Shoulder Pain

The shoulder joint allows a lot of movement, however, this movement comes at the expense of stability and security, and is often the cause of many dislocation and instability conditions. The shoulder joint is a “ball and socket” joint, and is supported by a network of ligaments and muscles. More specifically, the shoulder joint is supported and controlled by four muscles known as the rotator cuff: supraspinatus, infraspinatus, teres minor and subscapularis. Shoulder pain occurs when these small, but very important stabilisers are easily overloaded and injured due to poor exercise design and technique.

Here at The Physicaltherapy Centre all our treatment of shoulder pain are individualised to the patient.

What should I do if I’m experiencing shoulder pain?

Many of the following injury reduction techniques focus on reducing the load on these small joint stabilisers.

Tip 1 – Limit overhead exercises: the safest overhead press is the “Arnold Press”. This exercise allows a greater range of motion
whilst keeping the hands closer to the centre of the body. It also reduces shearing forces around the shoulder joint.

Tip 2 – Avoid the dislocation position: imagine yourself lying face up on a bench with your arms at 90 to your body, elbows bent 90,and palms facing the ceiling. Keeping your arms in this position, if you were then to rotate your arms such that your hands would approach the floor and allowed to continue, you would eventually dislocate your shoulder joints. Avoid, shoulder pressing behind the neck, be careful when using 90/90 pec-deck machines, and avoid wide grip lat pulldowns behind the neck.

Tip 3 – Avoid small muscle overload: your rotator cuff muscles are small muscles. Exercising your chest on day 1, shoulders day 2, then back on day 3, will be exercising your rotator cuff on all three days. In this instance, you’re more likely to fatigue your rotator cuff and predispose yourself to injury. Either group pressing movements into a single workout session, or rest your body by training other non-related muscle groups on consecutive days.

Tip 4 – Increase thoracic spine mobility: the thoracic spine (or upper back) plays an integral role in loading and unloading the shoulder joint. Spending long hours at a desk inevitably results in a more “hunched-over” posture. This is accompanied by stiffness and tension felt along the length of your back. You may well be in need of physical therapy to relieve yourself of this increasing tightness, and at the very least, a series of back extension exercises to offset poor posture at work. A duo ball or peanut roller can be used at home to relieve thoracic tension.

Tip 5 – Avoid the impingement position: impingement occurs when you raise your arm above shoulder height whilst keeping yourarm internally rotated.

Mimicking this position repetitively, causes a continual “pinching” or “jamming” of structures between your arm bone and shoulder blade occurs, felt as pain at the tip of your shoulder. Avoid exercises such as lateral raises with thumbs down, close grip high upright rows and some versions of bench pressing where the bar is in a high position, almost under the chin.

The shoulder joint is a joint that can be easily overloaded and damaged in poorly constructed health programs. It is essential that a health professional understands intimately, the anatomy, physiology and common risk areas and exercises for treating shoulder pain/injuries.

An effective modality for treating shoulder injuries is active release technique. Combined with chiropractic care, these two applications of physical therapy can improve both range of motion and muscular health at the shoulder joint.

*DISCLAIMER: This discussion does not provide medical advice. The information, including but not limited to, text, graphics, images and other material contained in this discussion are for informational purposes only. The purpose of this discussion is to promote broad consumer understanding and knowledge of various health topics. It is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified health care provider with any questions you may have regarding a medical condition or treatment and before undertaking a new health care regimen, and never disregard professional medical advice or delay in seeking it because of something you have read in this blog.