Lateral Raises and Shoulder Trauma

Many trainees tip the front of the dumbbells down on laterals, but that can cause joint damage.

by Joseph M. Horrigan, D.C.

The lateral raise—a.k.a. lateral or side lateral—is one of the most common shoulder exercises. It doesn’t take long for any new trainee to try it in a routine. It’s also an exercise that survives in the programs of veteran trainees. Still, the simple, common exercise can cause problems if you don’t follow biomechanical and clinical guidelines when yo perform it.

The muscle on the side of the shoulder is called the deltoid, and it’s divided into three parts, or heads: anterior, or front; lateral, or side; and posterior, or rear. Most trainees believe that the lateral raise targets the lateral head only. That’s not true. The lateral head may be more active in the movement than the other two heads, but they are active as well. Other muscles also help raise the arm out to the side. The trapezius muscles, or traps, help raise the shoulder blade.

One of the most important muscles of the shoulder girdle is the serratus anterior. It starts on the border of the shoulder blade closest to the spine and wraps around the rib cage to attach, or insert, into the ribs on the side of the chest. It’s most active during the military press but still fires in the lateral raise. The military press also targets the deltoid, but that’s a topic for another day.

The shoulder has unique anatomy and is vulnerable to equally unique problems. The first is a form of entrapment, or impingement, that occurs under the roof of the shoulder, a bony and ligamentous extension of the shoulder blade known as the acromion. The space under it is called the subacromial space.

The fact is, we’re not made on the Ford assembly line; our anatomies can vary. Sometimes the acromion is shaped differently. Sometimes it’s down sloping, or it’s hooked instead of being flat, which reduces the available space under the roof. If we change the movement of the lateral raise, we can reduce the space even further and cause a problem.

Trainees are commonly taught by gym veterans, friends, training partners or personal trainers to perform the lateral raise “as if pouring water from a pitcher,” so the front of the dumbbell is turned downward at the top of the rep. The idea is that it places the deltoid in a better position to train the lateral head. Here’s the flaw: As the shoulder turns internally, or medially, a bony prominence is driven into the roof of the shoulder. That causes the rotator cuff, biceps tendon and subacromial bursa to be impinged between the two bony structures. It leads to inflammation and rotator cuff tendinitis and subacromial bursitis, which will cause pain during many shoulder or chest exercises. When the shoulder is turned into external, or lateral, rotation, the impingement does not occur, or it does to a far lesser degree. Keep your arm in a neutral or slightly externally rotated position, which means the dumbbell should be horizontal to slightly turned up to reduce the potential shoulder problem.

Ligaments attach bone to bone. The ligaments that form a capsule in the back of the shoulder can become too tight. Once that occurs, the ball is shifted upward and backward in the socket, which can also cause subacromial impingement and other types of shoulder damage. The best thing you can do if you’re in that situation is lie on your side with your downside arm straight out in front of you at 90 degrees. Bend that elbow and place the other hand just below the wrist and push the forearm toward the floor or bench while keeping the arm at 90 degrees in front of you. You may feel a mild ache the back of the shoulder as the capsule stretches. A mild ache is fine. Do not cause pain. Time is required to stretch the capsule. The stretch will help your shoulder function better, and that will let you gain more from your shoulder and chest training.

Train smart, then train hard.