As a physiotherapist I get to see a ton of patients that come in with shoulder problems. The number one profile I see with this; a late 30s, early 40s desk jockey who hits the gym and trains but is otherwise sedentary, overweight and living a happy suburban life. They come in, take of their jacket and immediately their shoulders are not level, not even close; one is always down and forward.
The typical story I get when taking their history goes along the lines of; “I was reaching up to the top shelf at work to get a package of computer paper, I turned to see who came into the room and ‘pop’ something happened to my shoulder. The next day I went to the ER cause it hurt like a ***** but the x-ray said no fracture. The doctor gave me muscle relaxants and told me to take a day or 2 off work. It’s been 2 weeks and it hasn’t gotten better.” I do a few quick tests and then begin moving the shoulder back into alignment.
The shoulder is inherently unstable compared to most joints. Think about how limited a knee is and how much muscle crosses it. There are a ton of things holding a knee in place. A shoulder, in order to maximize mobility—part of our primate inheritance for climbing—must be loose in the socket. 4 small muscles which make up the rotator cuff stabilize the gleno-humeral head and the scapula (shoulder blade). They are the supraspinatus, infraspinatus, teres minor and subscapularis. There won’t be a test, don’t worry. Since we don’t spend our time climbing, hanging from rings or ropes, getting into forest canopies, etcetera, the function of these stabilizer muscles isn’t fulfilled. Combine that with a lifetime of forward pushing (bench press guys), crappy desk jockey posture, crappy watching the game on the couch posture and what do you think is going to happen to those 4 small muscles when you break alignment?
We can avoid 90% of shoulder issues with a simple prehab program. 3 days a week at 2×15/day complete the following exercises:
1. scapular retraction with depression
2. side-lying external rotation
3. side-lying horizontal abduction
Illustrated: Y, T, H special thanks to thefitchronicles.com
Illustrated: M by Al-Jahara hospital, W by restorept.com
The overwhelming majority of shoulder problems can be solved with direct muscle work and minor postural corrections. Rather than waiting till you have a problem, you can add this to your routine as part of warm up or cool down. It’s a bit tedious but so boredom from injury is worse.