If your knee hurts and you go see a physical therapist or doctor, they are going to assess your knee AND the surrounding joints. We know that faulty movement or weakness at one joint can cause problems at another.
When it comes to shoulder pain, we can’t ignore grip and how it influences muscles and joints up the chain.
Research has shown that good grip strength improves rotator cuff activity and may play roles in injury prevention and rehabilitation of shoulder injuries. REF
If you’ve ever worked with a personal trainer or been to a Crossfit gym, you may have heard your trainer or coach give you cues like “break the bar” when bench pressing or “screw your feet into the ground” during a squat. These cues facilitate tension in the muscles in the hands and feet which then spreads to increase tension in the more proximal joints like the shoulder and hip.
We call this concept “muscle irradiation”. In simple terms, when you grip something with your hands, your brain says “we’re about to move something with this limb, I better turn on the muscles in the shoulder so we can perform this activity properly”. Try it out for yourself. Clench your fists as hard as you can. Feel the shoulder muscles engage?
It’s obvious that grip strength is critical to performance in dead lifts, pull ups, but how is this all applicable to injury prevention and recovery from an injury or surgery? Buckle up, it’s going to get a little sciency.
To start, let’s talk about force couples.
A force couple is group of muscles moving together in a synergistic manner to produce movement of a joint.
There are a few force-couple relationships in the shoulder, but let’s focus on the deltoid and rotator cuff force couple because this one is often thrown out of whack and can lead to shoulder impingement or rotator cuff tears.
This schematic shows the line of pull for the deltoid and the rotator cuff. You can see that the deltoid has an upward pull on the humerus (arm bone) while the rotator cuff has a downward pull. Having balance between these muscle groups keeps the head of the humerus centered in the joint.
Often times, the rotator cuff is weak in relation to the deltoid, so we get a net upward force on the humerus leading to shoulder dysfunction and potential compression of the soft tissues within the joint space which we call shoulder impingement. Not good.
We know through research (REF, REF) that improvements in grip strength are correlated with improvements in rotator cuff strength and activation which improves the ratio of muscle force between the deltoid and the rotator cuff.
Developing grip strength will help reduce your risk of injury AND act as a tool to rehab from an injured state to re-establish balance in your shoulder musculature which ultimately leads to a more stable and resilient shoulder.
How do we train grip?
If you’re injured or recovering from a shoulder surgery, start small. Squeezing a stress ball can be effective at this stage.
For my patient’s entering the early stages of strengthening following rotator cuff repair surgery, I will have them gently squeeze a towel roll in their hand while performing some gentle movements simply to recruit more muscle fibers.
If your shoulders are healthy and looking for ways to keep them that way, try some of these exercises to develop more grip strength.
Bottoms Up Kettlebell Press
Plate Pinch
Pull Up Hang
Farmers Carries
Still not motivated to increase grip strength?Did you know grip strength is inversely correlated with all-cause mortality?! (REF)