A year and a half later, after some ups and downs with that shoulder, I found myself in an orthopedic surgeons' office, where he told me what I already knew - that I probably had a partially dislocated shoulder and a partial tear in my rotator cuff. He said I could have surgery or quit lifting weights. No physical therapy or corrective exercises were offered. I was a little disappointed.

I later discovered that poor posture contributed to my problems by placing them in an inefficient position. Did pulldowns behind my head contribute to this injury? Most definitely. However, it wasn't the sole problem.

After that point, I started doing some reading on shoulder problems and came across some interesting information. One study done in 1993 by a group of medical doctors, looked at 20 patients with shoulder pain and instability who lifted weights. It was determined that certain exercises put the shoulder in what they termed "the at-risk position."

This position occurs when the upper arm is 90 degrees away from the torso with the elbow also bent at 90 degrees and behind the head, such as in the lat pulldown done behind the head. Other exercises in this category included the military press behind the head and chest flyes on a machine that places the bent elbows in a 90 degree position with the palms facing forward.

Ten of these patients studied had to have surgery and the other ten were able to complete conservative exercises for the shoulder. Eight of those who didn't require surgery went back to lifting weights and by avoiding this at-risk position, had no more problems. One of these patients, however, avoided the advice to skip these exercises and the pain came back. After rest and modifying the exercises, he was able to lift without pain.

In the last 15 years or so I have worked in and worked out in many different facilities in many different cities. In probably 90% of the time I saw people doing the behind the head pulldown, they finished this exercise bent forward, usually by doing a crunch to help finish the exercise.

Now its bad enough for your shoulders by doing them sitting straight upright. But the crunch just adds to the stress your shoulders receive, along with killing your posture. The solution is simple - sit perfectly upright and pull the bar straight down to your collar bone.

You work the same muscles that way. Then you can change the muscles affected by altering your grip and you can also lean back at a slight angle and pull down to your chest. You get all the benefits at a much lower risk of injury. If you are over 35, like I am, you need to weigh the risk versus the rewards. You can still work out intensely, but be a little smarter.

And by the way, the average age of the twenty patients in the study - 28. I was a little younger than this when I injured my shoulder. Also, at least a third of the guys I've talked to in various gyms, who have lifted fairly intensely for several years, have some degree of problems with one or both shoulders. Sounds like a need for some prevention.

An exercise that could also potentially cause harm is the barbell upright row with a very narrow grip, so that the hands are almost touching. This places the shoulder into extreme internal rotation so that at the top of the movement, where the elbows are above the chin, you run the risk of impingeing the shoulder, irritating some of the tendons as they rub against other shoulder structures. This information comes from the book "The 7 Minute Rotator Cuff Solution."

If you want to do this exercise, I would modify it by moving your hands farther apart so they are about shoulder width. When doing pec flyes with either dumbbells or on a machine, just make sure not to go too far with your stretch. Don't let your hands go farther than your body. If using a machine, use one that puts your hands at the same level as your shoulder, that you grip with your hands.

Another exercise that did further damage to my shoulder was the power squat. In this exercise you set the bar farther down your back than you do with the bodybuilding squat. This is done for better leverage, to lift heavier weights. In my case, my lack of flexibility and poor posture put a great deal of pressure on my unstable shoulder. So if you are doing this lift, make sure you have proper stability in your shoulders first.

In closing, I would recommend doing plenty of work to strengthen the muscles surrounding the scapula and to make sure that you balance out the amount of pushing and pulling you do. For every press, do an equal amount of rows and pulls. And make sure to watch your posture while lifting.

Brian Morgan has been a Certified Strength and Conditioning Specialist (CSCS) since 1993 and is also a massage therapist, having worked with people of all ages. For more information go to http://www.brianmorganfitness.com and sign up for the newsletter "Mobility for Life."

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