SHOULDER PAIN AND POSTURE…Therapeutic Insights to LOOK BETTER & FEEL BETTER
One of the most common upper body musculoskeletal complaints we see in our massage and acupuncture clinic is hands down: one sided shoulder problems.
Clients with shoulder and neck tension are very common at ViVi Therapy. People regularly seek massage therapy and acupuncture for one sided shoulder dysfunction. This post will highlight some detail and solutions to help you understand and learn more about your shoulder and what you can do to make some significant changes right from home.
Let’s get started. But before we dive in I want to thank Marissa Hoen RMT Kineseology student at University of Victoria and Movement aficionado for her amazing pics and illustrations below. You can book online with Marissa in June 2020. We should be back to work then!
As well I direct you to our ViVi Therapy Massage and Acupuncture Facebook page to view the strengthening tutorial from Harland Derkson RMT described below. He can be booked online in June as well and I thank him for creating these educational videos that are easy to follow and invaluable for your progress.
An excellent collaboration brought to you by members of our ViVi Team.
The common problem of shoulder dysfunction often relates to how we use our shoulders every day. YOUR SHOULDER GIRDLE is attached to the trunk of your body at one single joint, the sternoclavicular joint.
This joint is located where the collar bone (clavicle) meets the breast bone (sternum) on either side (right and left). The shoulder girdle and its relationship to your rib cage is a feat of engineering specifically for optimal movement of your arms, hands and head.
The upper body is designed for freedom of movement to facilitate dexterity, agility and fine motor coordination, think calligraphy to golf and tennis, all require eye hand coordination and your mental attention.
Unlike the pelvic girdle (lower body) with its large and powerful musculature supported by the dense pelvic bone structure the shoulder girdle relies more heavily on good posture and balanced muscle action to stay functional and pain free.
We find the dilemma of shoulder related problems appearing more than ever because our culture has become reliant on seated or upper body focused work and activities for hours at a time.
Let’s consider your shoulder issue. Do you ever wonder if your shoulder problem led to other issues on the same side of your body? For example neck tension or even arm, elbow and hand aches and pains.
Did the shoulder problem start but never fully resolve and now there are other issues? Do you have postural challenges at work from too many hours in front of a computer or screen? Do you really know how to get to a good posture that doesn’t require a special “ergonomic set up”.
Maybe your problem was a slow adaptation to poor functional movements from being overly stressed or tense, leaning to one side while standing or sitting and habitually elevating your shoulder for no reason at all?
Maybe you were injured at home or at work? Do you do a lot of lifting, pulling or pushing in a hurry? Trying to maintain productivity, but moving too fast to be able to think about how you are using your body. If you pull, push or repetitively work with your hands and arms, there is no question that you need optimal shoulder blade (scapulae) and shoulder girdle mechanics.
I have observed that almost every assessment I have done relating to the shoulder have a common theme. Upper body issues like carpal tunnel syndrome, thoracic outlet syndrome, rotator cuff issues, frozen shoulder, tendinitis of the elbow (golfer/tennis)and pain or numbness from nerve compression all share this theme.
The shoulder in question I find consistently has lost some natural movement usually in the downward direction and has a tendency to over elevate. When this happens some muscles are habitually contracted all the time and others are left with very little use creating what is called a muscular imbalance. Fixing the issue however, is not just about getting a massage or acupuncture or strengthening the weaker less utilized muscles.
“So what is UP with this shoulder?” I find anatomy and movement habits reveal a lot when we look at healing outcomes for individuals with shoulder pain.
THE ISSUE IS LOSS OF SHOULDER BLADE (SCAPULAR) DEPRESSION:
Your shoulder blade is the flat bone positioned at the back of your shoulder. It floats on your rib cage gliding up, down, toward and away from your spine according to how your nervous system dictates and which muscles are recruited for action or stability. When you lose shoulder blade depression it means this bone no longer optimally moves downward when your arm is lifted for action (think of a lever and fulcrum) with or without a weight in your hand. You then lose skeletal power for lifting your arms up and over head. Plus poor posture is inevitable because the muscles that depress your shoulder blade are key to good posture and feeling upright.
