Shoulder injury or pain is one of the most common complaints I hear from my patients. Whether caused by direct trauma, overuse, or poor posture, shoulder pain is a very frustrating ailment to deal with. This is because any movement involving your hands or elbows is initiated by the shoulder. In this blog we will discuss the anatomy of the shoulder, why shoulder ailments are so common, and some strategies to prevent and address these issues.
Anatomy is Fun
So let’s talk some basic anatomy. While often referred to as the shoulder joint, the shoulder is more of a complex as it is a complicated structure made up by not one, but four different joints that all must work in synergy in order to achieve pain free motion. It only has one true connection to the rest of the skeleton via the sternoclavicular joint, which attaches to the sternum via the collar bone. The other joints making up the shoulder complex are the glenohumeral joint (what most think of when describing the shoulder), the acromialclavicular joint (which is the bony prominence on the top of the shoulder), and the scapulothoracic joint (made up of the scapula sitting over the thoracic rib cage). These three joints are not directly connected to the rest of the skeleton, but instead are held in place by ligaments and muscles. This allows for a very large range of motion in our arms and shoulders, permitting us to reach high above our heads or far behind our backs. The shoulder in fact has the widest range of motion of any joint in the body! However, this wide range of motion also means the joint is far more unstable than any other in the body, increasing the risk of injury.
Now a little bit about the muscles. There are seventeen muscles that attach to the shoulder to pull, stabilize and push the shoulder in various directions. The larger muscles are designed to take on the majority of large movements, while the smaller muscles primarily act as stabilizers. In a perfect world, these muscles would work together to help us achieve optimal performance in our daily tasks. However, as we are all shown time and time again, things rarely operate as they should.
Why Does My Shoulder Hurt?
If you fall or get hit in the shoulder, then the cause is pretty apparent. But most patients I see who are experiencing shoulder pain have no idea what caused it. This is because the problem is not usually a single event, but rather builds over time as a result of everyday living. Modern life, with all of its sitting, typing, and texting, encourages us to slouch our upper back and round our shoulders forward. Our body eventually learns this position and remains in it even when not sitting or playing with our many tech toys. Unfortunately, this rounded posture is not ideal for many of the motions we want to perform with our arms. The muscles and fascia adapt to this new posture, leading to a dysfunctional movement pattern that eventually causes imbalance and pain.
For example, try to raise your arm above your head while you are slouching with your shoulders rounded forward. See how high you can raise your arm without swaying your back. Do not push your arm past it’s natural stopping point! How high could you raise it? Next, stand up straight with your eyes forward, chest up, and shoulders slightly back. Raise your arm again. Notice a difference? You should be able to now raise your arm straight above your head without any pain, popping, or clicking or motion from the rest of your body. Unfortunately, most of us tend to perform this and similar motions with improper mechanics, causing nerve, blood vessel, and muscular compression. In case you haven’t guessed yet, this is the perfect recipe for disaster.
Alleviating and Preventing Shoulder Pain
There are a number of injuries that can occur at the shoulder, ranging from minor to severe. Below are some suggestions for addressing and preventing shoulder pain and injury. However, if you are experiencing chronic pain or extreme pain, it is important to seek out professional care as soon as possible to ensure proper diagnosis and treatment.
Stretching can help reduce pain and prevent further injury. It is important to incorporate stretches into your daily routine as well as prior to and after strenuous exercise. It is important to warm up before stretching by doing at least five minutes of light movement. When stretching, move slowly into the stretch until you meet a slight resistance and stop there. If you feel any burning or shearing pain, you are stretching too far and need to back off a little bit. Hold each stretch for one to two minutes. As your muscles relax, you may find that you can naturally move deeper into the stretch, but never push past your personal edge. Below are a few great stretches to open up and relax the shoulders.
If stretching alone is not working, then you may need to couple it with foam rolling. When performed correctly, foam rolling can be a great tool to loosen muscle tissue. When foam rolling it is important to roll over tender areas slowly. Once a tender spot has been identified, stay on that spot for 30 seconds to one minute. As with stretching, it is important to warm up the body with light movement before foam rolling. Here are a couple ways to foam roll the shoulder complex.
If you are experiencing shoulder pain that continues after a few weeks of self-care or gets worse, make an appointment with your doctor. Chiropractic care combined with Active Release Technique (A.R.T.) is an excellent treatment for many shoulder issues. Seeking treatment sooner than later can help decrease the risk of severe shoulder conditions.
If you have any questions about injuries to the shoulder or any other part of your body, feel free to reach out to me at firstname.lastname@example.org.