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367
Journal of Strength and Conditioning Research, 2002, 16(3), 367–372
q2002 National Strength & Conditioning Association
Shoulder Strength and Range-Of-Motion
Characteristics in Bodybuilders
JOSHUA C. BARLOW, BRIAN W. BENJAMIN, PATRICK J. BIRT,
AND
CHRISTOPHER J. HUGHES
Graduate School of Physical Therapy, Slippery Rock University, Slippery Rock, Pennsylvania 16057.
ABSTRACT
The purpose of this study was to compare shoulder range-
of-motion (ROM) and strength values between bodybuilders
and nonbodybuilders. Fifty-four men (29 bodybuilders and
25 nonbodybuilders) between the ages of 21 and 34 years
participated in the study. Goniometric measurements were
used to assess shoulder flexion and internal and external ro-
tation ROM. Isometric manual muscle tests were performed
using a handheld dynamometer. Shoulder flexion, internal
and external rotation, abduction, and prone shoulder retrac-
tion and elevation strength were tested. Independent t-tests
were used to determine levels of statistical significance be-
tween the groups. Bodybuilders showed an overall loss of
shoulder rotation ROM (1668vs. 1808) and a significantly de-
creased internal rotation ROM (2118) compared with the
control group. Bodybuilders were significantly stronger on
all isometric shoulder-strength tests than nonbodybuilders,
except for the assessment of lower trapezius strength when
expressed as a percentage of body weight. The results of this
study indicate that bodybuilders have imbalances regarding
strength and ROM at the shoulder that may make them sus-
ceptible to shoulder pathology.
Key Words: bodybuilding, strength training, shoulder
injuries, shoulder strength, shoulder flexibility
Reference Data: Barlow, J.C., B.W. Benjamin, P.J. Birt,
and C.J. Hughes. Shoulder strength and range-of-mo-
tion characteristics in bodybuilders. J. Strength Cond.
Res. 16(3):367–372. 2002.
Introduction
W
eight lifting is a popular activity that is used to
maintain fitness and also to train for various
sporting activities. ‘‘Weight lifting’’ is a generic term
that is applied to several strength training sports in-
cluding power lifting and bodybuilding. In bodybuild-
ing, the primary objective is hypertrophy and form (1).
Bodybuilders participate in the activity for the pur-
pose of increasing their general health, strength, and
fitness or for entering into competition in a formal
show or venue. In an attempt to increase strength,
many athletes who lift weights inadvertently overem-
phasize strengthening the pectoralis, deltoid, and ab-
dominal groups while neglecting the muscles that sta-
bilize the scapular and glenohumeral joints (5). Body-
builders have been found to demonstrate weakness in
scapular stabilizers and the rotator cuff muscles (5).
These types of strength imbalances can lead to poor
scapulohumeral rhythm during shoulder elevation and
may be a factor in the development of shoulder im-
pingement. Furthermore, repetitive use of the shoulder
complex during extreme ranges of motion (ROMs) un-
der heavy load (i.e., bench press, overhead pressing,
dumbbell fly, etc.) can lead to the development of dy-
namic shoulder instability, impingement, and rotator
cuff tears (3). Changes in shoulder laxity, select cap-
sular restriction, or muscle strength imbalances sec-
ondary to weight training need to be identified to ed-
ucate strength athletes on proper exercise selection and
injury prevention strategies. A comparison between
the bodybuilding population and non–weight training
individuals (nonbodybuilders) has not been previous-
ly studied. A comparison of strength and ROM values
would be useful to further delineate ‘‘exercise risk’’
related to long-term shoulder pathology in this pop-
ulation. Mazur et al. state that ‘‘future prospective
studies are needed to better define the incidence of
injury in strength training . . . and in body building
...’’ (11). The purpose of this study was to compare
mean shoulder ROM values and mean shoulder-
strength values between bodybuilders and nonbody-
builders.
Methods
Subjects
Men between the ages of 21 and 34 years were re-
cruited from Slippery Rock University and local
weight lifting gyms. None of the subjects reported re-
cent shoulder pathology of their nondominant arm.
