Shoulder Woes

A little counter-intuitively, the largest demographic for shoulder reconstructions is young men (Science Daily, 2010). As a group, we’re both highly active and still growing, meaning our joints are mobile. This makes for a bad combination when in comes to structures as fundamentally unstable as shoulders. Bear in mind, everything that follows is equally true of young, active women. Whether it’s an irritation after a workout that you decide you’re just going to tough out, or a full-blown dislocation five minutes into a game of basketball, pain should never be ignored and injuries are almost always avoidable.

Before I offer any advice, please note that this is not a professional article on shoulder rehabilitation. If you have an issue with your shoulder, go and see a physio. However, for anyone interested in general shoulder health, here’s a few simple pointers.

There are only two things you absolutely need to know about shoulder anatomy in order to take care of them; they break easily, and they’re complicated. Shoulders achieve mobility at the expense of stability. Compared to your knees or elbows for example, shoulders have an enormous envelope for movement, horizontally, vertically, and rotationally. Second, shoulders are really really complicated. There are four (that’s right, four) joints articulating every time you move your arm (glenohumeral, acromioclavicular, sternoclavicular and scapulothoracic). This means there are a lot of variables to think about if you ever get injured. Here’s how you can avoid it:

First, it’s all about your shoulder blades (scapulas). If your scapula is in a bad position, your shoulder is in a bad position, period. There are 17 different muscles that attach to your scapula, making it both difficult and very important that its stable before you perform any given movement. Think about squeezing your shoulder blades together and pushing your entire shoulder girdle down as often as possible. It doesn’t matter whether you’re cycling, doing push ups, or going rock climbing; that’s where your scapulas should be.

Second, you can’t get your shoulder back and down if you slouch. The more rounded your upper back, the tighter your neck will become, pulling your scapula up and forward. If you sit down less and stretch/rollout/do yoga regularly, your shoulders will thank you.

Third, anyone who has ever been to the physio for anything related to their shoulder has probably been told to do rotator cuff exercises. The rotator cuff is a collection of four muscles originating from your scapula that attach to the head of the humerus (upper arm bone). They are responsible for rotation, but more importantly, they hold the humeral head in a secure, central position in the joint socket whenever you move your arm. If your rotator cuff is weak and you add force, it won’t take much for the humeral head to slide out of place. This could mean a click or a niggle at best, and a full-blown dislocation at worst.  If that sounds familiar, Youtube “rotator cuff exercises” and give them a go.

So before you jump on the climbing wall, decide to take up full contact rugby, try a barbell turkish get-up, or go for a slam-dunk-just-because-its-awesome, ask yourself ‘are my shoulders actually ready to do this?’.

Save yourself the trauma. Physio is expensive, rehab is boring, and surgery is hell. Take care of your shoulders.