Why Your Shoulder Still Hurts After Rotator Cuff Exercises for the Snatch.

Sammy's shoulder kept subluxing because her posterior rotator cuff was quite weak, according to Dr. Aaron Horschig's evaluation. A subluxation is when the ball of the shoulder joint pops out of the socket and then comes back in — Sammy experienced this three separate times while snatching.

Functionally, when her arm went overhead to receive the snatch, her shoulder joint wasn't stable. Because the back of the rotator cuff wasn't pulling its weight, the front of the shoulder took over, allowing more motion at the joint than should occur in that overhead position.

Not automatically, says Dr. Aaron Horschig — three physical therapists told Sammy to stop weightlifting entirely, but he disagreed with that as the default answer. He notes that weightlifting as a sport is actually quite safe with a low risk of injury compared to other sports, a fact he says most medical professionals fail to realize.

Instead of shutting down her training, Sammy traveled to St. Louis for an evaluation with Dr. Horschig, who looked for the underlying mechanical cause of her recurring subluxations rather than just removing the stressor.

Basic external rotation exercises didn't fix Sammy's pain because they don't train the shoulder in the same overhead position where the pain actually occurred. Sammy still hurt even just raising her arms, despite doing the simple exercises three separate PTs had prescribed.

The fix had to match the position the shoulder actually works in during a snatch — arm locked out overhead — not just a generic, arms-at-the-side rotation drill.

Rebuilding shoulder stability for the snatch means training the rotator cuff in the overhead, load-bearing position it actually has to stabilize. Dr. Aaron Horschig used a two-step progression with Sammy:

1. External rotation work with pauses, plus a press with a pause, to rebuild shoulder stability in a position specific to the snatch.
2. Snatch grip overhead presses with the Earthquake Bamboo Bar — the bar's shaking, bouncing weight forces the rotator cuff to work dynamically to stabilize the shoulder joint.

This progression was designed to eventually get Sammy back to loaded snatching, rather than permanently pulling her out of the sport.