Avoid Lat Pull Downs for Impingement
Reference:Struyf F1, et al Scapular positioning and movement in unimpaired shoulders, shoulder impingement syndrome, and glenohumeral instability. Scand J Med Sci Sports. 2011 Jun;21(3):352-8.
Although I have nothing personally against doing lat pull downs or lat pull ups (as I do them), we should technically recommend against them in those presenting with shoulder impingement syndrome or instability. This review article based on 30 papers concluded that patients with either impingement syndrome or glenohumeral instability demonstrate decreased scapular upward rotation during arm elevation.
Clinical Relevance: Considering that the latissimus dorsi and rhomboids are powerful scapular downward rotators, it may be unwise to continuously strengthen those muscles as they may be a contributing factor to various shoulder pain syndromes.
The imbalance between the scapular upward and downward rotators is often a cause of scapular dyskinesis which is a known risk factor for developing shoulder pain as reported in the last study.
The irony is that lat pull downs is one of the most popular gym exercises for guys wanting to bulk up. It is also one of those few exercises that guys with shoulder pain can actually do at the gym and not have pain. Taking that away from them can seem illogical to them.
Posted on: December 22, 2014