The nondominant arm of all participants was used in
an effort to control for possible asymmetrical laxity,
tightness, or strength values normally present in the
368 Barlow, Benjamin, Birt, and Hughes
Table 1. Subject information.
Subject
group Age (y) Height (cm) Weight (kg)
Subject
group Age (y) Height (cm) Weight (kg)
Nonbodybuilder Bodybuilder
1
2
3
4
5
6
7
8
9
10
23
25
24
26
28
23
27
26
28
25
180.3
175.3
180.3
167.6
177.8
177.8
170.2
180.3
190.5
180.3
104.5
67.7
79.5
71.4
70.5
72.7
72.7
59.1
81.8
86.4
1
2
3
4
5
6
7
8
9
10
24
27
27
25
22
23
24
23
25
23
190.5
190.5
190.5
177.8
188.0
188.0
182.9
180.3
180.3
182.9
106.8
104.5
109.1
79.5
97.7
81.8
85.0
104.5
89.1
90.9
11
12
13
14
15
16
17
18
19
20
31
25
34
26
27
30
28
27
23
30
182.9
170.2
172.7
182.9
177.8
177.8
177.8
177.8
193.0
172.7
100.0
71.4
79.5
72.7
77.3
75.0
79.5
74.1
95.5
71.4
11
12
13
14
15
16
17
18
19
20
28
21
26
23
26
21
22
27
24
22
167.6
160.0
167.6
175.3
177.8
188.0
177.8
167.6
172.7
182.9
79.5
63.6
84.1
88.6
79.5
103.2
100.0
68.2
79.5
87.3
21
22
23
24
25
Mean
SD
25
22
24
24
26
26.3
2.8
165.1
180.3
195.6
190.5
177.8
179.0
7.4
70.5
75.0
111.4
89.5
75.0
79.4
12.0
21
22
23
24
25
26
27
26
26
29
26
29
26
24
175.3
180.3
193.0
180.3
182.9
182.9
182.9
84.1
100.0
102.3
84.1
104.5
93.2
88.6
28
29
Mean
SD
20
26
24.7
2.4
175.3
170.2
179.7
7.9
81.8
76.4
89.6
11.7
dominant arm because of increased use. Twenty-nine
bodybuilders served as the experimental group, and
25 nonbodybuilders served as the control group. To be
included in the experimental group, subjects reported
lifting weights primarily for strength and size gains a
minimum of 3 times per week for at least 3 consecutive
years. Age, height, and weight of each subject can be
found in Table 1. Specific strengthening exercises and
repetition maximum loads for each bodybuilder were
not delineated. All other subjects who did not meet
these criteria were placed in the control group. Ap-
proval from the Institutional Review Board for the
Protection of Human Subjects was obtained before the
study. All subjects were required to sign a university-
approved consent form before participating in the
study.
Testing
Before ROM and strength testing, all subjects were re-
quired to perform a standardized warm-up of the
shoulder for the nondominant arm. This warm-up
consisted of 3 active stretches, which included the pen-
dulum exercise, a horizontal adduction stretch, and a
flexion stretch. The pendulum exercise stretches the
posterior cuff and shoulder extensors, the horizontal
adduction stretch stretches the posterior cuff and pos-
terior capsule of the shoulder, and the flexion stretch
involves the posterior capsule, triceps, and inferior
capsule of the shoulder. For the pendulum stretch, the
subjects were instructed to lean forward and support
themselves with their other hand, relax the arm, and
sway their body weight and make circles with their
arm. Subjects performed clockwise and counterclock-
wise rotations of the arm for 30 seconds each. The pos-
terior capsule stretch required the subjects to pull their
arm across their chest until they felt a stretch at the
back of the shoulder. This position was held for 30
seconds. To perform the flexion stretch, each subject
was instructed to stand facing a wall and slide his non-
dominant arm as far up the wall as possible with his
palm in a supinated position. This stretch was held for
30 seconds.
Effects of Bodybuilding on the Shoulder Complex
369
Figure 1. Internal rotation range of motion.
