I want you to try something before you continue reading this. Start by rounding your shoulders forward and lift your arms overhead, as if you are reaching for something on a high shelf and take note of how high you can lift them. Step 2 – Sit up nice and tall and now try to lift your arms above your head. What changes? Does it feel any different?
You should have noticed a difference in how high you could reach your arm overhead depending on where your shoulders were positioned. You also may have noticed some pain or discomfort as well when moving them overhead.
This rounded shoulder posture is a frequent position we as humans find ourselves in on a daily basis. Due to our technology-oriented world, we are constantly sitting at a computer, watching television, driving, and looking down at phones. All these activities feed into this poor posture. Did you know it takes thousands of repetitions to make something a habit? Imagine how often you sit, stand, and walk in this rounded shoulder and forward head posture on a daily basis. This posturing can place increased stress on your neck and shoulder musculature and joints.
As you can see, posture plays a huge role on shoulder motion because of how these structures work together and the motion that is allowed. This change in motion is due to complexity of the shoulder girdle. The shoulder girdle is made up of multiple joints and muscles that play a key role in movement.
The shoulder girdle has narrow space called the subacromial space that allow the bursa, joint capsule, and supraspinatus muscle – one of your 4 rotator cuff muscles to pass through. This space is only 9-10 mm which does not allow for much room for error when performing overhead motions.
When performing overhead motions in the rounded shoulder posture, the subacromial space is even smaller than 9-10 mm. This narrowing causes increased pressure on the underlying structures – specifically a rotator cuff muscle. Over years, this constant stress to the muscle causes small microtears in the tissue and inflammation as it tries to heal.
After years and years of microtears and constant inflammation, the muscle has had enough and a few things can happen. Think of the muscle as a rope that’s been slowly fraying over the years. This muscle can get a partial or full tear and cause an increase in pain. Another reason for shoulder pain is the buildup of scar tissue caused by constant microtears. This buildup of scar tissue causes the muscle to weaken over time which will in turn limit the amount of motion available for everyday use.
After years of wear and tear on the muscles, what can you do to improve your shoulder pain? There are a couple of options available. Some orthopedists will perform injections to help decrease inflammation, others will use what’s called platelet rich plasma to promote healing. These options are just fixing the symptoms – they don’t necessarily get to the why of the problem.
By improving one’s postural awareness, upper back strength, joint capsule mobility and muscular endurance, this will in turn lead to improved mechanics for the shoulder. These mechanical improvement results in decreased inflammation and better shoulder positioning for daily activities. 3 key aspects to decrease one’s likelihood of developing this abnormal wear and tear in the shoulder joint are: 1. Stretch structures in front of the shoulder. 2. Strengthen upper back. and 3. Develop postural awareness.
By stretching the muscles that makeup the front of the shoulder, one allows the muscles to loosen up in order to achieve proper positioning for movement. This is done by a pectoralis stretch. One standard way to stretch these muscles is to use a doorway stretch. Position the arm up on the wall with the elbow at 90 degrees and the shoulder at 90 degrees. Step forward with the opposite leg. If there is no pain or tingling into the hand/arm, hold this position for 1 min and repeat twice. This is a simple way to loosen up the front of the shoulder.
To strengthen the upper back, there are a variety of exercises targeted at this muscle group. One of the best and simplest exercises for this muscle group is performed while laying down! What could be better than working out while laying down? Start by taking a rolled up towel or washcloth and place it on your forehead while laying on your stomach. Let arms rest by your side with palms facing the ground. Next, lift the arms up off the ground by squeezing the muscles in the back together. Hold this position for 5-10 sec depending upon the difficulty. This is a great exercise to help develop endurance and strength in these postural muscles.
The third major player when it comes to shoulder pain and injuries is postural awareness. Being aware of one’s posture as you go about your daily life is critical because very often posture breaks down and over time this breakdown leads to poor movement patterns. During the day, one exercise to assist with postural awareness is to sit up nice and tall. Think about squeezing a pencil between the shoulder blades. Hold for a few moments and relax. By repeating this tasks, the body starts to relearn where those postural muscles are and how to engage them during daily tasks.
For those of you looking for a little more info on preventing shoulder pain then check out our Free Shoulder Pain Video Course here. By checking out the course and following the steps above you will be far ahead of most people when it comes to preventing and even improving your shoulder movement and pain.
If are looking for a little more info on preventing shoulder injuries in the future or have any questions regarding your current shoulder pain, please do not hesitate to give us a call at 610-295-9256 and get started on the path to pain free shoulder movements.
That’s all for now! Feel free to post any questions in the comments section below and if you sign up for a course you will be able to get to stay on top of all things Robbins Rehab!
