The shoulder joint is one of the most complex structures in the human body. The shoulder joint is the most freely movable joint we have, and with that freedom comes the highest risk of injury. Our shoulders are involved in almost every daily activity, from getting dressed to making food, as well as during intense bouts of exercise. With so much happening, the shoulder is exposed to various positions it does not always like to be in, and these motions can expose weaknesses and abnormalities in our anatomy.
Some individuals who have sharp pain when lifting overhead, or who play in sports with a lot of rotation on the shoulder such as tennis or baseball, are diagnosed with impingement syndrome. Impingement syndrome is caused primarily when the supraspinatus of the rotator cuff muscles is being imposed on by the skeletal structure of the acromion, and over time the subacromial bursa becomes inflamed, which could lead to tendonitis. Impingement syndrome can potentially be resolved by first reducing the inflammation and allowing time for the structures to heal, then by proceeding to strengthening the surrounding muscles that allow the shoulder joint to move more freely.
One common issue is a disruption between the working relationship between the scapula, known as the shoulder blade, and the shoulder joint itself. This working relationship is referred to as the scapulohumeral rythem, and when disrupted it is referred to as scapular dyskinesia. This disruption of a natural biorhythm creates the opportunities for injuries and poor movement patterns, so a major focus for anyone with impingement issues is to focus on scapular retraction, allowing the shoulder to then move more freely.
Scapular dyskinesia can impede most activities in the shoulder girdle, creating extra strain along the rotator cuff, possibly leading to tendinitis, loss of mobility and loss of strength. Focusing on strengthening muscles that act on the scapula is of vital importance before working on the shoulder joint itself. Strengthening the trapezius muscle as well as the seratus anterior muscle will help the scapula stay retracted when working overhead, and help to reduce impingement.
Firstly, try to squeeze your shoulder blades together, for 10-15 repetitions, 3 sets, and holding each contraction for 2-3 seconds. Focus on exercises such as a seated row with scapular pinch, shoulder shrugs, and supermans to build endurance in the muscles of the lattissimus dorsi, the rhomboids, and trapezius.
Secondly, upon noticeable change in scapular position, use exercises such as the internal and external shoulder rotation with arm at the side, still focusing on scapular retraction during the movement and working with a pain free range of motion. Use very light weights first, 12-15 repetitions, 2-3 sets.
Lastly, a great exercise to start working on more functional movements is external and internal rotation with shoulder abduction. Having our arm 90 degrees will provide a more realistic scenario for our shoulder joint, allowing it to now work under slightly more stress. Perform 12-15 repetitions of each type of movement, 2-3 sets per arm. Once again, ensure to focus on scapular retraction and stabilization through each exercise, working within a pain free range of motion.
Shoulders are complicated joints so it is best to consult your physician, physiotherapist, chiropractor, and trainer if you are experiencing persistent shoulder mobility issues. Always work towards being pain free!
Need more advice on shoulder impingement and mobility. Inquire to one of our certified personal trainers or kinesiologists at Your House Clinic for an assessment to get started on your fitness program.