Shoulder complaints are running rampant these days. Why? Simple. Most of us are sitting at desks, working on computers, and have our heads down as we pray to the ‘smart phone’! This posture creates over-active (read: tight) upper trapezius and levator scapulae muscles, and, in turn, weak lower traps and serratus anterior muscles. Plus, if we’re the few that go to the gym we’re likely doing the wrong exercises. All exercise is good, except when it’s not! Shoulder problems are not simple. In fact, the shoulder is considered the most complex joint of the whole body. It is actually comprised of four joints working together:
1.Sterno-Clavicular Joint (collar bone meets the breast bone)
2.Acromio-Clavicular Joint (collar bone meets the shoulder blade)
3.Gleno-Humeral Joint (arm in socket)
4.Scapulo-Thoracic Joint (shoulder blade floating around rib cage)
Because the shoulder requires so much range of motion (ROM), all of these joints must work together to allow for said ROM, yet still provide stability. In short, this is accomplished through balanced coordination of musculature governing all of those joints. The number of muscles involved requires more than two hands to count, speaking nothing to the complexity of how they work together in a balanced fashion. Here’s a who’s who list of some of the key players of the shoulder joint balancing act:
1.Rhomboids
2.Lower Trapezius
3.Serratus Anterior
4.Rotator Cuff (Supraspinatus, Infraspinatus, Teres Minor, Subscapularis)
5.Levator Scapulae
6.Upper Trapezius
7.Pectoralis Minor
8.Biceps
9.Deltoids
Plus, the shoulder takes direction from the nerves of the cervical and thoracic spine. So, any neck and upper back problems will directly impact the shoulder. Sound complicated? You bet. Not only that, but overall posture (think poor sitting posture) not only causes poor low back and upper back posture, but the two areas of the body are directly related. You can’t have bad low back posture with good upper back posture, or vice versa. So, if you’ve got a bad low back, you’re destined to have a shoulder problem at some point down the road (if not at the same time)!
I’ve painted a bleak picture so far, I know. But, never fear, Dr. B is here! I’m completing an eight week advanced shoulder course (inspiring today’s article). What I’m learning is immediately applicable to so many people – those with and without shoulder problems. As always, the most important first step is an accurate diagnosis. Because the shoulder is complicated there are many possible diagnoses for your shoulder problem. Here’s a brief list:
1.Glenohumeral Capsule Instability
2.Labral Tears
3.Rotator Cuff Strains / Tears
4.Shoulder Impingement
While all of these diagnoses are different, it often boils down to correcting the muscle balancing act of the shoulder joints. Careful identification of the muscles that need to be strengthened will not only help rehabilitate the current shoulder problem, but also help improve the shoulder posture to prevent reoccurrence.
My usual tools help get the job done. Laser helps speed healing and reduce pain and inflammation. Instrument Assisted Soft Tissue Mobilization (IASTM) and my hands help massage and manipulate the needed muscles. Chiropractic for the spine addresses the spine’s role in the shoulder problem. And, as explained, first and foremost, an accurate diagnosis with appropriate (and safe) shoulder exercises to improve the “balancing act” that is our shoulder.