When it comes to keeping your body healthy and pain-free, there are a few target areas that I feel should get a little more attention than others. The lower back, which I discussed last week, has to be number one on the list. Shoulders are a close second.
The shoulder is a fairly complicated and unstable joint. It doesn’t have a lot of security provided by the bony structures, so it relies on soft tissues like the small rotator cuff muscles to help keep it safe and strong. I would estimate that 80-90% of my training clients over the years have presented with some degree of shoulder problems. Sometimes this is from an acute injury, but most often it’s a problem that has developed slowly and nagged them for a long time.
Throughout my own sport and exercise career I’ve probably had more issues with my shoulders than any other body-part. A lot of this involved injuries caused by soccer, football or heavy weight training, but I’ve also had a lot of chronic pain from tendonitis, impingement and so on. The thing that I’ve learned from dealing with my clients, and my own issues, is that the majority of chronic shoulder problems don’t usually originate at the shoulder joint.
To effectively prevent, manage and improve shoulder problems, it’s important to understand how the shoulder joint works, and how the function of the rest of your body is contributing to any problems you might have. With this understanding you can proceed in the right direction toward building strong, healthy shoulders.
Always remember to perform a progressive warm-up before training or sports, and get medical approval before beginning a new fitness program, especially if you have a history of lower back pain or injury.
Knowledge – As mentioned earlier, it helps to be knowledgeable about your existing condition, and the rest of your body, when you’re trying to improve your shoulders. Having a thorough assessment by someone with a good working knowledge of shoulder mechanics and overall body function can be invaluable. Because of the shape and mechanics of the structures in the shoulder, avoiding certain positions or movements could be important for you, but not for someone else who has shoulder pain for an entirely different reason.
In a lot of cases shoulder pain can result from compromised spacing inside the shoulder joint. This space, which is usually around 10mm in a healthy joint, can be reduced significantly by poor posture, muscle imbalance or faulty movement patterns. This can cause pinching of tissues like the rotator cuff tendons, producing inflammation, tearing and even rupture.
A simple test of flexibility and joint range of motion can usually reveal this condition. If you learn that one or both of your shoulders is in this state, there are a number of simple maintenance exercises to improve it.
Prevention – Once I learned what was causing the issues with my own shoulders I was able to train and play hard without problems. This has helped me to implement successful prevention and rehabilitation programs with many of my clients. Maintaining good posture is a huge factor in avoiding shoulder issues. By keeping your spine, ribcage and shoulder blades in the right position, your arms are fee to move without putting stress on your shoulder joints. Good flexibility throughout the body is also essential for shoulder function. Anytime your muscles restrict your movement, your joints usually suffer. Keep the muscles that surround and attach to your shoulder blades loose and balanced to ensure fluid motion at your joints. This can be done with stretching, massage or rolling out your muscles.
Another major factor in shoulder maintenance is the movement strategy that you use when pushing or pulling. At all times, focus on generating force from the center of your body. This should come from the middle of your chest when pushing, and between your shoulder blades when pulling. Doing this will engage the larger muscles and take strain off your shoulder joints.
Treatment – If you do have shoulder problems, whether acute or chronic, try to get an assessment and treatment by a qualified practitioner that you trust. I know from experience that Active Release Technique, known as A.R.Ttm is a remarkably effective treatment for long-term shoulder problems. If you start to feel pain in your shoulder joints during or after activity, be sure to rest the area immediately and do what you can to reduce inflammation to the injured tissues. I offered suggestions for this last week, including icing the area right after the injury occurs to reduce the level of pain and inflammation, trying homeopathic remedies or nonsteroidal anti-inflammatory drugs and/or pain-killers for comfort. Unfortunately too many people ignore shoulder issues when they’re small, which is how they become more serious.