Figure 2. Lower trapezius manual muscle test.
Figure 3. Appley scratch test.
A goniometer was used to assess passive ROM of
the nondominant arm for flexion, internal rotation,
and external rotation. A picture of the procedure for
measuring internal rotation can be found in Figure 1.
Subjects were positioned supine for all ROM tests.
Arm positioning for these measures was according to
the guidelines set forth by Norkin and White (12). Four
pounds of overpressure was applied at end range for
all movements, using a Microfet II handheld dyna-
mometer (Hoggan Health, Draper, UT).
Isometric manual muscle tests (MMTs) were con-
ducted to evaluate strength of the shoulder flexors, in-
ternal rotators, external rotators, abductors, middle
trapezius, and lower trapezius of the nondominant
arm. Subject positioning during strength testing in-
cluded the seated, prone, and supine positions (Figure
2). All standardized test positions for shoulder flexion,
internal rotation, external rotation, and abduction were
according to Soderberg (13). Subject positioning for as-
sessing the isometric strength of the scapular stabiliz-
ers involved testing for the middle and lower trapezius
muscle groups using procedures described by Kendall
and McCreary (7). Middle trapezius strength assess-
ment required the subject to be in a prone position
with the arm abducted to 908and in full extension and
maximal external rotation. The lower trapezius
strength test position was similar to the middle tra-
pezius test position except that the arm was abducted
to 1208. The trials for strength measures were random-
ized across all subjects. Subjects were required to exert
a maximum voluntary isometric contraction for 3–5
seconds. A 30-second rest period was allotted between
measurements. After strength testing, subjects were
asked to perform 3 clinical tests commonly used to
assess shoulder impingement. The tests included the
bilateral Appley scratch test, the Neer test, and the
Hawkins test (10). The Appley test required the subject
to stand up straight, actively place 1 arm over his
shoulder, and then reach the other arm up the back in
an attempt to touch the fingers of the opposing upper
extremities (Figure 3). This test was scored by mea-
suring the distance, in centimeters, between the fin-
gertips of the subject’s opposing hands. The Neer test
was performed with the subject seated by passively
moving the subject’s arm into full shoulder flexion.
The Hawkins test was performed with the subject seat-
ed with the shoulder passively flexed to 908in the sag-
ittal plane and the elbow flexed to 908. The examiner
then passively rotated the shoulder internally to end
range. A participant’s report of pain was considered a
positive sign for the Neer and Hawkins tests.
We conducted a pilot study of 10 subjects to ensure
intrarater reliability for each of the measures. An in-
traclass correlation coefficient (ICC) (3,1) model was
used. One researcher conducted goniometric measure-
ments, another researcher operated the handheld dy-
namometer, and a third researcher recorded all data
for each of the measurements. Three trials were col-
lected for each measurement. ICC values for all ROM
measurements were found to be above 0.94. All ICC
370 Barlow, Benjamin, Birt, and Hughes
Table 2. Performance data for subjects.*
Control
group mean
6SD N 525
Experimental
group mean
6SD N 529
Subject characteristics
Age, y
Height, inches
Weight, pounds
26.3 62.8
70.5 63.0
174.6 627.0
24.7 62.4
70.8 63.2
197.1 626.1
ROM, degrees
Flexion ROM
Internal rotation
External rotation
184.7 67.3
71.8 610.1
107.8 67.6
183.6 613.0
60.8 612.5
105.1 69.6
Strength, % BW
Flexion
Internal rotation
External rotation
Abduction
Middle trapezius
Lower trapezius
41.3 66.06
34.3 64.85
22.2 63.55
35.9 66.21
12.0 61.95
11.8 62.2
46.6 67.07
37.9 66.9
26.0 63.9
41.3 67.1
13.2 62.1
12.8 62.8
Clinical tests, cm
Appley’s:
Right arm externally
rotated
Left arm externally
rotated
2.2 63.6
4.3 64.7
7.7 68.1
11.3 69.3
*ROM5range of motion; BW 5body weight.
Table 3. Statistical results of independent t-tests using
Bonferroni correction.
