Shoulder Pain
When talking about shoulder pain we first need to know where exactly the pain is coming from, we then need to assess if the pain is coming from past injury or simply from improper posture. If the pain is from a past injury the only thing that can be provided is ways to relieve the pain caused from the injury and added strengthening exercises. If the pain is stemming from improper posture we would then need to correct the posture by adding in exercises to lengthen the muscles that have been shortened. Since most Americans spend most of their day in a seated position staring into a computer screen, whether it be a desk job or for entertainment purposes this has a great deal of impact on the clients posture creating an increased thoracic spinal curve. This increased thoracic curve lengthens muscles located on the back that could be creating the pain the client is experiencing. The first goal is to give the client corrective exercises that would put the thoracic spine into extension over time leading to an improved posture.
The rotator cuff is a collective group of four muscles: supraspinatus, infraspinatus, teres minor and the subscapularis. These muscles attach the scapula to the humerus. Rotator cuff injuries result when more emphasis is put on training the anterior muscles and little emphasis on the posterior leading to weakened posterior muscles with added strain.
Both of these scenarios can be corrected by balancing the training of the posterior muscles.
Corrective exercises for these imbalances:
For posture:
- Thoracic Extension on Roller
This is to improve extension in the thoracic spine.
Positon yourself on the floor with the knees flexed to 90 degrees and your body perpendicular to the roller behind you. Lie back so that the roller crosses your upper back, just below the shoulder blades, clasp your hands gently behind your head, pull your elbows together, and tuck your chin.
From the starting position, extend your upper back, hinging over the foam roller. Keep the stomach tight throughout, and make sure to extend at the upper back versus your lower back
- Quadruped extension-rotation
This will improve extension and rotation in the thoracic spine.
Start in a quadruped with the hands underneath the shoulders and knees underneath the hips. Place one hand behind your head.
Gently move the elbow of the “top” elbow down and back towards the opposite knee. Reverse the motion, coming past the starting point to promote extension and rotation. Driving the eyes upwards will help as well.
Be sure to stabilize the lumbar spine and move from the thoracic spine.
- Side-lying cross-body stretch
This stretch will improve the length of the posterior rotator cuff muscles and improve shoulder internal rotation mobility.
Set-up by lying on your side on a stable surface, tucking your shoulder blade down so that the chest puffs out. If possible, make sure your head is supported by a foam roller (or similar object)
With the elbows flexed to 90 degrees and the arm elevated to 90 degrees and resting on the floor, pull the elbow and upper arm across the body slightly.
Make sure the scapula is stabilized throughout. Don’t allow your shoulder to round during this movement. Keep the chest out.