A theme on this site throughout the years has been the need to train the upper body overhead. Especially for those with shoulder (and or neck) issues. I’ve covered the rationale behind this thoroughly in:
- A progression to lifting your arms overhead pain free
- Musings on scapular winging: Anatomy (muscular and nerve), causes and exercise considerations
- 3 common tight muscles
- 3 common weak muscles
- Miscellaneous notes on raising your arms
- Just because it feels tight doesn’t mean it is
This is antithetical to many shoulder rehabilitation philosophies, which seem to take the approach of “Never raise your arms overhead again;” “Do a ton of rowing and pulling;” “Strengthen your rotator cuff.”
The excessive rowing and pulling not only gets people nowhere, it’s detrimental. When we’re working on trying to more easily raise our arms overhead, we don’t want to be doing a bunch of exercises which hypertrophy and stiffen the musculature which pulls our arms down! In many shoulder cases, you want to be doing zero rowing and pulling. At least temporarily.
For instance, if you go from a relaxed posture to one in which your shoulders are pulled back, then try to lift your arms…you can’t. By definition, doing something like “pulling your shoulders back and down” prevents one from lifting their arms up and forward! If you’re trying to make something like lifting your arms up easier, you don’t want to be practicing the opposite all day.
-> If you’re wondering why this approach started and has lasted so mind-boggingly long, I will write about that eventually.
This presents a conundrum when it comes to training the biceps.

Both images from http://www.KenHub.com
We all know the biceps brachii flexes the elbow, but take a closer look at where it originates:
One of the areas the bicep pulls on is the coracoid process. The bicep can pull the forearm to the humerus -elbow flexion- but it can also pull the coracoid process down to the forearm.

Biceps contraction: Opposite ends, coracoid process and forearm, getting pulled towards one another (arrows).

Sliding filaments aka muscle contraction. Note filaments coming towards one another -contraction- then away from one another -relaxation. (GIF made from this cool video: http://www.youtube.com/watch?v=0kFmbrRJq4w )
If we pull the coracoid process down -we grab the front and top of the scapula and pull it down- the bottom of the scapula will reciprocate by moving back and up. The scapula anteriorly tilts.

When superior aspect of scapula tilts forward, inferior aspect tilts backward. (Red lines. Some removed for clarity.)
Notice the line of pull between the coracoid pulling aspect of the bicep and anterior scapular tilt:
This is an aspect of the biceps we don’t want to be training when it comes to dealing with shoulder issues. Excessive scapular anterior tilt is anathema to good shoulder function, particularly when the arms are trying to get overhead.
You can gain an appreciation for this quite easily. Try to lift your arms up with your shoulders rounded forward and notice how much more uncomfortable it is compared to when you’re nice and upright.

Contrasted with a nice and upright starting position (good scapular posterior tilt). This is NOT the same as pulling the shoulders “back.” The above is thoracic extension; not scapular retraction.
However, the other origination of the biceps:
Connects over the humeral head into the supraglenoid tubercle.
This is an important site because when the bicep pulls here, the humeral head will be pulled back towards the glenoid. For many, the humerus glides too far anteriorly, so anything that can help posterior glide is great. The biceps brachii can act similarly to the rotator cuff in this regard: keeping the humeral head snug in the glenoid fossa.

Anterior glide: Right picture is bad, left is better. From: http://www.manualtherapymentor.com
So far, we have a biceps brachii which we don’t want pulling the scapula into anterior tilt, yet a biceps we do want helping out with humeral posterior glide. The conundrum continues though.
Looking below, we can see when the shoulder (proximal humerus) glides too far forward, the elbow (distal humerus) is typically gliding too far backwards -the humerus is extending. Again, there’s a level of reciprocation here. When one side of a lever goes forward, the other side goes backward.
The bicep helps with humeral posterior glide, and in conjunction with this helps flex the humerus.