Test
statistic
(t-value)
p-Value
(2-tailed)
Subject characteristics
Age, y
Height, inches
Weight, pounds
2.28
3.31
3.10
0.027
0.742
0.003*
ROM Data†, degrees
Flexion ROM
Internal rotation
External rotation
0.386
3.50
1.13
0.701
0.001*
0.263
Strength data, pounds
Flexion
Internal rotation
External rotation
Abduction
Middle trapezius
Lower trapezius
2.93
2.17
3.67
2.95
2.10
1.50
0.005*
0.035
0.001*
0.005*
0.041
0.140
Clinical tests, cm
Appley’s:
Right arm externally rotated
Left arm externally rotated
3.10
3.48
0.003*
0.001*
†ROM5range of motion.
* Indicates significant finding (a50.014).
values for strength measurements were greater than or
equal to 0.90 with the exception of the middle trape-
zius (0.77) and the lower trapezius (0.74).
Statistical Analyses
On the basis of the pilot study, the GPOWER statistics
software program was used to calculate a power of
0.90 (2). The program uses sample standard deviation
data and mean difference information as inputs to cal-
culate sample size. A sample size of 23 subjects for
each group was needed to obtain a power of 0.90.
Strength measurements were converted from
pounds to percent body weight to account for differ-
ences in body weight between groups. Independent t-
tests were performed using a Bonferroni correction to
adjust the significance level for rejection to a50.014
to determine significant mean differences between
bodybuilders and nonbodybuilders (8).
Results
Table 2 shows the means and standard deviations for
all measures for the 2 groups. Table 3 shows the sta-
tistical results for each of the independent t-tests. The
bodybuilders’ mean weight was significantly heavier
than that of the control group. The mean age and
height were similar between the groups. There was no
significant difference between the groups for flexion
and external rotation ROM measurements. The body-
builders had a significantly decreased average internal
rotation ROM by 118. Strength values, expressed in re-
lation to percent body weight, are also shown in Table
2. Bodybuilders were significantly stronger for all iso-
metric shoulder-strength tests except for lower trape-
zius strength. The mean strength values were 3–6%
larger for the bodybuilder group in flexion, abduction,
internal rotation, and external rotation. The body-
builders’ middle and lower trapezius muscle strength
values were approximately 1% greater than the control
group values. Three bodybuilders and 2 nonbody-
builders showed positive impingement signs with the
Neer and Hawkins tests. The Appley scratch test
showed differences in scores between the groups. The
scores were 5–7 cm larger for the bodybuilder group,
which indicated decreased shoulder mobility for the
bodybuilders.
Discussion
The nondominant arm internal rotation ROM values
for bodybuilders were significantly less when com-
pared with the values for nonbodybuilders. These re-
sults support our original hypothesis of a decreased
internal ROM among bodybuilders. A combination of
increased muscle mass and posterior capsule tightness
Effects of Bodybuilding on the Shoulder Complex
371
as a result of bodybuilding may have contributed to
the decreased internal ROM. These findings were fur-
ther supported by significance in means between the
groups on the bilateral Appley scratch test scores. A
previous study by Jobe and Pink (6) has shown that
decreased shoulder internal rotation ROM has a high
correlation with shoulder pathology. Although previ-
ous studies (6) have suggested that bodybuilders’ ex-
ternal rotation ROM was increased because of com-
promising lifting positions, our study found no sig-
nificant differences between the groups.
The bodybuilders’ average weight was found to be
significantly greater when compared with the average
weight of subjects in the control group. To make
strength values relative to the size of the tested sub-
jects, strength values were expressed in relation to per-
cent body weight. As hypothesized, bodybuilders had
increased strength values for almost all tested motions.
