Shoulder health.. what's your prehab/maintenance routine?

I've had achey shoulders (one is worse than the other) for years.  I've been to PT, get sports massage a couple times of month (painful), stretch, do some light work, but still my shoulders are pretty sore all the time.

What magic bullet have you discovered to keep your shoulders healthy?  I see pros at the gym using rubber bands to warm up their shoulders before bouldering, but I'm sure there's more to it than that?!

Depends on what your injuries are and what is causing it to be achy. One thing to consider is looking at some articles that discuss the mechanics of the shoulder joint to help determine the root cause and or see a doc to confirm what is causing the issue. A common injury is rotator cuff tendonitis (or more serious tendonosis). This results when the shoulder joint has more internal rotation and weaker lats, causing the shoulders to roll forward, creating less space in the shoulder joint and creates rubbing of the tendon, causing soreness, and could ultimately cause a torn rotator cuff. To counteract this, focus on exercises that are more “pulling” in nature rather than “pushing” exercises.

note: I have no medical training. Source of info is based on my own experiences with shoulder issues (torn rotator cuff and torn labrum) that I managed thru PT and exercise. 

Warm those babies up until they burn, then go.

You could try bench presses to give those opposing chest muscles some exercise. I still do rotator cuff exercise years after having ended post surgery PT.

Kelly O wrote:

Depends on what your injuries are and what is causing it to be achy. 

My PT said bicep tendinopathy.  He gave me exercises and they help, but still get pretty achy shoulders after a hard gym sess.

Nate Allen wrote:

I've had achey shoulders (one is worse than the other) for years.  I've been to PT, get sports massage a couple times of month (painful), stretch, do some light work, but still my shoulders are pretty sore all the time.

What magic bullet have you discovered to keep your shoulders healthy?  I see pros at the gym using rubber bands to warm up their shoulders before bouldering, but I'm sure there's more to it than that?!

One arm hand stands.

Sounds like you need some oppositional strength work. Dips, shoulder presses, bench press. Try to progressively increase weight and reps, not just light stuff. 

Also, are you stretching or doing yoga at all?  Just be careful not to push it too far with the stretching, have to be careful at first with shoulders.

If possible, do oppositional rotator cuff work with weight instead of bands.  Look up the exercise where you take a light barbell with cactus arms and lower it forward.  That exercise has helped me alot with back shoulder pain.

Nate Allen wrote:

My PT said bicep tendinopathy.  He gave me exercises and they help, but still get pretty achy shoulders after a hard gym sess.

When I had biceps tendon problems I had the best luck from working on shoulder posture.  I was advised that the problem was caused by the shoulder bones pushing on the biceps long head tendon, which passes over the humerus before attaching to the scapula.  As a result if the shoulder is out of line in that it is too far forward it will put pressure on the tendon where it passes over the humerus.  Stretching and balancing oppositional muscle masses is the way to go here, so what you need depends on where you are at with flexibility and muscle mass/strength.

TRX. I’s Y’s T’s and W’s. Giant shoulder circles both directions as part of warmup - get the scapulas moving up and down. 

Nate Allen wrote:

My PT said bicep tendinopathy.  He gave me exercises and they help, but still get pretty achy shoulders after a hard gym sess.

I had a similar thing, first round of PT helped but it came back eventually. The second round with a different PT really working on fixing movement patterns seems to have stuck. apparently my scapulae were doing something funky and my upper traps were doing way too much of the work whenever I pulled down, which put a lot of stress on my shoulders.

i started with smaller more targeted exercises and gradually moved up to more compound stuff. early on it was wall slides (google “wall slide + Y lift off” for videos), foam roller snow angels, Ys and Ts, scap push-ups, and something I don’t know the name of where you essentially lay facedown arms at your side and squeeze your shoulder blades in the back to bring your shoulders off the ground. 

once I did that stuff for a while I moved to prone swimmers (really helpful - facedown, arms by side, squeeze shoulder blades, snow angel up to Y position, then reverse it), kettlebell windmills, more wall slides, and d2 diagonal pulls with a cable or band (start opposite hip, pull across body and up like you’re drawing a sword). also massage gunning the area of the tendon and inside my armpit helped too. 

good luck! a fun bonus of all this shit is my posture is better now too.

No magic bullet. "For years" means chronic and indicates a need for comprehensive rehab strategy. Yes, you should warm up before strenuous activity, but just a warm up before climbing is not going to fix a years old problem.

I've been through the wringer with shoulders, multiple problems over many years, a couple years of down time from climbing, a couple hundred PT visits with more than ten PTs, surgery etc. IMO, the best thing is to correct whatever specific problems there are with PT and other treatment, then approach it as maintaining as much comprehensive normal range of motion and movement, and strengthen wholistically, not just train for climbing or climbing itself as your only activity (like I did for decades). 

It can be a pain getting started, but like anything else, if you build the habit, it becomes routine. I look forward to my routine every evening, it is all of 10 minutes of stretchy band, light dumbbell and stretching/hanging that works the entire range of motion and reinforces joint stability. And I am glad that I've been able to re-start a comprehensive weight lifting routine 2-3 times/week for complete body strength and fitness. 

I can summarize the evening routine, I think it is a useful general practice based on my own experience, but I hesitate to post it since it is based on my N=1 and may not be great if you have different underlying problems.

EDIT: just saw the post about bicep tendiopathy. Very sorry to hear this. Very unlikely to heal if you keep provoking it like that in the gym. Tendons do not heal well as they do not have good blood supply. With the problem years old, it could take years of babying. I had bicep tendonesis as part of surgery because bicep tendon was involved. The whole surgical package did make things better, after 6 months more rehab I climbed again, and that tendon problem's been gone ever since... 13 years now.

Nate, I have had both shoulders replaced.  Osteoarthritis and wear and tear.  I’ve found working with a PT who is familiar with climbing and it’s physical and mental components has been extremely helpful in keeping me on the rock. As you have read each situation is unique and though there are universal components we all have a varied history that benefits from a therapist’s assistance in developing a plan for the individual. A good surgeon comes in handy also.Best to you in finding a path to continued climbing

Hi Nate!

It looks like you've received a lot of great advice already and I agree with everyone saying that the best program is one that is unique to you. One thing you're already doing that is great is taking a proactive approach to taking care of your body. I am a physical therapist and it's true that the best way to treat an injury is to prevent one. It sounds like a huge missing piece is strength to ensure that your shoulders are resilient and that they can handle all the work that you're asking them to do while climbing. I'm going to attach an article from The Climbing Doctor blog that includes a few key exercises for shoulder health that can also be used as a warm-up. This blog is run by Dr. Jared Vagy, a physical therapist and climbing specialist in Southern California. If you would like more options there are a variety of shoulder mobility, strength, and general performance articles that you can explore on the blog. The Climbing Doctor social media pages also post a lot of helpful exercises and tips that sound a lot like what you are looking for. 

https://theclimbingdoctor.com/the-three-best-exercises-to-prevent-shoulder-injury-with-sasha-digiulian-and-josh-levin/

Keep up the great work! Don't hesitate to reach out with any questions or comments!