Using Jeremy (pictured above), let’s do a little “biceps recap.”
- Scapulae are anteriorly tilted => coracoid process of bicep can contribute to this, and we don’t want it to.
- Humeral head is anteriorly gliding => bicep can prevent this, and we want it to.
- Humerus is in extension => bicep can prevent this, it helps flex the humerus, and we want it to.
But we’re not done yet. Notice how Jeremy’s palms naturally face behind him some -his forearms are pronated.
The biceps brachii also supinates the forearm, turning the palms so they face more forward. In someone like Jeremy, when it comes to supination, the biceps brachii aren’t working enough. This is particularly true on his right arm. Notice his elbow is pointing nearly directly backward, but his palm is turned in. His humerus is not internally rotated, but his forearm is pronated.
This makes sense as Jeremy makes a living on the computer (as so many of us do now). Think about the arm positioning when you’re typing. Elbows are flexed, but forearm is pronated.
And what are Jeremy’s elbows held in? Flexion.
There’s a hang up here though. Some may be expecting me to say, “The biceps are too active into elbow flexion,” but that’s not quite true. Jeremy’s elbows are held into some flexion and forearm pronation. The biceps flex the elbow more with supination. The biceps aren’t really too active into flexion here, they’re not active enough.
-> If you’re wondering what muscle is doing a lot of the elbow flexion work here, it’s the extensor carpi radialis longus (amongst others). Discussing that is beyond this post. I actually wrote a whole book about this though. My tennis elbow one.
Let’s recap again:
- Scapulae are anteriorly tilted => coracoid process of bicep can contribute to this, and we don’t want it to.
- Humeral head is anteriorly gliding => bicep can prevent this, and we want it to.
- Humerus is in extension => bicep can prevent this, and we want it to.
- Forearm is in pronation => bicep can prevent this, and we want it to.
- Elbow is in flexion but with pronation => indicative bicep is not active enough as elbow flexor.
In other words, we want to:
- Posteriorly tilt the scapulae
- Posteriorly glide the humeral head
- Flex the humerus
- Supinate the forearm
That is,
- We want to flex the elbows with the forearms supinated, humeri flexed, scapulae posteriorly tilted, and humeral heads posteriorly glided.
There is potential for this to be accomplished with simple, yet mindful, good ol’ fashioned bicep curls.
First, rather than do these free standing, we set up against a wall. Using the wall to insure our entire spine is upright, we get a little scapular posterior tilt, especially compared to the common kyphotic posture. (We also straighten out the neck.)
Next, we bring the hands in front of the body some, flexing the humeri, and further helping posteriorly tilt the scapulae.

At worst, we want the elbows a little in front of being vertical, with more forward being better (green). We never want them behind vertical (red).
Turning the palms up -supination.
And flex:
This can work quite well. There is one hiccup though. Especially as the weight gets more challenging, and sometimes with even very light weight, it can be very, very hard to prevent the scapulae from anteriorly tilting. No matter the concentration given.
One way to help with this is to further cue for humeral flexion. The more we flex the humeri, the more our scapulae are likely to posteriorly tilt.
–
Sometimes no matter how diligent someone is, their technique leaves something to be desired. At some point, you have to acknowledge this isn’t on the person, but the exercise. Where, if you can, you change the exercise so better technique is facilitated.
Because of this, I’ve been playing with a different version of a bicep curl. An overhead one.
Set up at a normal pulldown station. Forearms are supinated (palms facing you), the weight is overhead (your shoulders are flexed and shoulder blades posteriorly tilted), and you curl:
–
If you don’t have a pulldown machine, you can set up on your knees with an overhead cable. Rope attachment works well.
This allows one to hit everything we’ve discussed, it’s just even easier to have solid form. Such as preventing anterior tilt. Posterior tilt and glide are hit, humeral flexion and supination, plus there’s the added benefit of working with the arms overhead. Just holding this position, as well as letting the machine pull the arms upwards each rep, is going to generate a good stretch in something like the lats.
