An essay on the upright row….and peanuts

This is a brief essay on the upright row. For some reason this humble exercise inspires immense hate; is the hate justified?

Let's begin with a peanut analogy. Stay with me. Two friends go out to dinner and decide to share a chicken curry laced with peanuts (unbeknown to both individuals).  

One individual happens to be allergic to peanuts, and thus becomes violently ill shortly after consuming said curry.  

The other individual is not allergic and enjoys the meal, relishing in its taste and nutritional value.

Two individuals, two very different outcomes.  

What gives?

The peanut remains the same humble peanut. It hasn't suddenly become evil and murderous. 

The peanut does interact with an individual that is allergic to it, and thus illness ensues. So, the problem arises when the peanut interacts with a host that can't tolerate it. They say it takes 2 to tango, and in this case it certainly does. 

Let us now consider a controversial shoulder exercise: the upright row. Some social media influencers believe it is the worst exercise you can do for your shoulders and that it should be avoided with NO EXCEPTIONS. The chief argument for the naysayers is that the exercise has a biomechanical cost owing to its abducted and internally rotated properties. 

“You may not pay for it now, or tomorrow, but you will pay for it!”. Or so goes the dramatic (verbatim) claim. 

Some even go so far as to say doing upright rows will CERTAINLY lead to shoulder surgery. 

Is this absolutist stance logical? 

Firstly, you can absolutely injure yourself by doing an upright row exercise. But this isn’t the debate. Any movement or activity has a risk profile, and that profile is contingent on many variables. I have seen shoulder injuries occur in diverse ways, both from traumatic and non-traumatic mechanisms. I can’t say someone has presented to me with their primary mechanism of injury being the upright row, but that doesn’t mean it hasn’t occurred. In fact, social media tells me it happens all the time. 

We lack data that suggests the upright row is a dangerous exercise or that it increases our chances of developing shoulder pain. We have theories, based on the impingement model of shoulder pain, which assert the exercise is bad because the position at the top of the movement resembles that of an impingement test (Hawkins Kennedy test). Let’s remember that the impingement model of shoulder pain has basically zero credibility in the year 2024 amongst industry experts, which has implications for theories using it as the basis of its claims. 

It is conceivable that the upright row may be good for one person, bad for another, and indifferent for the next. The upright row itself doesn’t have good and bad properties or essences; its utility is determined by its interaction with a person! Same as a peanut.

How the upright row will interact with an individual will depend on many individual factors. For example, age, rotator cuff health, glenohumeral joint health, past experience with upright rows, weightlifting and general loading history, thoughts, and feelings regarding upright rows, sleep habits, psychological distress etc. etc. These are factors that can’t be standardised across space and time. Which begs the question, can we say the upright row is a dangerous exercise and should be avoided, no questions asked? 

No. 

Remember that it is very hard to predict injury [1] and how an individual will respond to a particular exercise. Even identical twins respond variably to the same exercise stimulus [2], how the hell can we predict outcomes across 2 totally unique individuals? Predicting a shoulder injury, or any injury, involves a tangled web of determinants and is now often conceptualised as a non-linear process [3]. 

Now obviously, we need some common sense here. If you were to give an untrained individual a 100kg bench press, there is a high probability of sustaining an injury. If you gave the same person 20kg upright rows, again there will probably be increased injury risk. In both cases it's a load issue and not an exercise type issue. You should still strive to be considered and responsible in your exercise prescription, and not subscribe to the nihilist claim that "anything goes" because injury is unpredictable. 

In summary, absolutist claims that emphasise binary outcomes (good/bad) (yes/no) (injury/non-injury) (surgery/non-surgery) probably have no place in complex areas such as pain and injury, and certainly not exercise selection. These claims simply rely on too many assumptions, most of which have been refuted (impingement), which leaves a very flimsy argument based mainly on “trust me bro”. So, feel free to do the upright row, or not, but please judge it on individual merit and context, and not some dude on YouTube.

My online course covers exercise prescription for shoulder pain in great detail, based on sound science and clinical reasoning (and a vanishingly small amount of "trust me bro"). 

Check the online course here

References

1. Bahr, R., Why screening tests to predict injury do not work-and probably never will...: a critical review.Br J Sports Med, 2016. 50(13): p. 776-80.
2. Marsh, C.E., et al., Fitness and strength responses to distinct exercise modes in twins: Studies of Twin Responses to Understand Exercise as a THerapy (STRUETH) study.J Physiol, 2020. 598(18): p. 3845-3858.
3. Stern, B.D., E.J. Hegedus, and Y.C. Lai, Injury prediction as a non-linear system.Phys Ther Sport, 2020. 41: p. 43-48.