Shoulder pain can be the force that halts your physical activity and curtails your goals. It may start small and slowly build. Trauma also can be a source of shoulder pain.

Lifting with poor form may not cause injury every time. The injury can originate from bad muscle recruitment patterns. Large prime-mover muscles are not always used as such and smaller stabilizer muscles take over when bad technique is used to lift.

The shoulder is one of the body’s most dynamic joints. It has a large range of motion and can lift heavy objects over the head. But the shoulder needs to be prepared before changing gears between everyday life and lifting.

Think of a manual transmission sports car. It can take you on an enjoyable ride around the neighborhood or it can be taken to the speedway and raced down the quarter-mile. There are certain things you wouldn’t do with a performance car, like trying to take off down the road from third gear. Sure, you can do it, but it’s not exactly best on the transmission.

If you consistently took off from third gear, you would need to see a mechanic fairly soon. Upon inspection, a good mechanic would know you have been driving pretty rough. Taking off in third gear is a viral pattern that costs your car dearly.

Unlike cars, replacement parts for people aren’t as good as the ones we come with from the "factory."

No disrespect to the medical industry. There is constant work on trying to find just the right materials to make replacement joints and cartilage. Until they figure it out, it is up to us to keep our joints and muscles in good repair.

Just as operating the car correctly will make it last longer, knowing how to control your shoulder will go a long way in preventing injury. Today I’ll cover how to create a stable environment for your shoulder while lifting. I demonstrate this with the shoulder press and the pullup, but you can apply it to all upper-body lifting.

Here is a simple example of what it takes to put your shoulder in a stable position. Hold your newspaper in one hand so you can keep reading and extend the other out in front of you. Pull the shoulder blade of that arm toward the spine so the whole arm moves back. Keep the elbow straight. Now turn the elbow toward the floor so the bend of the arm is facing up. This is an externally rotated position for the shoulder. It combats the chronic and viral internal rotation that many people display when pressing and pulling.

Internal rotation creates a stable environment at the shoulder joint. The action of externally rotating the shoulder joint recruits the prime movers to move and the stabilizer muscles to stabilize.

Internal rotation can be spotted easily if you train your eye to find it. Essentially, if the elbows turn outward in relation to the hands, there is some degree of internal rotation. Most people can correct their viral patterns by simply adopting a better form. Just like the driver, by simply starting from first gear instead of third. Problem solved.

If the muscles are already tight, a person may not be able to control positioning. Internal rotation has created a bad environment. You may need to perform some maintenance with a foam roller or other mobility tool. Just like a car that is already broken because of bad driving may need some maintenance to restore its proper function.

I believe that one of the best ways to perform self-maintenance is to move correctly. Correct movements provide the proper stimulus to the involved muscles and allow them to move without being overworked. A section of PVC pipe or an empty bar may be the only tool needed to create a good movement pattern.

Get with a trainer to dial in your movements and help you create safe patterns.

Watch Laura as she performs the shoulder press and pullup. It may be subtle, but when those elbows turn out, her shoulder is not in the best of positions.

Just because your shoulder may hurt doesn’t mean that it is caused by a viral internal rotation problem. Correct positioning can help the shoulder recover. If you are unsure about your specific pain, consult a professional. Your doctor may request scans or refer you to a physical therapist. Follow your doctor’s instructions.

Instructions for Internal Rotation Shoulder Press


Hold a bar at the collarbone height and with hands outside the shoulder width. Straighten the back, and contract the glutes and core. Pull the shoulders together and gently push the elbows up so they are slightly in front of the bar.


When pressing the bar overhead, make sure the elbows stay inside of the vertical plane made by each hand. Return the bar the same way.

Many athletes start in a good position but see the elbows turn out halfway through the press. Make sure the elbows stay inside the width of the hands on the bar.

Instructions for Internal Rotation Pullup


Grip the pullup bar at outside the shoulder width. Straighten the back, contract the glutes and core. Straighten the feet so they are slightly in front of the body. Pull the shoulders back and turn the elbows forward.


When pulling the body up toward the bar, be sure the elbows stay inside the vertical plane made by each hand. Return to the starting position the same way.

Many athletes start in a good position but see the elbows turn out halfway through the pullup, as in the second photo above. Make sure the elbows stay inside the width of the hands holding the bar.

* * *

Chris Huth is a Las Vegas trainer. He can be reached at Consult your physician before beginning any exercise program.