Shoulder Pain

Possibly the most common patient I’m getting these days is the shoulder pain patient.  “It hurts every time I reach overhead......” or “ twist my arm back”.  I’ve been joking around with my Crossfit patients that I’m going to write the New England journal of Medicine and propose a new diagnosis called, “Crossfit shoulder”.  It’s that deep pain in the front of your shoulder that shows itself during overhead squats/kipping pullups, etc.  So today I decided to blog about the shoulder.

The shoulder is the most exposed joint in the body.  Why?  It has a better range of motion that any other joint.  Think about it, it moves in 5 different planes!  Really, I think the shoulder is amazing.  It really takes a very specific mechanism of injury to dislocate it, and it has an unbelievable range of motion.  During more cynical times, however, I’ve heard it described as a golf ball on top of a tee that is tilted about 45 degrees.  Because of that, it’s the soft tissues’ (muscles as opposed to bones) job to create stability.  So you need proper muscle function for a truly healthy shoulder.  

Here’s the problem.

Extended exercise, sleeping with your arm over your head, or just poor nutrition can cause decreased oxygen deliverance to the soft tissues of your shoulder, which leads to adhesion (fibrotic buildup) of certain muscles which will cause a shift in the ‘centration’ (the ability to stay centered) of the shoulder joint.  That’s why you feel pinching or tightness in your shoulder muscles around the joint.  

So what do we need to do?

You have a number of options.  Number one- if the shoulder is already in pain, you need intervention.  I recommend a manual therapist (chiropractor/message therapist/physical therapist) that does soft tissue techniques such as Active Release Technique (ART) or Graston technique to restore the elastic properties of the muscle to normalize the ‘centration’ of the shoulder.  

Shoulder Treatment

Number two -  Most people don’t realize the contribution of the thoracic spine (upper back) on shoulder motion.  During an overhead movement like overhead squat, the thoracic spine has a great deal of extension (or backward movement) that allows the shoulders to go back.  Without thoracic extension, all the stress of the overhead movement goes right on that shoulder.  The problem is that people don’t typically address thoracic extension so deficiency is extremely widespread.   There are plenty of manual therapies, correction exercises, stretches that one can learn to address thoracic extension deficiencies.  

Shoulder Exercises 

Upper Back Flexibility

Turkish Get-Ups

If you or someone you know has shoulder pain and would like to avoid surgery, please visit www.Mobility-4Life.com