Managing Shoulder Posture & Pain

Functional Health find ourselves managing Shoulder Posture & Pain quite regularly. Sit up straight: The first thing you can start doing right now for your shoulder pain.

Shoulder Pain

Shoulder pain is one of the most common complaints that our Physiotherapists and Exercises Physiologists will see. It is so prevalent that often it is not even the main reason for the visit but comes up when asked about any additional issues because the individual has learned to put up with the pain.

When we think about the reasons for shoulder pain, we have to consider its attachments to other structures in the body. The arm is attached to the scapula (or ‘shoulder blade’), which is then attached to the collar bone and rests on the rib cage.

The shoulder joint is purpose built for movement, but the trade-off here is that it is also a very unstable joint. The way that the shoulder is attached to the scapula is very similar to how a golf ball sits upon a tee, which makes it very prone to falling off and causing injury. Fortunately, we have a complex series of muscles and ligaments that help to keep the shoulder located within the socket of the shoulder blade.

The main muscles that help to stabilise the shoulder are collectively known as the rotator cuff muscles, which all arise from the scapula and insert onto the arm to help keep the shoulder joint strong and prevent injury. When these muscles become damaged or don’t function well, this can often be the cause of shoulder injuries or pain. However it is not as simple as strengthening the rotator cuff to improve shoulder function, because based on the anatomical relationships, the function of the rotator cuff muscles is dependent on the posture and movement of the shoulder blade.

In the age of everyday computer use, poor posture is unfortunately a common side effect. As you read this, you might notice that you are sitting with your shoulders rounded and chin sitting forward (even as I wrote this sentence I needed to sit up straight and correct my own posture!).

This position often leads to the muscles of our upper shoulders and neck becoming particularly tight (often leading to headaches if the tightness is severe enough) and the muscles that move the shoulder blade becoming weaker and not working optimally. The issue here is that when we get this combination of tightness and weakness, it changes the way that the shoulder blade moves on the rib cage when we go to move our arms. In particular we rely very heavily on the movement of the scapula when we lift our arms to the side as if we are drawing a big circle.

As anyone with shoulder pain will know, this simple task often elicits pain very quickly. If the shoulder blade fails to move as we begin to elevate our arms, it can cause compression of the tendons of one of the muscles of the rotator cuff (the supraspinatus muscle). As this happens over the course of weeks and months, damage to the tendon can occur leading to one of the most common causes of shoulder pain.

Correct Shoulder Posture

It should be clear by now that there is a very important relationship between the arm and the scapula and how this can impact shoulder pain. So, what can you start doing about this now, or how can you take steps to prevent this from happening? Well the first thing that we teach any of our clients is that it all starts with correct posture.

Proper posture allows the muscles of the shoulder blade and rotator cuff to work more effectively and can prevent the negative spiral of muscle tightness and weakness from leading to injury. This can be as simple as sitting up straight whenever you are sitting at work.

Another way to think about it is to relax your shoulders, then roll them up, back (not so far that your shoulders are completely pulled together and that you can’t move your arms comfortably) and down, as if you are trying to fit your shoulder blades into your back pockets.

Doing this regularly when sitting at the computer, driving, walking or even before doing household jobs that require some sort of arm movement can go a long way to improving your shoulder function and preventing injury.

If you have shoulder pain or are looking to improve your shoulder strength and function, consider giving us a call at Functional Health to see one of our experts in shoulder rehabilitation.