Shoulder prehab: Building strength and control to stay injury-free
- Mary Brooking
- 2 days ago
- 5 min read
If you think about your shoulder compared to your hip, one thing stands out straight away: It’s built for movement, not stability.
The shoulder has a huge range of motion, which is what allows you to swing your arms when running, reach overhead in the gym, or move efficiently through the water when swimming.
But there’s a trade-off. The more mobile a joint is, the more it relies on the surrounding muscles to keep it stable and functioning well.
Why shoulders get injured (runners, swimmers, and gym-goers)
I regularly see injured shoulders in:
Runners
Poor posture (especially desk-based work) affects arm swing
Tight chest and stiff upper back change shoulder mechanics
Low-level repetitive loading over time adds up to an overload
Swimmers
High-volume, repetitive overhead movement
Fatigue leading to loss of technique
Overuse of some muscles without enough stabilisation from others
Gym-goers
Overhead lifting without control
Too much pressing, not enough pulling
Focus on load instead of movement quality
Across all three, the common thread isn’t just “weakness.” It’s poor control under load.
“Just strengthen it”: Is that the full answer?
You’ll often hear: “Strengthen your shoulders to prevent injury.”
That’s true—but incomplete. There’s growing emphasis now on how the shoulder moves, not just how strong it is.
Two key ideas matter here:
motor control – how well your muscles coordinate movement
proprioception – your awareness of joint position
You don’t just need stronger shoulders—you need shoulders that:
Move well
Stabilise at the right time
Handle load without creating compensations elsewhere
A better way to think about shoulder health?
Instead of: “More strength = more protection”
Think: “Better control + appropriate strength = more resilient shoulders”
That includes:
Strength in the rotator cuff
Stability from the scapular muscles
Mobility through the upper back (thoracic spine)
Gradual exposure to load
Osteopathic viewpoint
One of my osteopath colleagues at the Sunflower Centre, Laura McCrave explains what she sees in her clinics and her viewpoint:
"Many shoulder problems I see stem from the rotator cuff muscles being overpowered by larger surrounding muscles. This can happen for a number of reasons—poor posture, fatigue, underuse, injury, surgery, or conditions like frozen shoulder.
The larger muscles aren’t designed to provide fine stability, so when they take over, they often become overworked and inefficient.
This usually leads to:
Movement feeling awkward or restricted
Pain around the shoulder and into the neck
A cycle that continues until the stabilising muscles are properly re-engaged"
A shoulder prehab toolkit
Laura and I have got together and come up with some trusted exercises to build shoulder control and resilience. It’s not about load intensity, it's about building good movement patterns.
IMPORTANT: Please only use if you don't already have shoulder or neck pain. If you are in pain, or have a pre-existing issue you should be assessed for a personalised rehab plan.
1. Scapular control (Building the foundation)
Why: Your shoulder blade is the base your shoulder moves on. If it’s unstable, everything else struggles.
Wall slides
2 sets of 8–10 reps
Stand with your back, head, and glutes against a wall, forming a 90-degree "W" with your arms. Slowly slide hands up to a "Y" while keeping wrists and elbows on the wall
Keep ribs down and lower back neutral and core engaged
Focus on smooth, controlled movement
Don’t shrug your shoulders up
What you should feel: Upper back and around the shoulder blades working
Scapular push-ups
2 sets of 8–12 reps
Movement involves only the shoulder blades, keeping arms completely straight, to retract (squeeze) and protract (spread) the scapulae, enhancing control and correcting posture.
Let the chest sink slightly, then push the floor away
Tabletop or plank
Why it matters: Builds control of the serratus anterior (key stabiliser)
2. Thoracic mobility (Often overlooked but plays a key role)
Why: If your upper back is stiff, your shoulder takes the strain.
Open books
1–2 sets of 6–8 reps per side
Follow your hand with your eyes
Keep hips still
Don’t force range—ease into it
Thoracic extensions over a foam roller
1–2 sets of 6–8 slow reps
Support your head with your hands
Gently extend over the roller (don’t hinge from lower back)
Breathe out as you extend
Focus: Movement through the upper back, not the lower spine
3. Rotator cuff strength (Building on a strong base)
Side-lying rotations
2 sets of 8–10 reps (each side)
Lie on your side with elbow bent to 90°
Keep a towel or small gap between elbow and ribs
Rotate the arm upward slowly without rolling your body, hold 3 seconds, return slowly down
Add weight (small dumbbell) to increase intensity
What to avoid: Letting the shoulder tip forward or using momentum
Banded external rotations
2–3 sets of 10–12 reps (each side)
Elbow tucked by your side
Slow on the way out, even slower on the way back
Keep the shoulder relaxed (no hiking up)
Focus: Control the movement—don’t just “get through the reps.”
4. Controlled overhead work
Goal: Teach the shoulder to handle load without losing position
Light dumbbell (or handmace) raises (with good form)
2 sets of 6–8 reps
Use a light weight you can fully control
Keep ribcage stacked (avoid arching your back)
Move smoothly—no rushing
Goal: Controlled strength through range, not max effort
Bottom-up kettlebell or plate holds
2 sets of 20–30 seconds (each side)
Hold the kettlebell upside down (handle down, bell up)
Wrist stacked over elbow
Stay tall—no leaning or wobbling
What you’ll feel: Shoulder stabilisers working hard to keep control
How to use: Build it up step by step
1) Start by learning how to control your shoulder blades with scapular wall slides and scapular push-ups daily or every other day for 1-2 weeks. .
2) Then improve movement through your upper back by including open books and/or thoracic extensions over a foam roller. Keep going with the scapular control exercises too.
3) Next introduce controlled strengthening of the rotator cuff around the joint with side-lying rotations and/or banded external rotations, maintaining the foundational scapular and thoracic movements on a less regular basis.
4) Finally, teach the shoulder to handle load properly, develop strength with control in more demanding positions with the light dumbbell press and bottom-up kettlebell hold. This is best alternated with the rotator cuff strengthening exercises rather than done in the same session.
Once you’ve built through the progression, this routine becomes part of your regular training—not something separate.
Use it regularly as a warm up or a standalone session:
1 scapular control
1 thoracic mobility
1 rotator cuff or overhead exercise
The takeaway
Your shoulder is mobile, not fragile —but it does need the right support to help it do all we ask of it.
Strength helps when it improves how your shoulder moves, stabilises, and handles load.
If you build that combination of control, strength, and mobility, you’re far more likely to stay pain-free—whether you’re running, swimming, or lifting.
If you’re unsure where to start, or if something doesn’t feel right in your shoulder, get in touch with myself or Laura — we are always happy to help guide you in the right direction.
Mary Brooking, Soft tissue/sports massage therapist
Laura McCrave, GOsC registered osteopath 11436
Laura specialises in treating musculoskeletal pain caused by lifestyle, work, and pregnancy-related factors, including discomfort in the neck, back, shoulders, and hips. Using a combination of structural techniques like massage and joint articulation, along with the calming approach of cranial osteopathy. She focuses on reducing pain and enhancing the body’s ability to manage daily activities with ease.
To book an appointment, email manager@thesunflowercentre.co.uk or call 020 8694 2714
Comments