Here’s a breaking news: you need good shoulder flexion to be able to perform overhead work safely.
All sarcasm aside, if you don’t have appropriate shoulder flexion range of motion, you’re setting yourself up for injury when performing overhead exercises.
Many different things can be the cause of a lack of shoulder flexion. Here are some of the causes of limited shoulder flexion.
A lack of upward rotation at the scapula can be limiting shoulder flexion. This can happen for a couple different reason. One of them is the lack of activation or the lack of strength in the serratus anterior and the lower trap.
The upper trap is usually the strong player of all 3 muscles that contribute to upward rotation, so it rarely needs more activation.
The lack of shoulder flexion can also be caused by shortness or stiffness of the pec minor, latissimus dorsi or the long head of the triceps.
Another factor that could limit shoulder flexion is the structural variation of the acromion.
There are structurally 3 different types of acromion, and depending on what type you have you might be limited in shoulder flexion. The type 3 acromion is usually one with which we want to stay away from overhead exercises.
I didn’t go into too much details about the causes of shoulder flexion limitation, but the message I want to get across is that although some of these limitations are modifiable, and some of them aren’t, there is significant damage that can be put on the shoulder if you try to grind through overhead work, especially exercises involving approximation (think pressing movements) of the humeral head in the glenoid fossa when your mobility is limited.
The other important thing to know is that if you force overhead exercises on someone who doesn’t have the shoulder flexion range of motion, he’ll definitely try and compensate in some way to get the weight overhead. One of the most common compensation patterns you’ll see is lumbar hyperextension.
The picture above is not even taken from the side and you can still see how hyperextended she is at the lumbar spine. Overhead presses, carries or other overhead exercises that involves approximation of the humeral head in the glenoid fossa should be avoided, at least in the short term while you fix the problem (if it’s not structural).
There are plenty of alternatives to overhead pressing that can yield similar benefits, depending what the goals are. Be smart about it, and make sure you assess your clients and athletes before throwing them under the bus with overhead exercises if their body is not ready for it.
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