Last month's article introduced causes of shoulder
pain and focused on the structure and general function of the shoulder through ranges of
motion. As a ball and socket joint, it
high-lighted the importance of the ball staying well centred in its socket as
you move your arm, so as to avoid injury or irritation to the various soft
tissues around the shoulder. That being
said, it is possible to have "damage" to your rotator cuff without
any symptoms. Research using diagnostic
imaging (i.e. MRI/ultrasound) has shown that up to 40% of elite overhead
athletes have asymptomatic rotator cuff tears.
They are also found in the general population at an increasing frequency
with advancing age. Up to 1 in 5 people
aged 60 to 69 and 31% of those aged 70 to 79 have been shown to have symptom
free cuff tears. This clearly shows that
normal function can be preserved despite structural changes and offers
encouragement that satisfactory function can be restored after an injury even
when incomplete healing occurs.
So, this begs the question "What can be done to
preserve or optimize shoulder function?"
Maintaining good posture is a good place to start. This allows the shoulder blades, the
"sockets", to move as they should, stay out of the way, and keep
"the ball" well positioned. To
illustrate this, stand with an intentionally poor posture with your mid back
and shoulders hunched as much as possible.
Now try to raise your arms forward and up as high as you can and take note
of your range. Then, stand with good
posture - back erect and your shoulders pulled back slightly - and raise your
arms again. If done properly you should
notice that the range of your shoulder motion is greater with better
posture. The shoulder blades can tip
backward as needed and not be limited by the rib cage, thereby allowing your
arms to end up near your ears.
Therefore, if you need to reach high for things or are doing overhead
exercises, be sure to start with a good posture. A good overall posture also decreases strain
on the neck, which is often an overlooked source of pain that is perceived at
the shoulder.
Improving mid back mobility is also important. While lifting your arms as described above, your
mid back should extend slightly to assist the motion. However, this area of the back, the thoracic
spine, is commonly stiff due to the many hours we spend being sedentary with a
slouched body position and doesn't move as freely as needed. Fortunately there are a number of things you
can do to improve mobility here.
Starting simply, you could lie on the floor with a small, rolled-up
towel lying under and across your mid back.
As you relax and lay flat this will arch your back slightly, and you can
also adjust your body up or down to target different areas. To get more aggressive over time you can use
a foam roller to increase the arch even further.
Maintaining the health and flexibility of shoulder
soft tissues, rotator cuff muscle strength and stability, and other shoulder
blade motions are additional aspects of a well functioning shoulder. However, unlike the above considerations that
are almost universally applicable, what may be needed for each individual is
quite variable and is best assessed on a case by case basis by a skilled health
care professional.
This article is for general
information purposes only and is not to be taken as professional medical
advice.
No comments:
Post a Comment