Shoulders: Problems & Solutions

Shoulders are beautiful, complex things. With 360° of movement and capable of pushing or pulling our entire body-weight in almost any direction, the potential of the shoulder is huge. They’re also a common talking point in my Physiotherapy clinic so I thought I’d pay them a little attention today.

“Do I need to pay more attention to MY shoulders?”

Let’s find out! Have a read through the checkpoints below to see if you’ve any flags waving…

Posture

This alone can speak volumes. Do you stoop? Are your shoulders rounded? Does your job involve you spending a lot of time sitting with your arms and shoulders in a fairly fixed position?

What are your shoulders currently capable of?

• Can you reach your seat-belt with the arm closest to it?
• Can you get your hand to the middle of your back?
• With your arms overhead, can you get them anywhere close to your ears?
• Can you comfortably do 10 wall push-ups with your feet 60cm (2ft) from the wall?

Do you have pain in the shoulder area or avoid doing certain movements?

Pain, or just niggles or aches speak for themselves. If your shoulders are bothering you significantly and the discomfort hasn’t cleared up of its own accord in a few weeks then it’s probably worth getting checked out. And if you know that you avoid using your shoulders in some way e.g. reaching high cupboards, pulling/pushing/lifting things, then it’s likely that you’ve an underlying issue that it may be best not to ignore.

Unsettling image of skeleton shoulders

“What is the Shoulder anyway?”

The shoulder is a cluster of 3 bones, 2 joints, several muscles and lots of ligaments. It’s a little like the hip joint but with a shallower socket and is better designed for movement than weight-bearing. It forms the foundation of much of what we ask of our arm and hand, allowing us to do anything from lift immense weight overhead – 264kg (582 lb) being the world record (a little like lifting my 10-year old son and eight of his mates overhead) – to performing the most delicate of surgical or artistic procedures.

“What can go wrong at the shoulder?”

Strain & Inflammation

Far and away the most common problem that I see relates to some sort of soft tissue strain and accompanying inflammation involving muscles/tendons/ligaments. The modern-day, technical term for this is ‘tendinitis’ (you may have heard of ‘rotator cuff’ and ‘impingement’, another couple of phrases relating to a soft-tissue strain).

Stiffness

Shoulder stiffness is another not unusual feature. The shoulder has an “ideal” range of movement but in actual fact everyone’s naturally available range is different. ‘Frozen shoulder’ is the most commonly heard and is arguably the most debilitating stiff shoulder condition but shoulders can become stiff for other reasons too and pain can be the result.

Is it the Shoulder?

Issues in the upper back and neck can spitefully refer themselves into your shoulder. The nerves that feed the shoulder, arm and hand all originate in your neck and it can be these that are responsible for pain felt in the shoulder.

Trauma

A good old traumatic event can pretty obviously cause shoulder problems. I often see a spike in these in the winter months when boringly treacherous pavements and paths lead to nasty falls onto outstretched hands. Tumbles off bicycles are another easy way to injure your shoulder. Anything from fractures to tears and strains of the muscles, tendons, ligaments and nerves can result.

Arthritis

Shoulders are not as susceptible to the wear and tear that knees and hips are, unless you’ve had a job or played a sport that places significant strain on the shoulder e.g. tradesmen, cricketers, farmers, tennis players. Arthritic shoulders are possibly not as painful as load-bearing arthritic knees and hips so people tend to bother less about them, but that’s not to say that they’re not a problem worth dealing with.

A less normal shoulder…

“What can I do to help my shoulders?”

Posture

Straighten up, roll your shoulders in circles a few times, gently squeeze your shoulder blades towards each other, draw your bellybutton towards your spine and BE TALL. Do this as often as you can, particularly if you spend a lot of time sitting.

Everyday moves

Treat the ‘flags’ above as shoulder improvement movements. Can’t get your hand to the middle of your back? Then practice! Arms nowhere near your ears if you raise them overhead? Practice! Next time you come to reach for your seatbelt try using the hand of the arm nearest to it.

Little extras

Whether you’ve niggles or not, try the following little moves to help keep your shoulders in tip-top condition!

SQUEEZE

Raise your arms out to the sides and, keeping them at a steady height, gently squeeze your shoulder blades together and draw your arms backwards – imagine a helium balloon tied to the top of your head drifting you gently upwards at the same time. Hold for a bit then relax. Repeat but with your arms slightly higher as shown. Repeat!

ROTATE

Stand as shown and keeping elbows tucked into your sides, take your hands out and away from each other. Does one hand move further than the other? Hold for a bit (remember helium balloon as above) then relax and repeat.

PUSH

I’m a huge fan of getting stronger (let’s face it, most of us need it) so here’s a move that ticks that box! Start with feet about 2ft from the wall and with fingertips at shoulder height and thinking of your body as a plank, bend at shoulders, elbows and wrists to lower yourself in towards the wall, just as far as is manageable then push back to start position. Aim for 10 and if this is easy, move your feet further from the wall… Still easy? Graduate to the floor 🙂

Shoulders often respond well to being used and challenged a little so if you suspect that yours may be slightly under par then give a few of the above moves a go, keeping the movements within comfort levels. Good old heat and anti-inflammatories may help and if you need any further advice then don’t hesitate to drop me a line!

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