If you perform the kneeling version, upon letting the weight up, you don’t want to let the lower back arch. This is true for the pulldown machine version too, but it’s more likely to occur on the kneeling version:
–
The abdominals will have to contract some to prevent this. So, you actually get a little ab work during the curl. It’s like a vertical ab rollout.
And of course, you don’t want to let the elbows drift downwards on this either.
We want these curls to be pure elbow flexion, not humeral extension. It’s a bicep exercise; not a latissimus dorsi, or long head of the tricep, exercise.
-> The long head of the tricep connects to the scapula. The triceps extend the elbow, but the long head also extends the humerus. When you flex the elbows, the long head may not like that full stretch (some stiffness). It reciprocates by attempting to generate humeral extension -lessening how much it’s on stretch. You pull the rubber band one way -elbow flexion- it tries to slacken the rubber band by not letting the other end stretch -humeral extension.
The catch to this exercise is you have to have the requisite mobility to get in the starting position. For some, this isn’t going to happen. Their shoulders aren’t initially ready for this. If you’re this banged up, getting a bicep pump shouldn’t be high on the priority list anyways.
“How about a preacher curl?” To which my response is “eh.” When flexing the elbows, a preacher curl can actually provide some nice elements. The humeri are flexed, palms supinated, and towards the top of the rep some humeral head posterior glide can occur. But it’s the bottom part of the movement that never looks very good:
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Tracing the humeral head, we can see the significant anterior and superior translation occurring:
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Each version has its pros and cons. I tend to use these as a means of getting people either 1) Back into some pulling or 2) As a break from pulling, but still getting some bicep work. Rather than immediately go into seated rows or something of that nature, these are a friendlier approach.
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Adam
January 15, 2015
Hey Brian, interesting post. In regards to shoulder pain though, anecdotally I have heard of a number of people with shoulder issues say that they feel ‘tightness’ along their triceps, often coupled with a tight feeling along the lats as well. Since the long head of the triceps does attach on the scapula, would you say that it’s possible or likely that a short triceps is often a significant factor in causing shoulder pain? On a personal level, I have been fighting a shoulder issue myself and often find that stretching or foam rolling the triceps does bring about a noticeable improvement in ROM and removes some discomfort.
Adam
reddyb
January 16, 2015
I wouldn’t say a significant factor, but it’s a factor. The lats, being so much bigger, are much more important.
Anything which inhibits overhead range of motion is typically a factor with shoulder issues. This is one reason to not focus so much on the muscle specifics, although it can be helpful (one reason I wrote this post), but the movement specifics. Doing the latter insures every muscle which needs to be addressed is.
If you use this post as an example, it’s more derived from a movement perspective. The biceps happen to go with that perspective. The movement is the plot, the bicep adds some characters.
physiotherapeia
March 9, 2015
Hey Brian,
Couple of questions raised up along reading this great article.
1. Do you have experience, is the ‘seeming’ or true-extension of humerus accompanied with scapular anterior tilt more often present with anterior glide of humerus? This is what I feel like. Actually so far I never saw humerus in extension with out anterior glide.
By ‘seeming’ I mean situation where anterior tilt manual fixing changes position of humerus.
2. In cases where humerus seems to be vertical and goes up in flexion along with scapular tilt correction, here flexing elbow neutralizes humeral alignment. I have only seen this reaction, but in theory if it didnt get fixed from slacking the bicep… that would indicate delt, upper pec or coracobrachialis involvement as I see. Did this ever happen to you?
One more thing! Wouldn’t it be a nice addition to these curls – between the dumbbel plates, having grip with your thumbs against outer plate of dumbbel adding stress on supination?
Cheers 🙂
reddyb
March 11, 2015
Hey Mikael,
1) If a humerus is held in extension, as in that’s someone’s resting posture, then there is a strong likelihood of anterior glide. That said, just because a humerus goes into extension doesn’t guarantee the humerus will anteriorly glide. In fact, this is something to work on i.e. humeral extension *without* anterior glide.
