Unfortunately, as you get older shoulder pain may be something you have to deal with. Often you will have no recollection of doing anything to bring it on.
For some of us it’s bad posture over the years, for others it’s the way you work which maybe involves reaching your arms forward to lift or turn something multiple times a day.
Bottom line, when you get pain it’s a real pain that can affect your sleep, your mood and your daily life.
So what can you do to avoid shoulder problems and help treat it?
Here’s a Summary of the key points of this blog:
This may seem odd but start by correcting your posture and strengthening your core muscles: bridging and leg raises are a good start.
This strengthens the power house that generates force before you push or pull something with your arms or legs.
If your core muscles are weak then you put too much strain on your upper arm muscles when trying to generate power to move something.
Stretch and massage tight or ‘pulled’ muscles: Pec stretch; Friction massage ( Use a lacrosse ball or tennis ball) between your spine and edge of the shoulder blade; massage the muscles above your shoulder blade and side of the neck where they hurt.
Strengthen the muscles that hold the shoulder back and downwards. This will prevent your shoulder blades from moving forwards and causing ‘impingement’ ) nipping of the muscles between bones).
My favourites are: shoulder pinches; low row using an exercise band; push-up plus against a wall; and Y’ and T’s lying on your abdomen (video coming soon)
Strengthen the rotator cuff muscles: these are small muscles so you only need a 1kg weight to start or a light theraband. Start by placing a rolled towel between your arm and chest then bend your elbow and do internal and external rotational exercises.
Why do we get shoulder pain?
Poor posture is often quoted as the main cause of shoulder pain.
But it can be down to many things:
An injury to the shoulder
Weak muscles or ligaments
Osteoarthritis forming a bone spur, osteoarthritis in the big shoulder joint, osteoarthritis at either end of the clavicle bone
Inflammatory arthritis like rheumatoid
It could be a repetitive action you do every day that puts strain on your shoulder muscles and joint.
The shape of the acromium ( the front upper part of the shoulder blade)
Referred pain from a nerve in the neck or sometimes from the liver or below the diaphragm.
You might have a rare muscle or bone tumour.
How do you reduce the risk of shoulder pain and treat it yourself?
For every injury or weak muscle group in the body, your physiotherapist, sports doctor, or physical trainer will usually advise that you work on strengthening your core muscles as well as the 'injury' zone in question.
The shoulder is no different. The core muscles in your abdomen, pelvis and lower back generate a lot power to help you move your upper arms and shoulders.
If they are weak to begin, then you will place more strain on the shoulder and upper arms when doing repetitive movements such as throwing a ball, cleaning windows, lifting weights or swimming.
Here’s a link to core strengthening exercises for adults.
This blog article focuses on exercises to ensure better positioning of your shoulder blades which ensures better movements of the arm when lifting it above your head.
These same exercises can also help decrease pain from 'impingement', osteoarthritis and tendonitis in the rotator cuff.
It takes time to re-educate the body to change posture even slightly but his can be sufficient to improve pain.
A lot of shoulder problems come from the shoulder blade (scapula) gliding forward and upwards from the back towards the front of the chest.
As a result the the muscle in the middle and lower back that usually hold it backwards and down, become weak.
The muscles that pull it up and forward, then become overworked and tight (short).
The muscles that hold the shoulder blade back:
Middle and lower trapezius
Rhomboids and,
Serratus Anterior
The muscles that lift it up and forward
Pectoralis minor ( At the front of the chest)
Levator Scapularis ( at the back of the neck)
Treatment for shoulder pain and impingement
Stretch the muscles that pull the scapula up and forward ( stretch pec minor and levator scapularis)
Strengthen the muscles that should hold the scapula down and back- serratus anterior and lower and middle trapezius by doing Low Row exercises and push-up plus.
Strengthen the rotator cuff muscles using the internal and external rotation exercises. This helps pull the top of the upper arm down and out of the shoulder socket so it doesn’t cause nipping or impingement.
Often on an X-ray you can see the top of the upper arm bone (the head of the humerous) high up in the shoulder joint. This is because the rotator cuff muscles are weak.
Weakness of the rotator cuff can be caused be poor posture causing over use of the upper neck muscles to move the arm (upper trapezius) instead of using the rotator cuff.
What happens is the upper neck muscles become overused and sore and then the rotator cuff becomes weak. Then eventually the upper arm bone moves higher into the shoulder joint.
The muscles which are tight respond well to regular stretching and also massage either using a lacrosse ball or yoga massage ball, or massage with your hands.
Remember that your shoulder pain may require regular work using massage, posture adjustment and strengthening of the muscles.
See what works for you. Once your shoulder is feeling better, you may be fine just watching your posture or you might find you need to do regular muscles massage and strengthening to keep it at bay. This normal.
Look out for my shoulder exercise video coming soon!