Tom Jensen, PT/ATC, On the Shoulder Joint

 

With so many of the activities that we do from day to day and also physical activity, the shoulder joint plays an integral part on how we perform these different activities. From swimming to softball to even basic reaching into the cupboard, getting dressed, etc., the shoulder has a lot of stress put on it throughout the day.

The shoulder joint itself gets a lot of attention. It is a ball and socket joint that allows significant amounts of movement but gives up stability for mobility. There are four little muscles that surround the shoulder called the rotator cuff, which helps support and maintain the integrity of the shoulder in its socket. Rotator cuff issues are well publicized and I daresay everyone has heard of the rotator cuff muscles. However, an area that has been extremely ignored by many for long periods of time is the shoulder blade. The shoulder blade is actually the socket part of the ball and socket of the shoulder that sits on the back chest wall. When the shoulder joint itself moves, it also has to keep a nice steady even fluid motion in the shoulder joint. We are seeing more and more, especially younger to mid-aged athletes, who are having chronic shoulder problems where the shoulder blade is too tight.

A test to do is to lie on your belly with your arms relaxed next to your side, then you should be able to grab onto your shoulder blade and go two to three knuckles deep under the shoulder blade. You should also be able to have someone pick you up by your shoulder blade and that is the kind of mobility that you are looking for. If you do not have this kind of mobility, the shoulder blade gets compressed on the chest wall and can limit efficient function of the shoulder and can also cause a significant amount of upper back and posterior shoulder pain and discomfort with any kind of movement. If you have someone do this and you see that there is significant limitation with that motion, the treatment is very easy. Several times a day lie down on a bed or floor, relax your arm, and try to have someone you trust place their hand or fingers underneath your shoulder blade and lift up as well as move up and down and side to side, trying to loosen up the shoulder joint. Thereafter, you would want to do some strengthening exercises, rowing types of exercises, lateral pull downs, or anything where you are using the shoulder blade to pull back and get your shoulder blade working more efficiently.

This will play a significant role in improving mechanics of your shoulder and decreasing any amount of pain that you might be having.

A quick and easy thing that you can do throughout the day which might prevent your pain is to sporadically pinch your shoulder blades together, trying to touch the inside borders together and then do a lot of shoulder shrugs. This pinching along with shoulder shrugs will get the shoulder blade moving, but again if you started having some diffuse posterior shoulder discomfort and you really cannot relate it to anything the first thing I would do is get it checked out to make sure there is not a rotator cuff or labral types of issues.

Even if you have not been having any problems, check your shoulder mobility to make sure that you ward off any problems and do these mobility exercises. This will go a long way in preventing future shoulder or shoulder related types of issues.

Thomas Jensen, P.T.