I tend to hold off on this though. I don’t do much pulling -humeral extension- initially with someone who has an issue of this nature. However, any time you do humeral flexion, you then work on humeral extension during the eccentric. So, i’m always working on humeral extension, albeit in a different manner.
After roughly 10 degrees of humeral extension, acquiring more extension is going to be accompanied by scapular anterior tilt. So, if someone is excessively anteriorly tilting, they tilt before that 10 degrees, that’s worth working on. And this often occurs with excessive anterior glide.
So, correcting someone who is anteriorly tilting too much or too soon, often has positive implications for a humerus that anteriorly glides too much. In fact, if you try to only correct the humerus in someone like this, you may not get anywhere. You often want to start proximal -with the scapula- which will then have a nice affect on the humerus.
2) Sorry, but I’m not sure what you’re asking here. Feel free to rephrase it, or send some photos to accompany the question.
3) I haven’t done anything like this (with the thumbs), but I don’t think that would be beneficial in this scenario. Unless you were looking to increase thumb strength for some reason.
physiotherapeia
March 11, 2015
Thanks for comment!
Yeah well, I meant at
2) That when you have lots of anterior tilt of scapula with humerus in extension/neutral, then you tell client to decrease anterior tilt of scapula ; you get kinda same result as you cue them by flexion to posteriorly tilt scapula. I’ll send photo later maybe though its not so big deal this question 😀
3) I explained really bad. I meant having hand not gripping centrally, but uneven, having index finger on the other end of “gripping stick” of dumbbel, |||—||| beeing dumbbel, and X beeing gripping hand
so like this: |||–X|||
I’m not sure if this made any more sense to be honest!
reddyb
March 16, 2015
3) I think I get what you’re saying now with the dumbbell.
If it’s the person’s right hand, like in a bicep curl, rather than have the person grip the DB like (Xs are the hand):
||||–XXX–||||
You go with this:
||||—-XXX||||
This way the inside of the dumbbell is pulling the hand into pronation, and you have to fight harder to keep the hand supinated. This is an interesting idea. I’ll play around with it with some clients and see how it goes.
physiotherapeia
March 18, 2015
Yes, that’s what I meant 😀
Other thing that came into my mind is; as far as I know about training that takes humeral glide into concern, Your texts and others… there haven’t been exercises for bicep with direct posterior glide from external source (like towel or stretch band etc) like there is with rotator cuff training. Is there some reason for this that I don’t just get?
reddyb
March 18, 2015
Can you give me an example of what you mean for the rotator cuff?
physiotherapeia
March 18, 2015
Example Your “Best exercises for subscapularis” where support is used to avoid anterior glide of humerus. Or in similar way done external rotation.
reddyb
March 20, 2015
Having a wall as feedback can be helpful here. I use a pole in the videos in this post, but I often will go with a wall as well. If you feel your shoulder blades coming off the wall, that’s a good sign the humeral heads are traveling too far forward. You don’t have something generating posterior glide here, but you have something helping feedback wise.
Something else you can do is a supine bicep curl with a cable. Where you have the elbows supported, and gravity is helping push the scapulae into posterior tilt. This is an idea I haven’t played with much though. The set-up isn’t as smooth as the standing variation, and you don’t really get the added humeral flexion benefit due to the line of pull, but I think it can work to some degree.
Here is a pretty good idea of what I mean: [broken link redacted]
cliff graves
September 4, 2015
hi there…once again fantastic above average stuff here…thank you. re the overhead bicep curls could these be performed with dumbells?
reddyb
September 6, 2015
Hey Cliff,
That would turn things into a tricep exercise actually.
If you laid on your stomach, say on a bench, then that may work. I’d have to try that, but there could be the benefit of actively working on shoulder flexion during that too. Where in the cable version I present in the post, that’s more passive shoulder flexion.
