These Exercises Can Help
Are you having trouble with a nagging shoulder pain when you lift your arm over your head? Does it bother you sleeping at night or get in the way of your ideal workout routine? If your wondering whether you should rest it or push through the pain, this article will direct you on what to do.
The most common source of shoulder pain is the impingement of either the rotator cuff or bicep tendons (the two tendon rest right on top of each other). Getting to the source of this impingement or “pinching” of the tendons can let the wounded tendons heal and return the shoulder to proper mechanics and prevent future injury.
First things first. Stay away from overhead activities or exercises that aggravate the pain. You can gradually work up to them after you address the core issue. For now just retire that old adage, “no pain no gain”. It does not apply here.
Impingement of the tendons in the shoulder can be caused by 1 of 3 things. We will review each of these. Typically one of the causes is the main cause, but all 3 can play a roll in the impingement syndrome. So understanding the role each of the causes play can be very helpful.
1. Tight pectoral muscles and/or poor posture.
When the pectorals are tight and our shoulders are rounded forward (think Arnold Schwarzenegger). Stretching this muscle is key to open up the space where the rotator cuff tendons reside. Those little guys need room to breathe and they don’t appreciate being crammed into a tight space. Stretch and massage are a both a good treatment.
2. Weak rotator cuff. Think of the rotator cuff as the “core” of the shoulder.
Their job is to hold the ball of the humerus (arm bone) in the the socket of the shoulder joint. When they aren’t working the shoulder moves all around pinching your tendons up against the bony prominence above. As with many things in life, we have to get back to the basics and train these muscles to do their job again before moving into other exercises. A word of caution – I have worked with many top level athletes pitchers, hockey player and weight lifters with this issue. Muscle bulk and definition doesn’t always translate into a functional rotator cuff. No offense but these simple exercises can benefit even the most brawny shouldered athlete.
3. A weak or uncoordinated scapula.
Say what? The muscles that surround the shoulder blade also known as the scapula can weaken and cause impingement of the shoulder. When they aren’t working correctly, the shoulder blade can stick out in the back, a condition known as a “winging scapula”. To test your shoulder blade back up against a wall and see if your shoulder blade protrudes more on one side than the other. Nine times out of ten working these key muscles will result in reduced pain in the front of your shoulder.
Addressing the shoulder’s mechanics can really make a difference. It will take pressure off of the hurting tendons and allow them to heal. It also gets to the “root” of the problem and is far more effective in the long run than taking medication or injections that mask the pain.
If you have radiating pain into the lower arm that persists more than a few weeks see a Physical Therapist. Often a quick hands on assessment and right intervention they can get you back to the activities you love to do and even stronger and better than before!
So let’s review what we’ve learned.
Top 3 causes of shoulder pain: 1. Tight pectoralis and Poor Posture (Sit up Straight – just like your momma said). 2. Avoid Overhead activity and Strengthen your Rotator Cuff. 3. Strengthen the muscles surrounding your shoulder blade. Check out these exercises for the how to on all of the above and you’ll be well on your way to a healthy shoulder again.
- Door way stretch: While standing in a doorway, place your arms up on the door frame and lean in until a stretch is felt along the front of your chest and/or shoulders. Your upper arms should be placed upward along the door frame.NOTE: Your legs should control how much you stretch by bending or straightening your knee through the doorway.
- Concentric Eccentric Rotator Cuff: Lie on your side with your elbow resting on your side and bent to 90 degrees.-Rotate hand up and point thumb behind you (keeping your elbow on your side) Lift arm up with a fist towards the ceiling.Turn thumb down (like you are pouring out a can) and slowly lower your straight arm down towards the table.
- T’s Prone: Lying on stomach, lift arms and shoulders making the shape of a “T”. Keep chin slightly tucked and squeeze shoulder blades together.
- W’s With Ball:Over exercise ball, lift arms and shoulders into the shape of a “Y”. Keep chin slightly tucked and squeeze shoulder blades together.
- Push ups Plus: Get down on all fours and place your hands on the floor so that they’re slightly wider than and in line with your shoulders.Your body should form a straight line form your ankles to your head. Brace your abdominals–as if you were about to be punched in the gut–and hold them that way for the duration of this exercise. Without bending the elbows, press your thorax away from the the floor. This is not a traditional push-up. Elbows stay straight and all movement is happening between the shoulder blades (scapula) and the rib cage. This strengthens the scapula stabilizers and keeps the shoulder blade in a better position – one that removes pressure from the biceps tendon.
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Yours in Health and Bliss,
