It is time for the final piece in our injury management series- over the last two weeks we looked into lower back pain and knee pain. Now however it’s time to look at the shoulder.
By this stage you should be starting to notice a trend- a lot of the time the cause for pain is often in a different location to the pain itself. Bad back? Those tight hips could be the cause. Knee’s are aching? Let’s build some strength in the glutes.
The same rings true in terms of the shoulder. Poor posture and shoulder pain or disfunction commonly go hand in hand.
Surprise, surprise it is our office jobs that strike again. It just goes to show that after three from three being related to sitting at a desk that perhaps the human body wasn’t deisgned to do so, for as long as we do- however that is a debate for another day.
There is a LOT happening at the shoulder- in addition to an incredible range of movement (at least there is meant to be) there are many muscles crossing the shoulder joint as well as ligaments and tendons holding the structure together.
With so much going on the health of the joint rides quite heavily on good posture- meaning the head of your humerous (funny bone) should sit nicely in the joint comprised of the scapula (shoulder blade) and the collar bone.
Once this movement is impaired and often it is only by a small margin, some of the smaller muscles, tendons, ligaments can become pinched, leading to inflammation, then to pain and if untreated to rather significant problems.
Again, like all other areas there are exceptions to the rule, but it is very common that the aches and pains can be alleviated by first and foremost working on posture- utilising exercises that don’t further inflame the angry joint.
Your personal trainer, no matter how experienced or even how accurate they may be in doing so, unless they are a qualified physiotherapist have no business diagnosing an injury. First things first and you should get someone who is qualified to have a look and make sure you’re good to go. Then your well intentioned trainer can work with the physio to ensure healthy progress around the injury.
Given that impingement is perhaps the most common cause for shoulder pain- lets take a look at some of the methods we would use at Hybrid Performance to assist with improving shoulder range.
Yet again the first priority is building mobility and stability to the joint. The shoulder should be mobile and able to move freely but given it’s extreme ranges of movement it is very important that it is stable enough to do so.
Its quite typical for the 21st century human to be incredibly tight through musculature of the chest (pec minor and major) through our heavily seated lifestyle. Add to that the typical males enthusiasm for a bigger chest, arms and abs paired with the common inability to properly recruit muscles through the back- it becomes little wonder that rounded shoulders are as common as they are.
Exercises such as shoulder dislocates to improve overall shoulder function and eventually build strength through the full ranges of movement of the shoulder are fantastic- pairing these up a combination of long static stretches (think arm against the wall opening the chest up) and pec minor release work and you’re on your way.
Loosening off unbelievably tight lattisimus dorsi (think the muscle under your armpits- your wings) will also alleviate a stack of tightness around the shoulder.
A bonus suggestion is working on thoracic mobility. The thoracic spine basically being the large chunk in the centre of your spine where your ribs attach. In work, life and even the gym our thoracic spine is kept in a neutral, set, or rounded position with little movement. As we have spoken of many times in this blog is the important message that a strong spine is both mobile and stable.
Perhaps the greatest point that we often give to our team about improving posture in addition to mobility work is general awareness. Of course it’s a little douchey- but if your posture stinks, each time you walk past a reflective surface just take note of your general posture. Straighten yourself up and tuck the shoulders back- the same should be considered when sitting for long periods of time at the desk too.
The less time you spend slumped and rounded, with an increased time spent in good posture is a very, very good thing.
As has been the trend in this injury series, as important as it is to release the tight muscles it is equally important that we strengthen the muscles that are weak.
Although there are many contributors to stability at the shoulder- one of, if not the most important muscle group would be the mid and lower traps. A muscle group often well and truly underdone while we slump over a computer desk and then when we do get into the gym incorrectly used when trying to strengthen it.
The secret to building strength through middle and lower traps is simple- it is much less about the exercise and more about execution.
You can do all the rows and chin ups in the world but if you aren’t getting a proper contraction through middle back, chances are you are rolling the shoulders over forwards which switches the target area off completely and further tightens muscles through the chest.
It should be the same with all exercises in regard to general safety and minimising the risk of injury but technique really is king.
One of the first “pulling” movements (I know- laugh it up) that we teach new members is hanging and importantly scapula retraction preferably while hanging. This promotes proper scapula movement (remember scapula’s are half of the shoulder joint) which further allows proper middle back recruitment.
In the world of lifting weights progress is often measured with numbers- success indicated through increases in load lifted. When it comes to the middle back I cannot stress the importance of prioritising activation and contraction well before concerning yourself with moving heavy weights.
The time for maximal weights will come- I promise you that, provided you focus on the basics first.
There are many other muscle groups that will require your attention, many are the usual suspects such as the core to help hold you a little more upright, serratus anterior that helps pull the shoulder into a desirable position, rhomboids (these should be getting worked with middle traps) and the posterior, or rear deltoid muscles.
All are important but the number one priority should be on the middle back first and foremost.
We hope that this helps you out- if your shoulder is in a world of pain it would be wise to get a professional to look at it first before kicking into a training program. Once you’ve got the all clear start working on the mobility and stability in your shoulder and enjoy the benefits of stronger, more mobile and healthier shoulders no matter your age.
The Hybrid Team