
o Before Riding to warm up for a ride
o With Workout
- 2 sets 10-20 reps, when you can do 20 in a row move to regular push up and back reps down
Things to Note:
- Keep elbows out and shoulders away from ears
- Don’t forget the importance of using your core with a push up
Exercise 4: Upright Row
Objective
- To increase Middle Trap Strength and Activation
- Help Support Rotator Cuff Muscles
Perform:
- 1 time a day
o With Workout
- 2 sets 15-20 reps, increase weight as needed, 10# is a great starting weight
Things to Note:
- Shoulder blades sink down as elbows go out
- Don’t strain neck
- To increase Middle Trap Strength and Activation
- Help Support Rotator Cuff Muscles
Perform:
- 1 time a day
o With Workout
- 2 sets 15-20 reps, increase weight as needed, 10# is a great starting weight
Things to Note:
- Shoulder blades sink down as elbows go out
- Don’t strain neck
All of these exercises are great for strengthening shoulders. If you have pain with these, please seek care/treatment. Pain can cause muscles to function improperly based on a protection mechanism. AKA… if the muscles hurts to use it, the brain won’t use it as much. These exercises are a great starting position but you may need to diversify.
After you have been doing these exercises for 3-4 weeks at least 4-5 times a week, retest the first exercises and see how you have improved.
About the Author:
Liz Koch, PT, DPT is a physical therapist that knows exactly what it is like to have pain. She has been to many PTs over her life, which directed her to becoming one. She has been a mountain biker since she was a kid and has recently opened up her own clinic in Western North Carolina, Blue Ridge BioMechanics. She wants to share the knowledge that you don’t have to be in pain when riding and you don’t have to stop riding to get out of pain. She has focused this mission to Rad Mountain Biking Ladies on Facebook and through her online business, The Ride Life.
Let her know if you have questions.
*If you have pain please consult with a doctor or physical therapist for further evaluation, Liz Koch and companies are without liability if you injure yourself while performing these exercises*
MENTIONS: @theridelife
Author Info:
Must Read This Week
There are numerous exercises that you can and should swap for the upright row.
I thought you were talking about side lateral upright row. That one hurts most peep. Kettle bell upright raise- I’m sure there are different ways to do it without getting rotator cuff injured.
www.stack.com/a/upright-row
This is the double-edged sword of social media and youtube, too much well-marketed, bad information in the hands of amateurs who now think the know something, and when good information comes along it gets ignored. The lady knows what she is talking about. Very difficult in a couple short minutes to advise in a general yet engaging manner. Take it for what it is, solid info.
But you are probably right, you should only do these in quick movements when you are on the trail vs knowing how to stabilize your shoulder (with light weight) off the bike.
Yes there are other exercises, yes this one can be performed where it is dangerous. But so can a lot more. I'm glad that you understand the mechanics of the shoulder from google scholar. Here is an article that backs my modifications and I even go one step farther ... I don't want you to use a bar, I want you to use a KB or a band so that at the top of the range, where it would be most likely for an impingement your hands are equal to your shoulders - not in internal rotation but in neutral position. journals.lww.com/nsca-scj/Fulltext/2011/10000/The_Upright_Row__Implications_for_Preventing.2.aspx-accessdate=12
Additionally, you do know that I said in the article many times... if you have pain with an exercise.. don't do it. You don't have to do this exercise. Use the rest of the information. It brings to light that strengthening their shoulders can actually help them from having a debilitating crash. I would figure that we would agree on that fact.
By the time I got the attention of a surgeon it was a couple weeks past safely doing the plate/screws thing. (I didn't have my wits about me to push the medical system harder as I also had a major concussion that wiped me out.)
Clavicle is now shorter and in a slight twist compared to my good shoulder. After 10 years the bone callous is now starting to release my nerves and blood vessels channeled nearby to clavicle through to arm.
PHYSIO IS MY EVERYTHING. After 4 rounds of physio (every time I sprained or dislocated the damned thing I had to go back) finally I'm starting to have my full flex and range of motion back.
High-load strength training isolations and some oly lifting has finally built enough muscle around my shoulders that I don't fear dislocations every time I wakeboard, bike, or play rugby.
Do your physio, kids! Then lift heavy things and get some bulk around your injury site while still retaining range of motion. Might save you a joint replacement or reconstruction in the future.
