Many of us who participate in sports such as golf, tennis, swimming or volley ball have experienced some sort of shoulder pain. The shoulder is one of the most poorly designed joints in the body in terms of stability but one of the most brilliantly designed in terms of mobility. It’s technically a “ball and socket” joint but the socket leaves a lot to be desired… Think of a golf ball on a tee, where the golf ball is the top of your arm bone and the tee is where it attaches to the body. That means that the muscles surrounding the joint have a tremendous job to perform and are then subject to injury. We’ve all heard of rotator cuff tears. Anytime someone has shoulder pain it must be the rotator cuffs fault, right?? Unfortunately, often the rotator cuff muscles get abused for trying to do their job in a poor position. And who put them in that position? The shoulder blade did.
For proper shoulder mechanics to occur the shoulder blade has to move in all three dimensions. It has to elevate and depress, rotate forward and backward, upward and downward and retract and protract. Many of us have muscle imbalances around the shoulder blade that in turn put the rotator cuff muscles at a disadvantage. Most commonly our shoulder blades are rotated forward and down (think of how your shoulders look when you slouch). What typically happens is that when we try to lift our arms over our heads the shoulder blade can’t or doesn’t rotate backward and upward properly because of these muscle imbalances or because our spine doesn’t extend properly. When our shoulder blade doesn’t rotate properly the space for the rotator cuff muscles (the supraspinatus in particular) gets compressed and impinged. Eventually this can lead to long term pain, tendon degeneration and rotator cuff tears. It can also lead to labrum injuries that may require more invasive treatments. I often see people in the gym doing their rotator cuff exercises which single out each muscle of the rotator cuff in its action which is good as long as it’s accompanied by proper shoulder blade stability exercises, and that doesn’t mean only seated rows. In addition, exercises that call on all the rotator cuff muscles to work at the same time should be incorporated since that resembles the action of our hobbies and sports more appropriately.
If you are having shoulder pain you be evaluated by a qualified physician or therapist to help determine the cause of the pain as shoulder pain can also result from neck problems. I am always available for questions or consultation either through my email, website, or by phone at 307-699-3170.
In Good Health,
Jeremiah Handschin, D.C.
