Hey 717,

On our first post here, we’re going to talk about what I think is the second most important concept in regards to our movement and training – proper shoulder and hip movement. Understanding spinal midline position and stability and applying those is without a doubt the most important (we’ll post about this soon, but since we just covered that recently at our last movement class, I thought we’d start here). BUT – shoulder/hip position and movement is a close second. Next to our trunk (the spine and pelvis), you can think of the shoulder and hip also as prime movers for virtually all functional movements. So if our shoulder and hip aren’t moving properly, then we can start to develop problems in those areas, or anywhere up and down the chain. From shoulder pain, to hip or back pain, knee pain, etc. Why are we talking about them together? It’s always helpful to make complex things easier to understand. And moving well can seem very complex. But the shoulder and hip move pretty much the same.

Structurally, they are both ball and socket joints, with a capsule around each one. The capsule is a mess of ligaments and soft tissue that’s purpose is to provide us with both mobility and stability. And mechanically, when we move, our shoulder and hip move (or should move) in a very similar fashion. Meaning, the ball in both the shoulder and hip, has to roll and glide in a certain fashion in their respective socket and capsule, in order to allow us to move most efficiently. And in the case of both the shoulder and hip, the ball must move back and down in the socket. We also need to be able to create torque at the shoulder and hip to help maintain a good position as we move.

So in the gym as well as in the real world, this means that anytime we perform any overhead or pressing movement (i.e. overhead press, push press, push-up, bench press, etc.), we want our shoulder to be in a position of external rotation. When our coaches are saying to you, “Get your elbows facing front”, and “Get your elbows up high” in the case of overhead movements, or ”screw your hands into the ground” or “let me see the front of your elbow” in the case of push-ups, this is what we’re really talking about and trying to achieve – better external rotation. This does a couple of things. First, it allows for more joint stability as we press. It also creates more space for our rotator cuff and biceps tendons to move so they don’t become impinged in the shoulder. As the joint surfaces (bones) are in better position, the capsule becomes more taught, and our muscles are in a more mechanically advantageous position. When we have good position along with better bony and capsular stability, we don’t have to compensate and over-rely on our soft tissue structures to try to create that stability – such as our rotator cuff, biceps tendon, and labrum, amongst others. Which our body will do naturally if we’re pushing weight but aren’t in good position. This is not a good thing, especially if we do it umpteen thousand times over the years.

In the case of good movement at the hip, we see the same type of pattern. As we squat or deadlift, we need to have the ball of the hip move back in the socket to achieve adequate depth in those movements (“Hips and butt back!”). We also need to be able to create torque at the hip to get into and maintain good external rotation throughout the movement (“knees out!” or “screw your feet into the ground!”). Doing this again allows for better joint/bony position, as well as helps us avoid impingement at the hip (something called femoroacetabular impingement or FAI for short). Sounds kinda like the shoulder doesn’t it?

Interestingly enough, when we develop solid movement at the hip and shoulder, we see something – both a vertical or almost vertical forearm in the push-up and press, and vertical or almost vertical shin in the squat or deadlift. Use this to cue yourself and monitor your position.

pushup   how-to-overhead-press

deadlift-edit   Box-Squat1

Lacking the ability to flex and externally rotate with pressing movements usually manifests itself as the shoulders being more forward versus back in any overhead movement, and the elbows flaring out with presses or push-ups. In the squat and deadlift, it can manifest itself as knees caving in, rounding the back, coming forward onto the toes and not staying on the back half of your feet throughout the movement. If any of these sound like you, stop it. Now. Modify you movements or exercises for the time being (as long as it takes to get it right), work on improving it, and never do it again. Your body will thank you for it.

The video below briefly discusses the shoulder and hip, and demonstrates some shoulder limitations in Brent, our newest PTA and volleyball all-star. We also show how modifying the movement to the use of dumbbells can be a helpful aid. We’ll show some videos in the future demonstrating what you can do to work on your limitations, and show Brent’s progress.

Train hard, train smart, and have fun 717!

Paul Erwin, DPT
CrossFit 717 and Hershey Orthopedic & Spine Rehabilitation

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