Who hasn’t dealt with shoulder pain at some point? Shoulder pain can be quite frustrating. Especially if it’s in your dominant arm. Daily activities become quite limited when you are dealing with shoulder pain.
Shoulder pain has infinite causes of pain. It is a very dynamic and mobile joint. What the shoulder gains in versatility it loses in inherent stability. Biomechanically a lot has to happen to keep the shoulder happy and ordinarily, this goes off without a hitch.
Unfortunately, minor disturbances in the system can throw a wrench in the system. Small things like incoordination of stabilizing muscles can be problematic. We get so focused on the rotator cuff that we forget about what gives stability to the rotator cuff muscles; proper coordination of scapular (shoulder blade) stabilizers.
One of the common shoulder pain problems is lack of recruitment/poor stabilizing strategies of muscles when our arms are overhead. As you are reading this, think about lifting something above your head. Putting your carry-on in the overhead bin for example. What should your shoulders be doing as you are pushing that bag above your head? Should they move down towards your waist or should they elevate toward your raised arm? Often, the thought is if the arm is lifting overhead, the shoulder should be elevated as well. Counterintuitively, it is the opposite. The shoulder blade should set down on the rib cage giving it proper stability.
The problem with the elevation of the shoulder/shoulder blade when lifting the arm is it over utilizes a muscle called the levator scapula. When this happens the scapula ends up rotating in the opposite direction of the arm leading to shoulder pain.
Think of watching someone do jumping jacks. If you are looking at their back, their right arm will be rotating in a counterclockwise manner. By over-utilizing the levator scapula, the shoulder blade will end up rotating in a clockwise direction. This is not ideal. The shoulder blade should rotate in the same direction, allowing more room for the humerus (upper arm bone) to continue moving. When this doesn’t happen it jams the joint and destabilizes it.
Preferably, a muscle on the underside of the shoulder blade, the serratus anterior, shares the dominant role. It does this by sucking down the shoulder blade and rotating it in the same direction the humerus is moving. So, as you are lifting your arm above your head, you should be pulling your shoulder blade down towards your waist.
A good exercise for this is a reverse bear walk with feet on furniture sliders. Pushing yourself backward will target the serratus anterior while relaxing the upper trap and levator scapula muscles.
In conclusion, this is just one of many examples of shoulder pain issues. If you are having trouble with your shoulders or know someone who is, be sure to schedule an appointment with us and get that taken care of!