Tuesday, October 5, 2010

A Deeper Look Into Shoulder Pain

If you haven't experienced shoulder pain before first hand, I am sure that you have heard someone talk about it. Depending on the severity of injury, it can take from 1 to 6 months to heal. Physicians often refer to it as a rotator cuff injury, tendonitis, bursitis, or even impingement syndrome. But what does that really mean?

The rotator cuff is actually comprised of four different muscles (supraspinatus, teres minor, infraspinatus, and subscapularis). Each has a different role in providing the shoulder joint with stability. These muscles along with others (traps, serratus anterior, levator scapula, and the deltoids) act as force couples on the shoulder blade (scapula) to move it away from the spine (or abduct) as we raise our arms. In order for the joint to function properly, these muscles should be balanced to maintain a smooth motion as we raise our arm out to the side or overhead. Having muscular imbalances involving any of the rotator cuff muscles may lead to an inability to move the scapula outward and can ultimately cause abnormal wear on the joint. As a result, pain often will occur on top of the shoulder.

So where do you start if you have been diagnosed with a shoulder injury? Whether you are working with a physical therapist or a MAT specialist, they should be able to identify what muscles are not working properly by doing a range of motion evaluation and muscle testing. According to what muscles are found weak, you can begin with corrective exercises. One other thing to keep in mind is that even though you have pain in your shoulder, it could be related to another area of the body. The trunk, spine, hips, and knees can also affect shoulder joint motion because all of the joints in your body are interrelated.
Here are some common exercises for shoulder injury prevention and rehabilitation. Any of these exercises can be done with bands or cables:

1) Scapular Retraction - This is actively squeezing the shoulder blades in toward the spine with arms in front of you, to the side or overhead. This can be done standing or even seated at your desk. A progression to this exercise would be a row (as shown below).

2) Arm External Rotation - Starting without a band, keeping your elbow at 90 degrees in close to the side of your body, rotate hand and lower arm out to side while squeezing shoulder blade in towards the spine. This exercise can be done at multiple angles and with bands as you get stronger.

3) Front Raises - Arms are straightened hanging down to sides then raised up to shoulder height.

4) Lateral Raises - This exercise is often the last one to be added in rehab because usually there is pain associated with movement out to the side. Arms are slightly bent and raised out to the side to shoulder height.

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