Shoulder Pain and Anterior Humeral Glide

Today I have a great guest blog post on Shoulder Pain and Anterior Humeral Glide.

The excellent info is from Zach Moore.

Take it away, Zach.

How can Anterior Humeral Glide Lead to Shoulder Pain?

Anterior humeral glide (AHG) is a common problem among many individuals and occurs when there is excessive or abnormal anterior movement of the humeral head during shoulder motions. AHG can occur during any movement where the humerus moves into extension or horizontal abduction.

It is important to spot and correct this mistake because AHG can eventually lead to, or further aggravate, anterior shoulder pain, AC joint problems, pec and lat strains, as well as impingements. Therefore, today I want to look at some common exercises where this often occurs and then go over possible solutions to help address it.

Again, this problem can occur during any exercise where the humerus moves into extension or horizontal abduction, but I am only going to cover a few popular exercises.

The fixes and mistakes for each will usually be similar, so you can apply them to other exercises as needed.

Horizontal Row

 

Video Demonstration of Anterior Humeral Glide during a horizontal row along with cues to help correct this:


Cues and Possible Fixes:

  • Place your hand medial to their scapula and cue them to squeeze back.
  • Point to the anterior part of their humeral head and tell them to pull that back.
  • Help guide them into the proper position. Place one hand on the anterior part of their humeral head and the other on their scapula. As the person begins to row, guide their scapula into retraction and apply posterior pressure to their humeral head.
  • Lastly, have them try rowing with both arms. Sometimes their inability to retract is just a coordination problem and this will better allow them to feel their shoulder blades being squeezed together.

Dumbbell Row

Video Demonstration (first two reps demonstrate AHG, last two reps demonstrate correct form):


Cues and Possible Fixes:

  • Same cues and fixes as described with the horizontal row above.
  • Make sure spine is neutral. If upper back is not flat then you are more likely to see a faulty rowing pattern.

Push-Up

Video Demonstration (first two reps demonstrate AHG, last two reps demonstrate correct form):


Cues and Possible Fixes:

  • Make sure spine is neutral. This will help to better position the scapula on the rib cage, which will help facilitate proper retraction on the eccentric (lowering) phase.
  • Cue them to squeeze their shoulder blades together in order to activate their scapular muscles as they lower their body.
  • Use an incline or raise the incline to make the exercise less challenging.
  • Shorten the range of motion (i.e. do not have them lower as far).

Chin-Up

Video Demonstration (first two reps demonstrate AHG, last two reps demonstrate correct form):


Cues and Possible Fixes:

  • Tell them to think about putting their shoulder blades into their back pocket.
  • Have them demonstrate to you how to squeeze shoulder blades down and back before they perform the movement. This will ensure they know what you mean.
  • Use a band or increase the band tension to make it easier.
  • Try a Chin-Up ISO. This is an exercise we will usually give to clients at IFAST before progressing them to a full chin-up. You basically get into the top position of a chin-up with chest to the bar and scaps depressed. You then hold this position for max time. It is very effective for teaching people the final portion of this exercise.
  • Lastly, if the above strategies do not work then I would take them to a Lat Pulldown where the stability requirements are less demanding.

Bench Press

 

Cues and Possible Fixes:

  • First, I would make sure the person could perform a push-up properly without AHG before giving him or her a bench press.
  • If AHG is occurring during this exercise, then you know they are not keeping their shoulder blades retracted, which is desirable when performing a bench press.
  • Make sure the client knows that he or she should not protract (i.e. make arms long) at the end range. This will better allow him or her to keep shoulder blades together.

Final Points

Never be afraid to lighten the load or decrease the stability requirements. Performing an exercise over and over with incorrect form (in this case, anterior humeral glide) will not fix the problem/form.

If the cueing and loading strategies above do not work, then you may need to resort to other corrective strategies such as soft tissue treatment and/or rotator cuff exercises.  For soft tissue treatment, I would first examine the posterior shoulder capsule as it can often be stiff and restricted, which will not allow the humerus to glide posteriorly as it is flexed.  Next, examine the pecs as they can become dominant and pull the humeral head anterior.

For the rotator cuff, I would examine the subscapularis.  If the subscap is too long or weak, then its downward and posterior pull will not be able to offset strong muscles, such as the pec major, that pull the humeral head anterior. Therefore, strengthening exercises for this muscle may be appropriate.

Summary:

Learn to retract/depress properly by squeezing the scapula back/down without allowing the humeral head to glide anteriorly.

Common Cues and Fixes:

  1. Make sure person is in a good spinal position.
  2. Put hand back by shoulder blade and tell person to squeeze shoulder blade back to touch hand.
  3. Point to anterior part of humerus and tell person to pull it back.
  4. If performing a unilateral pulling exercise try to pull with the other arm at the same time, which may allow for better proprioception.
  5. Lighten the load.
  6. Reduce stability requirements
  7. Make sure the problem is not due to soft tissue restrictions and/or a weak cuff.

Hope this helps!  If anyone has any other tips or suggestions, leave them in the comments.  It is always great to hear other cues!

Zach Moore is a strength coach at Indianapolis Fitness and Sports Training (IFAST), named one of the top 10 gyms in the US by Men’s Health magazine. He works with a variety of clients ranging from athletes wanting to improve performance to general clients looking to improve body composition, fitness, and/or get out of pain.

Zach obtained his bachelors and masters degrees from Indiana University Purdue University-Indianapolis and holds certifications with the National Strength and Conditioning Association as a Certified Strength and Conditioning Specialist (CSCS) and with USA Weightlifting as a Sports Performance Coach. Check out his blog at Zimoore.blogspot.com .

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It is Rick again.

Big thanks to Zach.

Lots of great and very helpful information.

If you want to check out the Rotator Cuff Exercise Program that I use with my client, it is right here:


A few other articles on shoulder pain and injuries that may interest you:

These videos may interest you as well:

Bench Press Technique and Injuries

 

Shoulder Pain and Tricep Dips

 

 

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What to do about Weight Training Injuries?

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