Hi everyone, the shoulder is complicated. It is capable of a huge range of movement made possible through an intricate system of ligaments, tendons, muscles, nerves and joints. If just one link in the movement chain becomes problematic, the effect is felt throughout the shoulder complex causing damage and pain, particularly in the rotator cuff which gives the shoulder its stability and control.
Poor posture, poor upper body strength, and ageing are all factors that can compromise the rotator cuff tendons and increase the risk of injury.
Poor posture causes the scapula (shoulder blade) to sag. Rounded shoulders and forward head posture (or poked neck) are typical examples of posture that leads to the scapula ‘sagging’ or what some term as a ‘dumped shoulder blade’. Hours spent in poor postural positions (such as long hours at the computer or driving) lead to the elongation and weakening of the muscles around the shoulder.
Poor upper body strength reduces our ability to hold the scapula in a steady position and as we get older (over 40!) our tendons become less elastic and less able to adapt to the changes of everyday life. All this leads to rotator cuff problems.
The pain can present in a number of ways. It may be that you reach for something in the back seat of the car and you feel a sudden twang of pain. Or you go to put on a heavy winter coat with the same sharp pain. For others it can be a gradual build of an aching pain in the shoulder that appears for no apparent reason. Either way, it is often the rotator cuff (in particular the supraspinatus) that has become damaged – usually a tear in the muscle. Sometimes the tendon is frayed and damaged.
Secondary effects of poor biomechanics of the shoulder with rotator cuff damage include shoulder impingement. A frayed and injured tendon can lead to inflammation of the subacromial bursa because the bursa and tendon become trapped as you lift your arm above shoulder height. This results in yet more pain!
Rotator cuff tendon and shoulder impingement problems are notoriously difficult to treat, and slow to settle. You need to be persistent with treatment in particular strengthening the shoulder.
Treatment should be focused on firstly avoiding the movements that aggravate the shoulder pain, addressing the postural issues that have contributed to the problem and strengthening the muscles that support the shoulder and the scapula. Physios are a great starting point to help with this.
There are several things however, you can do to keep your shoulder tendons healthy, and decrease the likelihood of a rotator cuff injury:
- Keep fit – good general fitness makes the tendon tissues healthy and resilient
- Keep good shoulder range – take your shoulders through their full range of movement every day. Lift them right up over your head, behind your back, out to the sides
- Change your environment to encourage good posture at your computer. Ensure you have a supportive chair, the computer mouse close to your body and computer monitor at eye level.
- Keep good movement in your thoracic spine (mid back), particularly if you sit a lot. Arching, lying over a rolled-up towel is a great way to help with this.
- Try this exercise:
- Sit or stand tall
- Gently squeeze shoulder blades together. Do not arch your back
- Hold for 3 seconds
- Perform 10 repetitions
Hope this has given you a little more insight to shoulder problems.
Have a great week, Deb