Instead of the natural mechanism of the shoulder blade gliding toward your pelvis or downward while lifting your arm it actually does the opposite. As you lift your arm the shoulder blade elevates to avoid discomfort or just habitually from chronically engaged postural muscles. The muscles that are tight and over contract dragging your shoulder upward are: UPPER TRAPEZIUS and LEVATOR SCAPULAE. If this happens long enough these muscles become rock hard, hurt, nagging you affecting your sleep, productivity and focus.
The upper end of the levator scapulae inserts in the bones of your neck, if tight can make you feel like your neck is strained and being pulled to the side. Think holding an old fashioned phone between your ear and your shoulder only permanent! Is that you? Look in the mirror…I often ask my clients to check their photos/selfies. Your internal image of yourself may not match what you see?
Combined with other neck and shoulder muscles this over elevation can contribute to compression of the nerves that innervate your arm and hands. That is why you may experience numbness and tingling usually below your elbow or hand.
SO WHAT CAN YOU DO FOR YOURSELF?
- Gain some awareness about how you move your shoulders. You can do this easily by scanning your body for specific motion and resting states of shoulder girdle.
- Learn to pay attention to your shoulders and how they relate to other parts of your body when you are working or exercising.
- Become curious about your movement. To know how you are doing something while you are doing it is mindfulness. This level of body intelligence will carry you through life stronger and more efficiently no matter your age or ability, improvement is possible.
- I like to call this awareness to regain your movement “re braining” your movement. Neuroplasticity or neuro movement is a combination of using your brain to feel and sense yourself while you are moving in order to compare, adapt and improve movement.
STRENGTHENING WEAK MUSCLES:
You also want to improve the muscular imbalance between the overused and over contracted muscles and the under active ones. Improving the balance between the muscles that lift the shoulder and the muscles that lower the shoulder will give you an incredible feeling of power and posture.
Understand that an over contracted muscle does not mean strong. When the muscle is chronically shortened it too is weak. Weak muscles can be muscles that do not engage regularly in action and muscles that are shortened and therefore do not have a full excursion of motion from length at full rest to full contraction.
We have a specific exercise to help balance the action of your painful shoulder. To improve scapular depression you will need to focus on the LOWER AND MIDDLE FIBERS OF THE TRAPEIUS MUSCLE.
HARLAND DERKSON RMT at ViVi Therapy has made three short videos to support you in your efforts to obtain better posture and skeletal power. The shoulder depressors need attention there is no question. Follow the specific instructions on these videos and their progressions and you will be feeling and looking better in no time.
LIVE MOVEMENT LESSON ON ZOOM PLEASE JOIN US
I am offering a live lesson via zoom on Tuesday at 5 PM April 28, 2020. This lesson is one of my favorite Awareness Through Movement Lessons and it is a pain free gentle awareness focused lesson that includes some anatomy and helps you improve your scapulae glide in all directions. Please join the ViVi Therapy community for this inaugural ZOOM lesson launched out of the desire to help folks like you manage your shoulder related symptoms while folks like us stay at home to reduce the spread of Corona Virus. Don’t miss this! I have a bonus feature at the end I want to share and I am not sure yet about recording!!!
All levels of fitness are welcome and learning minds a necessity. Moshe Feldenkrais coined many inspirational sayings over his years as a teacher and developer of his method. One I especially love goes something like this “we are not after flexible bodies as much as flexible minds.” Lets get together and experience something new together cause I’m learning too.
Zoom meeting ID is https://us02web.zoom.us/j/84935824018?pwd=czlqNDBqMW9ZNUhoOHVVbm9nWkhLUT09
Call or email firstname.lastname@example.org for the password or if you have any trouble using Zoom. Invite a friend its free.