Glenohumeral Extension and the Dip: Considerations for the Strength and Conditioning Professional

Abstract

A significant number of resistance training injuries occur at the shoulder complex. However, there is a lack of research identifying predictive variables, which may increase the risk of these injuries. Certain exercises, such as those requiring the apprehension position (glenohumeral abduction with external rotation), have been investigated and found to be associated with shoulder pain and injury. However, there are additional exercises or positions that may also be associated with increased injury risk. The position of end-range glenohumeral extension, particularly as it pertains to a dip, is a vulnerable position that may have previously been overlooked.

Bench, Bar, and Ring Dips: Do Kinematics and Muscle Activity Differ?

“…The elongation of this ligament is likely to present as anterior shoulder instability [ 31 ]. This larger shoulder extension ROM may also excessively strain the PM when likely operating at a mechanical disadvantage [ 18 , 32 ]. However, the smaller load and low intensity of PM activation may mitigate PM injury risk.…”

“…Intuitively there are perhaps the greatest concerns for injury while performing the ring dip. However, this variation utilized the least amount of shoulder extension, which was previously identified as the dip’s most vulnerable position [ 18 ]. As the technique was entirely self-moderated, participants were potentially avoiding the vulnerability of end-range extension whilst performing a less stable task, which would likely have reduced end-range loading in the more unstable condition.…”

“…In addition to the lack of evidence justifying the dips use in exercise programs, the dip has also been criticised as a potentially high-risk exercise for injury to the shoulder [ 2 , 7 , 18 ]. A potential mechanism of injury has been suggested by McKenzie, Crowley-McHattan [ 18 ] relating to injury of anterior shoulder and PM.…”

“…In addition to the lack of evidence justifying the dips use in exercise programs, the dip has also been criticised as a potentially high-risk exercise for injury to the shoulder [ 2 , 7 , 18 ]. A potential mechanism of injury has been suggested by McKenzie, Crowley-McHattan [ 18 ] relating to injury of anterior shoulder and PM. However, supporting evidence is limited, with only two case reports of PM ruptures caused by the bar dip [ 19 , 20 ], anecdotal examples of PM injury caused by the ring dip [ 21 , 22 ], and unsubstantiated claims of the ring dip being a high-risk exercise for shoulder injury [ 7 ].…”

Fatigue Increases Muscle Activations but Does Not Change Maximal Joint Angles during the Bar Dip

“…Dips are completed some height above the ground and decreased movement control may increase fall risk, forcing the shoulder beyond the maximal range of motion, resulting in traumatic injury. Any potential increase in the risk of injury warrants investigation, particularly when considering that there are currently un-investigated practitioner concerns for a suspected high risk of injury to the shoulder when completing dip repetitions [ 22 ].…”