Question: Why elbows out for pushups and shoulders not retracted? Always been told that's the safe way of doing them.
If the shoulder blades are closer to the spine the serratus anterior doesn't activate quite as much. Its main jobs are to protract and prevent winging of your shoulder blade. Protraction is where your shoulder blade comes around your body (away from your spine) the push-up plus is a good example of this and it is why I want you to be less retracted. also elbows out help you to incorporate a little but more deltoid in the exercise than before and makes your more in the downhill aggressive position. It is harder and you should go down on load/reps.
Does this make sense?
Thanks for the question .. I like it when people are thinking about what I put out. It also tells me i need to add a bit more in the explanations that I give
Lying on my belly, face down with my forehead resting on the top of my hands. I push my shoulders down my back and push my hands into the ground with more focus on my shoulders being pushed back. Hold for 3 seconds and repeat.
The post is a good one, and props to her for getting out there and doing something positive, we need more articles like this to help injured riders, but a little more consideration for the evidence base behind any recommendations would prevent misunderstanding which leads to doubt, which leads to a lose of engagement and trust from patients / clients - not conducive to a good patient-therapist relationship or outcomes.
I do have a doctorate in Physical therapy, aka rehab science, and own my PT clinic that treats and focuses on mtn bikers. In this article, I'm trying to help the non-injured rider. So not our typical population, patient, that has rotator cuff tears or impingement, but might make themselves known that they need PT or other direction for fitness to prevent other major issues with crashing.
Here is an article that backs my modifications journals.lww.com/nsca-scj/Fulltext/2011/10000/The_Upright_Row__Implications_for_Preventing.2.aspx-accessdate=12
I go even further than the article by using a KB or a band so your hands can be equal to the shoulders, thus being in a neutral position than in an Internally rotated position. I also only want a 10# weight or a band.
@darabebe As for your comment about it not being mtn bike specific. Here are two videos from GMBN that demonstrate in body position and in jumping where an upright row can help and should be taught as a stabilizer for on the trail movements. Yes there are other exercises but this one is very applicable to riders check them out.
Body position - youtu.be/lienHJ82Pj4
Jumping (mainly the push) - youtu.be/6f-91HEKdQI
Would love to hop on a phone call or message with either one of you in regards to this and talk more through it. Thanks for your input.
Sorry for such a delay in replying...life gets in the way some time.
Firstly I would like to apologise if my original comment came across as negative. It was not meant to be in any way a slight on your professional integrity, knowledge and training, or care towards your patients. It is not in my nature to be derogatory towards a colleague.
Secondly, I would reiterate the positivity towards your venture to get yourself out there and try to make a positive impact by sharing your knowledge and experience in an attempt to help the mtb community. Too many people sit on the couch and make negative comments without actually trying to make a difference themselves. So keep going, you’re clearly doing a good job of it.
Unfortunately though, I will continue to respectfully disagree with the selection of an upright row. I understand that at very low resistance and carefully metered sets/reps the actual real world risk of negative effects is so low it is almost not worth worrying about. Sadly, the same reasons will likely negate any clinically significant training effect beyond a short term neuromodulation effect....similar to the documented responses to manual therapy/manipulation/soft tissue techniques. The very fact that it needs to be kept very low intensity/ low load is the same reason it will likely have a very limited physiological training effect, and therefore begs the question ‘is it really worth it?’
From a personal perspective, as I mentioned previously, I spend too much time in direct contact with upper limb patients under the care of orthopaedic consultants, consultant physiotherapist, and fellow advanced practitioners to advocate the use of an upright row in the rehab process for those presenting with upper quadrant dysfunction. I understand it may still be advocated in the specific fields of athletic training etc but I don’t see a place for its use in therapeutic rehabilitation, as the number of alternatives which do not come with the need for such specific performance cues or considerations to avoid a negative outcome are just too numerous.
Thank you for providing the research links, they made for very interesting reading, and it is always nice to delve deeper and continually questions ones own opinions and beliefs...without this approach we risk becoming set in our ways and miss out on development and progress.
Good luck with your ventures and best wishes for the future. I hope to see more content from you appearing on here, and thanks for the stimulating debate. @theridelife:
How come you chose elbows flared out vs. tucking elbows closer to lats while doing pushup? Same reason.. more shoulder activation?