My Shoulder!
Shoulder pain is something that is all too common in today’s society no matter if you’re an athlete in a sport like baseball or lacrosse, or you work in an office 5 days a week. Today, we will take a look at what causes most shoulder pain, some common diagnosis for the same problem, and what can be done to correct it.
What’s Happening?
I find that most shoulder pain (there are obviously exceptions) is varying degrees of the same issue. Shoulders are internally rotated due to posture or overuse of the same muscle complexes and other muscles become weakened and lengthened as a result. That’s it. However this can cause a myriad of pain patterns. Pain deep in the shoulder, a shoulder to “freeze” and lock up, nerve pain down the arm and sometimes into the wrist and hand are just some of the common symptoms. Going to a doctor can bring about a diagnosis of arthritis, frozen shoulder, bursitis, tendonitis, or a problem with a rotator cuff muscle.
Internally Rotated Shoulder? What Is That?
Internally rotated shoulders refer to a misalignment or positioning of the shoulder joint where the shoulders rotate inward towards the chest. This alignment issue can lead to a host of problems, including muscle imbalances, restricted range of motion, and increased risk of injury. Some common factors contributing to internally rotated shoulders include:
- Muscle Imbalances: Tightness in the chest muscles (pectoralis major and minor) and latissimus dorsi, coupled with weakness in the muscles responsible for external rotation (teres minor, infraspinatus), can pull the shoulders forward and inward, causing internal rotation. Also, weakened muscles that are supposed to stabilize the scapula (mid and lower trapezius, rhomboids) throw fuel to the fire by creating an unstable joint to boot.
- Poor Posture: Prolonged periods of sitting, slouching, or improper lifting techniques can contribute to the development of internally rotated shoulders. Over time, these postural habits can exacerbate muscle imbalances and alignment issues.
- Repetitive Movements: Engaging in activities that involve repetitive forward-reaching motions, such as typing, driving, or weightlifting, can further exacerbate internal rotation by overloading certain muscle groups while neglecting others.
The joint or muscles attached to it can become swollen and inflamed from the poor positioning, causing inflammation in nerves, tendons, muscles, etc.
Fix It!
Stretching and manual therapy (massage, dry needling, etc) on shortened and tight muscles is a great place to start. Pec major and minor, latissimus dorsi, subscapularis, teres major, and anterior delt are major muscles to target.
We also want to strengthen the weakened and lengthened muscles. Horizontal rowing (trx, cable, chest supported, 3 pt), postural carries (farmer, overhead, rack), and corrective exercises like the band pull apart, external rotations (dumbbell or banded), and your “ITY” lifts will help strengthen and target major muscles in question such as the lower and mid traps, rhomboids, infraspinatus, teres minor, and posterior delt. We also want to do some unilateral lifts and movements for scapular stability like upside down kettlebell presses and holds, stability ball drills, etc.
Fixing posture and being aware of what is causing the issue is a definite priority. Practicing proper posture and ergonomics during daily activities can prevent further exacerbation of shoulder issues. Maintaining a neutral spine, retracting the shoulder blades, and avoiding prolonged periods of slouching or hunching can promote optimal shoulder alignment.
What Did We Just Learn?
Internally rotated shoulders and impingement issues stemming from tight internal humeral rotators and weak external rotators and scapular stabilizers seem to cause the most instances of shoulder pain. By addressing muscle imbalances, improving posture, and implementing targeted exercises and stretches, individuals can alleviate discomfort, restore mobility, and promote long-term shoulder health.