Here’s the Key Ingredient for Healthy and Strong Shoulders

Save Your Shoulders

Here’s the push to pull ratio that makes all the difference!

For as long as people have been exercising, shoulders have been a key player in the game. Unfortunately, the pesky rotator cuff (street name: rotary cup) and bicep tendon like to be the easily-irritable gatekeepers to all things shoulder related. These are often the first structures to become bothersome in most non-traumatic shoulder injuries. Thankfully there is a better way to approach upper body strengthening that acknowledges their short tempers and mitigates the risk of injury. 

In order to understand the approach, we need to review our basic upper body motions. For simplicity, we’ll break it down into two categories: pulling and pushing. Now it’s also necessary to understand pulling and pushing can occur horizontally or vertically. This is pretty comprehensive in outlining most (emphasis on most) upper body motions.

•  Horizontal presses are things like bench press, pushups, seated chest press, etc.
•  Horizontal pulling is going to be your “row” variations such as a seated row, bent over row, inverted row, etc.
•  Vertical pressing focuses on shoulders with overhead press, landmine press, etc.
• Vertical pulling is going to be pull-ups and lat pull-downs for the most part. 

The great thing about fitness is the unlimited potential for creative exercise variations. So please understand the bullets above are meant to be reductionist and serve as examples for the basic movements. 

Now the fun part of the approach ::cracks knuckles::, how to sprinkle those 4 categories into your workout routines. The basic rule is a 3:1 ratio of pulling to pushing, total reps. This is because the shoulder blade (in the back of your torso) is a major player in the game of shoulder health. Most shoulder health/performance stems from adequate strength and control of the muscles that attach to the shoulder blade. In order to move your arm properly, the shoulder blade must move as well and it is a very mobile joint. As such, it has less margin of error than other areas of the body, just my educated opinion.

This 3:1 ratio was a concept first introduced to me by another great therapist and colleague, Dr. John Rusin. As someone who spent a lot of time working as a strength coach for Olympians, he was worth the listen. What was found was that individuals who respected that ratio sustained far fewer training injuries than those whose training fell outside of those numbers. Once this information supplemented my previous knowledge on rehab and biomechanics it was a game-changer for managing shoulder injuries and writing training programs.  What was glaringly obvious after the fact was how spot-on it was. I started polling every client and lifter with shoulder pain or a history of shoulder injuries (it’s not hard to find lifters inside of a Gold’s Gym, by the way) and the majority of people with complaints had their ratio completely backward. In general, people love pressing far more than pulling. Bench, incline bench, decline bench, pushups, flies, military press, shoulder raises, etc all seemed to outweigh seated rows, bent-over rows, and lat pull-downs. Again, very reductionist but anecdotally, this is what I found. It was a revelation and one that I am eager to discuss with new clients all the time. 

 So there’s the rule: 3 to 1 pull to push. At the end of the week, count up all reps for pulling (H+V) and if it’s not 3 as much as pushing (H+V) then that’s the lowest hanging fruit for you to pick. There is another step in the breakdown but I’ll save that for the next blog. For now, take a look at your lifting program and make a list of all pulling and pushing exercises. Where do you stack up? What’s your ratio? Give us a shout. 

Happy Training!