The tradeoff here though is once the arms got past halfway, the curl would turn into a tricep exercise. (Gravity goes from resisting the curl to helping the curl.) Some tricep work isn’t necessarily bad, but the exercise would be different. I may play around with this!
cliff graves
September 20, 2015
Hi Brian. Thank you for your feedback. Talking about triceps exercises if I may please (yes I know the article was regarding biceps curl exercise), but I have heard exercising the long head of the triceps assists dramatically in helping correct anteroir humeral glide. What are your viewpoints?….great article, great knowledge!! keep it up
reddyb
September 22, 2015
I’m not sure I see how the tricep could have that influence. Feel free to pass along wherever it is you’re reading that from, and I can take a look. Don’t think I’ve heard of that before.
I could perhaps see an influence with superior glide.
cliff graves
September 22, 2015
ok Brian thank you for that. I was certain I had seen it somewhere. If I can locate it will let you know….as ever thank you for responding
reddyb
September 22, 2015
You got it.
Sebastian
June 22, 2016
Hello, my English is not very good but i’m really interested by this article because i have this type of problem, if i have understand i have to not train biceps because they pull the corracoid and the humeral head forward ?
reddyb
June 24, 2016
It’s more how you do it than what you do.
Patrick
May 26, 2017
Hey Brian, any tips for training the triceps given the same shoulder problems?
b-reddy
May 28, 2017
My biggest thing when someone does cable extensions ala- https://www.youtube.com/watch?v=BvvMqxGdJY0
is to insure the shoulders do not roll forward / the person isn’t leaning over. That is, in a triceps exercise like that one, the triceps are what should be doing the work, not the shoulders. In other words, the shoulders shouldn’t be moving.
The person should be pulling the cable down, not pressing it.
I like overhead tricep extensions, though a person needs to have the shoulder mobility to get into position in the first place. A common issue is leaning back at the lower back to compensate for a lack of overhead mobility (photos here: https://b-reddy.org/2014/11/18/7-very-common-movement-issues-and-how-to-work-on-them/ ), and rocking the spine back and forth to get the weight up. (Other reason for this is the weight is too heavy.)
Similar to the cable extension- if the goal is to isolate the triceps, having another area helping isn’t ideal.
armourknight24
August 13, 2017
Hey Brian,
Awesome post. This is a good post and all, but how do I actually fix this anterior numeral glide? Instead of just doing exercises that compensate? I have the same problem as the woman doing the preachers, where my shoulder lunges forward. What muscles do I need to exercise to prevent anterior numeral glide? I have tried retracting scapula, but to can’t feel it all due to too much anterior glide. Left shoulder is fine and I use that as a normal gauge.
I heard training subscapularis fixes this?
b-reddy
August 15, 2017
Good deal more info here: https://b-reddy.org/2011/06/19/best-exercises-for-the-subscapularis/
And some other articles: https://b-reddy.org/?s=anterior+glide
Clyde
May 20, 2020
Great post! I’m making it my reference for my shoulder problem. What do you think about arm blaster? Does it support the shoulder when doing bicep curls?
b-reddy
May 22, 2020
Hey Clyde,
I haven’t used an arm blaster before, but I do think they could be helpful. One of those not necessary items, but fun to have.
It can help keep the elbows in better position, but you can still end up leaning back. Where standing against a wall would still be helpful.
Example of a guy still rocking a good deal: https://www.youtube.com/watch?v=CKGwyDPCZys
Alex Adams
September 2, 2020
I am learning so much. As it turns out, I suck at avoiding irritating everything. I’ve been doing the preacher curls for a while now and never realized that i’m actually tugging on my shoulder instead of isolating it. That’s why it’s not working any better than just doing it upright. I’m going to try the overhead.
b-reddy
September 4, 2020
Glad the article gave you some insight. Best of luck!