Man giving helping hand to friend to climb mountain rock cliff

Why is shoulder pain so common?

Are we just asking too much of our shoulders? It is the joint with the largest range of motion, does that just make it more susceptible to injury?  What is the key to stabilizing your shoulder? What do you need to adjust in your lifestyle to support more stability in your shoulders? I am going to address one major concept to help you regain your shoulder stability…Don’t Push Your Shoulder!

 

What do I mean by “push your shoulder”?

Well I am referring to exercises that involve a pushing motion with your arms/shoulders. For example, a push up, see push is in the name of the exercise so that is an easy one to identify. To be clear, a pushing exercise does not always have to be a motion, it could be a sustained “pushing” exercise called an isometric exercise. In an isometric exercise, there is no change in joint angle or muscle length. A perfect example is planking. In case you are not familiar with this exercise it is performed with your elbows, forearms and toes on the floor while you make a straight flat “plank” with your body, from your ankles to your shoulders. This is an isometric pushing exercise because you are pushing into the floor with your arms and shoulders but there is no change of positioning.

Why do these pushing exercises create instability you ask?

When you push you activate the muscles on the front of your trunk, or your anterior muscles. These muscles pull the arm forward in the shoulder joint and usually also bring the scapula with them causing a rolled forward look. There needs to be a balance from front to back, or anterior to posterior, to give strength and stabilization to a body, let alone a shoulder.

 

How do I achieve shoulder stability?

I recommend to get your posterior muscles strong! Stop the planking, pushing, and pressing! Start pulling your shoulder, i.e. rhomboid rows or latissimus pull downs, to balance those anterior to posterior muscles. It may sound easier than it is, and you are right. It is a common occurrence with my patients who experience shoulder pain that when I tell them to squeeze their shoulder blades, aka scapulae, together and down they cannot do it without me physically guiding their scapulae together and down. Remember the saying, “Use it or lose it”? If a patient has been doing more anterior muscle exercises, then the brain becomes less connected and aware of the back muscles. So when I ask my patient to use those back muscles it is challenging for their brain, to “remember” where those muscles are and how to use them correctly. Another common issue with someone starting scapular stabilization exercises is they do not use their scapulae. They think they are doing a rowing exercise, which is initiated with your scapulae moving down and together, but they only move their shoulder joint and bring their shoulders to their ears. This keeps the scapula forward, thus engaging anterior muscles to stabilize which just makes the shoulder more unstable and can lead to more damage and pain. To correctly do an exercise you must focus on the movement and do it correctly otherwise you do not reap the benefit from your efforts.

 

So let the thoughtful and intentional pulling begin! Avoid pushing exercises till you have restored balance to your front and back muscles and then still incorporate more pulling than pushing to maintain that balance. If you have been “pushing your shoulder” then call and schedule a free 20-minute consultation if you would like more information in person.

-Dr. Cindy Downing DC, DACNB

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