Smart Shoulder Solutions: An Evidence-based Approach

The deltoids, which make up the shoulder musculature, are among the most important muscle groups when it comes to the performance of both sports-related movements and activities of daily living. Whether your goal is to shoot a volleyball or place items on an overhead shelf, or anything in between, strong shoulders are vital.

The shoulder is a complex ball and socket joint capable of flexion, extension, rotation and more, which is what makes training the deltoids so complex. Anatomically, the deltoid is a large triangular muscle that is divided into three parts (or heads) based on the attachment of the muscle fibers — the anterior, middle (or middle), and posterior deltoids (Figure). Many exercisers focus on the part of the shoulder they can see in the mirror while training (ie, the anterior deltoid) and neglect the medial and posterior. Unfortunately, the resulting imbalance can sometimes lead to injury and dysfunction.

What the research reveals

To determine which exercises activate the shoulder muscles best, Research sponsored by ACE evaluated 10 exercises popular with athletes and regular gym goers alike. The researchers began by evaluating each of the study’s 16 participants‘ one repetition maximum (1-RM) enabled seven of 10 following exercises:

*1-RM was not collected for these exercises, which use body weight or rope as resistance.

In two subsequent training sessions, the researchers placed electromyograph (EMG) electrodes on the three different heads of the deltoid muscle—the anterior, medial, and posterior—and had the participants perform five of the exercises during each session. For those exercises for which 1-RM was determined, participants performed five repetitions using 70% of their 1-RM.

Here’s what they found:

• For the anterior deltoid, the dumbbell shoulder press produced the greatest muscle activation.
• For the medial deltoid, the 45-degree incline row and bent-arm lateral raise came out on top.
• For the posterior deltoid, the seated rear lateral raise and the 45-degree incline row provided the greatest muscle activation.

The bottom line is that, due to the complexity of the shoulder joint and the variety of possible movements in the shoulder, there is no one best exercise for training this muscle group. It is impossible for a single exercise to maximally activate all three heads of the deltoid muscle simultaneously.

Additionally, it is vital to understand which area of ​​the deltoid each exercise targets so that you can properly balance your training. For example, if a routine consists of dumbbell shoulder presses, bent-arm lateral raises, and a 45-degree incline row, it accidentally neglects the posterior deltoid and doubles down on the medial deltoid.

The researchers recommend that people perform the dumbbell shoulder press for the front of the shoulders and either the 45-degree incline row or the seated rear lateral raise for the back of the shoulders, noting that all three exercises are also relatively effective at activating the medial deltoid.

Finally, one last piece of advice from the researchers: It’s best to start your training with exercises that target the posterior deltoid, as this is usually the weakest muscle in the shoulders, and then work the anterior deltoid.

Expert advice

In order to provide options for clients, we asked two experienced ACE-certified pros to tell us about their favorite shoulder exercises.

Man San Gilwho has been an ACE Certified Personal Trainer for 24 years, chose rotator cuff exercises and dumbbell shoulder presses as his choices. “Our rotator cuffs are often overlooked and undertrained“, he explains.Just some simple ones Shoulder internal/external rotation exercises play an important role in maintaining the structural integrity of our shoulder and help prevent shoulder impingement and other injuries.“

Dumbbell shoulder presses are a great way to work the delts while engaging other parts of the body, including the triceps, scapulae, trapezius and rhomboids, he explains. A word of caution: People with current shoulder problems may want to avoid doing overhead presses and instead do lateral raises or front raises as needed.

Cindy SullivanACE Certified Personal Trainer and Group Fitness Instructor, says two of her Favorite shoulder exercises for my middle-aged and older clients are the dumbbell smallshoulder prest (sitting or standing) and smallshoulder rair bows (light or weightless).

To make the dumbbell shoulder press easier, use lighter weights (or none) and perform the exercise seated for added stability. To make it harder, add tempo (slow on the way down), hold it at the top, or stand up in a staggered stance to engage the core.

Shoulder rainbows are ideal for clients working on mobility, posture and coordination, Sullivan explains. “I often use it with those who have limited range of motion or past shoulder problems—especially when we relax into shoulder work without pushing too hard.”

To make this exercise easier, reduce the range of motion or perform without weights. To increase the challenge, add resistance (eg light weights or small Pilates balls) and slow the movement for more control and time under tension.

Final Thoughts

Movement variety is essential when targeting a muscle group as complex as the deltoids. According to ACE-sponsored research, a training program that includes the dumbbell shoulder press for the front of the shoulders and either the 45-degree incline row or the seated rear lateral raise for the back of the shoulders is effective for both athletic performance and function. Also, consider adding our expert recommendations to the mix. Watch this YouTube video to learn how to perform each movement used in ACE-sponsored research, including the first four listed below:

Also, check out the links below for our expert recommendations and be sure to share all of this information with your customers:

To see all 10 exercises evaluated in the survey, check this out Downloadable PDF: Shoulder exercises.

	Corrective Exercise (worth 2.5 ACE CECs): As an ACE Corrective Exercise Specialist, you will design programs for clients affected by chronic conditions or injuries, enabling them to regain daily function and move with confidence.
	Movement without pain (worth 1.2 ACE CEC): As an expert in pain-free movement, you will better understand how pain affects movement and how to create new strategies to help people move without pain.