Smoldering Shoulders No More!
Erin Clougherty, DPT
Do you sometimes find yourself rubbing your sore shoulder? It might happen while sitting at your desk, reaching for a your favorite coffee mug, cooking, gardening, throwing a ball, or countless other scenarios. This article will cover the stabilization of the shoulder joint and 3 exercises you can do to keep it healthy.
Your shoulders are complex and delicate structures. In my practice, they are likely the most challenging to rehabilitate after spine injuries. The shoulder is also vitally important to our everyday life's activities. Shoulder injuries are often more stressful and frustrating than, say, a knee or ankle injury.
Consider this, a shoulder injury makes it difficult to do daily self care tasks like brush hair, showering, and putting on a shirt. The solutions can mean involving another person to help. Whereas compensating for a knee injury is often achieved with a mild limp, crutches or a wheelchair and not necessarily requiring another person's hands on assistance.
Shoulder injuries affect our quality of life and independence on a daily basis.
No matter the injury, shoulder stabilization exercises are a crucial part of prevention and rehabilitation. If you have summer activities, chores, or a hobby that historically causes a sore shoulder, preventative strengthening can break the cycle of irritation, inflammation, and frustration from your shoulder.
So where do we start? Posture is key. Keep your spine tall and shoulder blades back, like you have a 1st place medal around your neck to show off. To make a change to posture habits, start with work-out or other personal time you have. This is time you have to focus on yourself, so it is reasonable to expect success and improve posture habits during this time. Trying to change your posture otherwise, at work for example, is less productive as there are too many other things demanding your attention.
Next we look to the support system of muscles around the shoulder blades. *****There are seventeen muscles that attach to the shoulder blade. To keep the shoulder happy, they must work together in concert for everything from reaching behind you to tuck in a shirt to throwing a baseball. Most shoulder injuries are overuse or repetitive strain injuries. Many are from obvious causes related to intense physical activities, but often there are shoulder problems caused by more silent stressors related to repetitive activity in the presence of a malfunction of the shoulder stabilization system. Our bodies aim to be efficient by default. With this they will try to get things done with minimal energy spent. If the shoulders are not challenged in a way that requires they use all these muscles in balance, some of these muscles will "go on vacation" and become weak over time if the pattern continues. *****
Here I describe a few basic shoulder stabilization exercises to help resolve any shoulder weaknesses hiding in the shadows to the more obvious or chronic problems. These three are great for their convenience and relative simplicity. As always, use caution if you have any injuries, including others besides those in the shoulders, and see your healthcare provider if you have any concerns before diving right into anything new or if any pain occurs.
Best to do these lying face down over a physioball positioned under the ribcage. You may also use an ottoman, bed, or just pillows on the floor. There are three main positions to know. The motion, however, once in the chosen position, will be exactly the same for all three.
Position 1: (all are face down) arms at sides with thumbs to floor.
Position 2: arms like a capital "T" with thumbs toward ceiling (you may need to start with palms facing floor and thumbs to crown of head - choose this if thumbs to ceiling seems particularly uncomfortable.)
Position 3: arms in "Y" like position like singing the "YMCA" song.
Motion: Start with hands resting on floor with elbows straight in one of the aforementioned positions. Focus your attention on your shoulder blades' position and motion. Avoid letting your arms rise higher than your shoulder blades (even if you are starting from flat on the floor). Bring your shoulder blades together as close as you can while drawing them toward your back pockets. Your arms hover off the floor serving as the resistance for the muscles between the shoulder blades. It is crucial to make sure you get as much motion from the shoulder blades and minimize the height of your hands relative to the shoulder blades. It is very easy, especially in a shoulder with history or pain/injury, to let the shoulder blades lag and instead "flap wings" at the shoulder sockets.
I found this great video on Youtube to demonstrate how the shoulder blade motion works. All you do then, is add a hover of the arms in one of the 3 positions to add more resistance.
You will find multiple variations to these if you do a search on your own. As long as you follow the principles, the other position recommendations you may find online are more icing on your cake.
Erin Clougherty, DPT