Shruggernaut (to shrug or not)


I know you’ve seen him. You may even want to be him (although, I don’t know why). Walking through the gym with his ripped Everlast cut-off on. The Shruggernaut is who I am talking about. Upper traps so big they block sound waves from getting in his ears. I think I may have even seen some granola eating Birkenstock wearing spelunkers repelling down his massive traps. You know what’s weird though, I have no problem with this guy besides the fact that he puts 4 45 pound plates on each side of a Universal bar and does “front” shrugs. Get some dumbbells, or a trap bar, get your shoulders back and chin packed, and let the shrugs fly.

This dude’s muscles aren’t the problem. It’s the actual shrug as an exercise that I have the problem with. And to go further, I have no problem with shrugs in a non-rehab setting (unless they are done like this, or like this). In Olympic lifting, they actually provide great benefits for the high pull portion of a clean, etc. But why on earth would a physical therapist have a patient who does not do Olympic lifts do a shrug?

Most likely conditions in which patients are asked to perform shrugs:

  • Neck pain
  • Shoulder pain
  • Mid Back pain
I don’t think I have ever treated a patient with any one of these issues that doesn’t score at least a 4+/5 on a manual muscle test.

quasimoto

Their shoulders are half way up to their ears usually! If you test these people and there is a significant upper trap/shrug weakness, and you think doing more shrugs will fix it, you need to re-assess. Chances are it’s a bigger problem in the Spinal Accessory Nerve which innervatesthe upper trap. Think about it, in today’s society where over 50% of the population spends like 6 hours a day sitting at a computer shrugging,do you think when this person comes in with neck/shoulder/mid back pain they need to shrug more?

And yet, you see it all the time in PT clinics. Patients endlessly droning away with 5-10 pounds shrugging, shrugging, and shrugging. At the same time, these patients would likely score a 3+/5 at best with a good lower trap muscle test. If I recall, when we use a muscle, the antagonist usually has to relax, so if we are constantly using our upper traps, our scapular depressors and downward rotators say “F this, we’re gonna chill”. When our lower traps and rhomboids take the day off, you can say goodbye to any semblance of good shoulder or spinal mechanics.
We need to stop making our own jobs harder by stepping back for a second, and truly assess what is the reason for these patients’ dysfunction. If a shrug is weak, chances are it’s not true upper trap/levator scap weakness, it’s probably a pinched nerve in the neck. By having patients with neck/shoulder/mid back pain shrug we are actually feeding into the issue even if we address the lower trap/rhomboid weakness (if present).
Do shrugs belong in the PT clinic? I’m under the impression they do not unless treating a patient who does Olympic lifts, or is maybe post-op shoulder surgery. I’d rather focus on the real problem of scapular stability and scapulohumeral mechanics.
Advertisements

2 responses to “Shruggernaut (to shrug or not)

  1. I work out of a Crossfit gym. One constant criticism I have of their technique is “active shoulders.” During any press movement, they will elelvate the scapula. I believe they reason that you are providing more upward force to the downward force of the bar overhead.

    I argue that the glenohumoral joint is in a compromised position (where a healthier position is the close packed position with the scapula depressed), and thereby, you load the cervical spine less by not recruiting the upper traps and levator scapula.

    Any thoughts on this?

  2. I agree that a standard shrug is useless in a PT routine, but when evaluating the starting position of the scapula, you may find it to be downwardly rotated and almosed dominated by the rhomboids. having the pt slide their arms up a wall and monitoring the start to end position of the shoulder blade helps to determine the source of the imbalance as well as closely monitored MMT. I recommend Movement system Impairment syndromes by Shirley Sahrmann as an excellent source for muscle imbalances.

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s