Feb 6 / Neil Dimmock

Prone and Quadruped Shoulder Stability Setup

How to stabilise your shoulder joint within a prone, quadruped, or press up position

The following blog came to me while riding through Clapham Common one early morning on my way to the studio. It was bitterly cold and the sun hadn’t yet risen. Riding through the park, regardless of the time of year, there are many military boot camps that provide an outlet for locals in the area. Given the darkness, I had to wonder how the participants followed the instructor and then, more importantly, how the trainer/instructor could see how the class moved in order to assess whether they were doing this exercise correctly.

I appreciate the service which fitness businesses provide and I'm certainly one in believing that our society should move more than what we do. However, we cannot overlook the role in which we play as educators.
The subtleties to an exercise are hugely important. Minor adjustments to the technique of an exercise can have a powerful impact. Shoulder stability within a quadruped (quad-ru-ped/all fours) position is one of the most over looked amongst these exercises. To put this another way - if you want your core to work more efficiently, then you need to position you shoulders in a more efficient position. 
Let’s face it, our shoulders become the poor relation to most prone-based ab/core exercises, especially when the intensity is turned up and fatigue sets in. However, the reality is that we have to look at the joint(s) above and below the focal area, to provide the support needed to create optimal stabilisation.

The Glenohumeral (Glenoe-hue-moral) Joint

The Dumbwaiter is a good example of how to utilise the glenohumeral joint
We have four joints within the shoulder complex. Two of which provide most (if not all) of the required movement. They are the Glenohumeral Joint and the Scapulothoracic Joint. Both joints are interdependent. They are both joints in their own right, however, they are dependant on the other joint's efficiency. It’s safe to say that soon after a joint has become compromised, the other(s) soon follow.
To find the Glenohumeral joint, try bending your elbow to 90 degrees then draw your elbow into the side of your body. Turn your palm upwards and without moving your arm way from your body, rotate your palm outwards. This joint is a ‘ball and socket’ joint, so you’ll feel the ball turning in the socket while rotating your palm outwards. 
This is what most would think is the shoulder joint in its entirety. This joint is supported by a network of muscles known as the ‘Rotator Cuff’. This synergy of muscles not only provide a supportive mechanism, they also create external (lateral) rotation, or the ball (of the upper arm) rolling back in the socket. These same muscles can become underused, weak and immobile, due to prolonged underuse of the shoulders and upper back.  
The deep set, rotator cuff group are in need of mobility to maintain a healthy and supportive status. Workspace in the joint is necessary to prevent a dominance within the muscular synergy. The joint must be actively moved through all ranges to maintain good health.

The Scapulothoracic (Scap-pue-loe-thor-asic) Joint

The Shoulder retraction is a good example of how to utilise the scapulothoracic joint.
To find this 'floating' joint, start by shrugging your shoulders. Then lift your shoulders into a shrug-cum-circular motion, both forwards and backwards. These muscles are responsible for the shoulder blades relationship with the upper arm (Humerus). As the Humerus moves (in any direction) the shoulder girdle reacts. 
Think of a rower in the pulling phase of the oar. When pulling the oar, the arm acts as a lever to activate the powerful muscles covering the top two thirds of the back. The arm simply could not leverage this power on its own. As described earlier, these muscles also become immobile, weak and underused due a sedentary lifestyle. This generally leads to a feeling of tension, as the muscles may not have a natural resting length. Creating 'workspace' within this joint is necessary in providing balance within the muscular synergy and avoiding a hierarchy of dominant muscles pulling in a particular direction. 

3 Steps for Creating Shoulder Stability

Now we've seen what we need to activate within the two most active shoulder joints, we can now focus on how we can physically activate the muscles surrounding these joints.
Firstly, we're going to find a neutral spine within a quadruped position. Simply put, this is an 'All Fours' position. However, you must have the correct posture, to create the correct length/tension relationships within the core and abdominal region. This provides a firm structure to the body, creating the right environment for muscles within the shoulder joint to offer support. In looking at on the picture below, focus on the shape of the spine. The objective is to create a little length to the spine, while still maintaining its natural shape.

Step 1: Take up the slack in the Glenohumeral Joint

We now have ourself in the quadruped position (above). Although, we have the ultimate aim at doing the following three steps simultaneously, let's look at each one individually and action one at a time. We know that by turning the ball back into the socket of the shoulder (Glenohumeral) joint, we can create stability. This can be done (within this position) by turning the 'crease' of the elbow to face forwards allows you to create the external rotation needed to pick up any slack within this joint. Think of this as turning a gently pulling and twisting a piece of rope. As the rope shortens, the rope becomes tighter and any slack that existed before has now reduced.

An alternative viewpoint is Kelly Starret's in his book 'Becoming a Supple Leopard'. His quote supports my theory: "Adding [external] rotation [of the shoulder] takes up all the slack within the socket, making the joint very tight and stable". He then follows this by wrapping a towel around a club, to replicate the shoulder joint. In this instance the club is the ball and the towel represents the Rotator Cuff (muscular) group. By simply twisting the towel the club becomes immobile and thus less likely to become compromised.

Step 2 - Drawing the shoulders away from the neck

Our shoulders tend to involuntarily lift into our necks, resulting from a number of reasons. This could be due to the overactivity of the muscles above the shoulder blades (Scapula) opposed to the under activity of the muscles below the shoulder blades. It could be a simpler reason, in that the intensity of the exercise is too high and the client is migrating towards what the body feels is a stable point. 

The more proficient you become at step 1 and step 2, the more likely you'll feel that this will be a singular movement. Both steps work together very closely. Drawing the shoulders away from the neck, utilises the muscles underneath the shoulder blades and around the armpits (Serratus Anterior, Lower Trapezius and Latissimus Dorsi). The sensation you'll experience, will be similar to when you grip a newspaper under your arm.As a result of your newly found shoulder position, your bodyweight will migrate towards the areas that need a little resistance/exposure within the exercise.

Step 3 - Give yourself a little lift

How many times have you heard "Shoulders back and down" from the trainer within your class? This command within prone, and quadruped (all 4's) positions, simply does not work!

We have to remember, that we are working against a gravitational pull. Therefore, we have to position our bodies to resist this downward force. This can be done by creating a lift within the chest and creating a subtle parting of the shoulder blades. By doing this, you will effectively be 'eccentrically loading' the the muscles between the shoulder blades (mid Trapezius, Rhomboids and Posterior Deltoids). This means that you are lengthening the aforementioned muscles and holding the load (bodyweight) with the same muscles groups.

Holding this load without movement is considered to be one of the most effective strengthening techniques available. This shouldn't be confused with a rounding of the mid/upper back (thoracic region).

By creating these three steps will not only create stronger, more stable shoulders, it will also enable you to reap the reward of your efforts within your (prone/quadruped) core based exercise.Thanks for taking the time to read our blog. If you know someone that may benefit from this information, please go ahead and share it!
Thank you!