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Body in Motion / Injury and Rehab  / Are you abusing your shoulder?

Are you abusing your shoulder?

Shoulder injuries and discomfort are quite prevalent across genders, age groups and sections of the population. These are, by no means, restricted to athletes or crash victims. Most of us have experienced niggles in varying degrees around the shoulder area and been at a loss to attribute a specific reason.

While injuries that result from impact or sudden jerk and broken bones are hellishly painful, knowing the cause makes it that much helpful to deal with them. The challenge lies with the other end of the spectrum when you sense something is amiss but can’t pinpoint what exactly and are left grappling with general discomfort which manifests even without apparent triggers.

Most people are unaware of the unique design of the shoulder and its capabilities. It is a joint with the greatest range of motion in the human body. It has a complex anatomy that allows maximum multi dimensional movement around it, but this ability also renders it most unstable! This is because to allow so much movement the joints need to be ‘free’, in a manner of speaking. Which in turn makes the shoulder joint most susceptible to stresses and strains, overuse injuries and aging (degenerative changes).

To drive home the anatomical complexity very simply and for the broad purpose of highlighting the need for treating it with the respect and caution it deserves, it would serve one well to learn that the shoulder joint is linked to the arm, chest wall, back, the shoulder blades (scapula) and the shoulder complex itself (bones, tendons, ligaments, nerves etc.). So there is plenty going on there and a lot of scope for things to go wrong due to imbalances and triggers anywhere in this interconnected web. Most day to day movements involving the arm and shoulders, especially weighted ones, are done thoughtlessly without postural awareness, proper engagement of the shoulder and of (surrounding) supporting muscles. What is commonly observed is a careless use of the shoulder joint as a pivot/fulcrum to lift, throw, reach, pull and rotate. More often than not these movements are performed using sheer momentum than thoughtful alignment.

While there is such an expression as “gym junkies shoulder”, to be honest most people are junkies when it comes to using the shoulder. The ‘slide-and glide’ aspect of movement is often ignored blocking engagement of supporting muscles. Poor proprioception of drawing the scapula (shoulder blades) in and out/down and up, not being able to differentiate between locked and natural elbow position for arm extensions and lifting, no supportive engagement of the thoracic area (trunk) to facilitate functional and/or training movements, pushing against painful range of motion, careless engagement of the shoulder and arms in supporting body weight etc., causes undue pressure to be exerted on the glenohumeral (shoulder) joint and gives rise to impingement in varying degrees.

So what’s the big deal with this lack of awareness? A lot actually. Apart from wearing and tearing the joint down, it can have long lasting uncomfortable side effects on daily life and enjoyment. It starts hampering with rest and sleep leading to overall fatigue and irritability. Difficulty driving, playing, lifting day to day things, carrying one’s baggage, reaching for overhead kitchen cabinets, typing, writing, inability in rotating the arm to reach the back, arm ache, neck aches, headaches… get thinking of what all lies in this Pandora’s box!

Given fascial connections that run across the whole body connecting the top to the bottom of the body – head to foot (covered in an earlier article), the negative effects can show up in seemingly unconnected areas. For example, runners with shoulder impingements might find their runs getting messed up – not being able to swing both arms smoothly can cause compensations in gait and landing, making the run unpleasant and harder, not to mention dealing with a stressed out, painful upper.

What can you do? Correct posture and learn to engage muscles for daily and athletic activities correctly. As with other body parts work on strengthening and stretching shoulder and surrounding body part muscles. Focussing on one without the other is self defeating. Take stock of your activities (athletic and otherwise) and sports (recreational or professional). Could you be building up cumulative shoulder stress across activities? Alter the pattern/schedule to reduce overuse. I see a lot of people getting carried away, posting their daily work out challenges that seem to lack foresight and forethought and there is every indication they are headed down the road of overuse abuse. You may not be doing active or heavily loaded shoulder raises or overhead snatches daily but if the other chosen activities and movements cause constant shoulder loading (even in supporting body weight) it is adding to the cumulative stress. It’s unfair on the joint.You leave it no choice but to cave. And the shoulder gets used in a lot more movements and positions than most imagine, given its extensive range of motion.

An intelligent variation of movements and exercising patterns could get similar (if not better results). I am wary of and alarmed by the latest breed of challenges and workout styles that seem to be assuming viral proportions (fed of course by social media that is breeding pathological degrees of narcissism) – where one needs to perform the same movements/drills day after day over extended periods of time. Also, unduly high number of repetitions in workouts seem to be gainingground.It makes no sense. And not needed. What is being proved?! You may be a warrior for now, but by putting the body repeatedly through such stress you are setting yourself up for deep burnout. Health should not be frenzy or fad driven. Performing workouts always to the point of fatigue, exhaustion and near muscular collapse is against the very basic foundation of safe and scientific exercising. Not to mention, good old (and now near extinct) common sense. Remember, the same body has to serve you as you grow old too. Don’t force it to degenerate and age way before it’s time by putting joints and muscles through senseless grind. You won’t be able to undo the changes.

A little understanding of the body’s structure along with a dollop of sense (Please!) could save a lot of unpleasantness and pain. So use that head resting on the shoulders. Your shoulders will thank you for it, and so will the rest of your body.

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