Bodybuilder strength values, expressed as a percent of
body weight, were found to be significantly greater in
all MMT positions except for the MMT that assessed
lower trapezius muscle strength. Despite the signifi-
cance of the findings, we were quite surprised to see
that the bodybuilders were only approximately 5.4%
stronger than the average control subject for abduc-
tion. Furthermore, these same bodybuilders were not
much stronger than the nonbodybuilders on the 2
scapular retraction tests. When compared with sub-
jects in the control group, they were only 1.2% stron-
ger for retraction using primarily the middle trapezius
muscle group and only 1% stronger for retraction and
arm elevation in the prone position to test the lower
trapezius muscle group. These findings may indicate
that the training the bodybuilders were involved in
may be creating muscle-strength imbalances that are
a result of an overemphasis on lifting larger muscle
groups (e.g., pectoralis and deltoid muscles) and the
neglect of scapular stabilizers. This type of strength
imbalance in the shoulder girdle musculature has been
correlated to a variety of shoulder pathologies (4).
An interesting finding regarding the clinical tests
for shoulder impingement showed that even though all
subjects tested reported no recent shoulder pathology,
approximately 10% of these subjects were graded as
having positive signs on these tests. Previous clinical
research by MacDonald et al. (9) has found the Neer
test to have a sensitivity of 75% and the Hawkins test
to have a sensitivity of 92% for the appearance of sub-
acromial bursitis. No comparative information could
be found regarding the sensitivity of the Appley
scratch test. On the basis of the results presented, these
athletes may be in an early stage of impingement and
may already have altered shoulder biomechanics, as
evidenced by the results of the lack of strength differ-
ences between the bodybuilders and nonbodybuilders
in this study. The clinical tests used in this study may
serve as useful tools in providing initial screening for
detecting shoulder pathology and avoiding certain ex-
ercises that may propagate additional symptoms.
Limitations are apparent in this study. One limi-
tation was that some subjects in the control group lift-
ed weights but failed to meet the inclusion criteria for
the experimental group. These individuals were not
avid and experienced lifters who trained a minimum
of 3 times per week for at least 3 years. Their inclusion
in the control group may have reduced the differences
among scores on the variables measured. We still
achieved significance, however, on some of the
strength and ROM tests that indicate appreciable dif-
ferences. The majority of the control group subjects
were young, very active, and health conscious.
To better represent the population, a wider range
of people with various activity levels and ages should
have been collected. A more diverse sample among the
subjects in the control group may have more appro-
priately represented the 20- to 40-year-old population.
A limitation regarding the bodybuilders is that specific
workout information, i.e., types of exercises, could have
been gathered from the bodybuilders to specifically as-
sess whether members in this group were performing
exercises that may adversely affect the shoulder.
Recommendations for future studies include a lon-
gitudinal study to determine if motion deficits in
bodybuilders correlate with an increased incidence of
shoulder pathology. Another recommendation is to de-
termine if the shoulder kinematics of bodybuilders dif-
fer from those of nonbodybuilders when performing
functional activities involving elevation and internal
rotation. Finally, a study could use goniometric mea-
surements to determine appropriate ROMs needed to
perform bodybuilding activities in a safe manner.
Practical Applications
The results of this study have implications for body-
builders, strength coaches, personal trainers, and
health care providers in suggesting proper education
and instruction on maintaining appropriate shoulder
flexibility through performance and selection of prop-
er resistance exercise to minimize the incidence of
shoulder pathology. This study provides evidence that
bodybuilders have decreased shoulder ROM motion
and, in particular, decreased internal rotation ROM
when compared with bodybuilders. Although they
were stronger in the large muscle groups compared
with the nonbodybuilding (control) group, bodybuild-
ers were not significantly stronger in the retraction
movement, which required strength primarily in lower
trapezius muscles. This muscle group, along with oth-
er scapular stabilizers, should be a primary focus of
strength training regimens involving the upper ex-
tremity and trunk to decrease the likelihood of altered
biomechanics in the shoulder girdle, which may con-
tribute to shoulder impingement. Lifting weights has
372 Barlow, Benjamin, Birt, and Hughes
the potential to be detrimental to shoulder function
even though the primary goals of strength and size
benefits can be achieved. This possibility justifies the
need for proper supervision and the use of trained
specialists in the field of strength and conditioning to
design safe and productive strength training pro-
grams.
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Address correspondence to Dr. Joshua Barlow,
joshbarlow@prexar.com.
