The Big World of Shoulder Injuries

Shoulder injuries are far too common, so common that in fact the majority of the clients I have consulted and worked with have experienced or were working through a shoulder injury. So why is it that we have so many issues with the shoulder to begin with? What can we do to prevent the frequency of injuries and who is the most-at-risk when it comes to these injuries?

First, let’s discuss the shoulder “joint” itself. It’s actually NOT a joint. The human body is comprised of many joints – 360 to be exact. Simply put, a joint is a junction of two skeletal bones that are then held together with ligaments and tendons. That’s the cliff notes version, anyway. The shoulder itself has eight muscles, four primary ligaments, eight tendons, and includes three bones: the humerus, scapula and clavicle. It’s no wonder why shoulder injuries are so complex!

There are six different types of joints in the human body …

·      Pivot Joint (vertebra/spine bones)

·      Saddle Joint (finger/toes)

·      Plane Joint (ankles)

·      Hinge Joint (elbows)

·      Condyloid Joint (wrists)

·      Ball and Socket Joint (hips)

Note that the shoulder is not included in any of these joints.

A lot of the reasons why we see shoulder injuries comes down to our lifestyles – we sit too much, we are on electronics WAY too much and do little to nothing to correct or address our postural problems. These three things alone are a recipe for disaster. Many people come into gyms and are looking to increase their shoulder strength. Then they immediately bee-line for the free weight area to work on shoulder presses, lateral raises and external rotations.

 Get those gains, bro!

Jokes aside, as much as these exercises are added in with the best intention, it is never thought out properly, or consulted with properly prior to any program. Even the best athletes out there prioritize stability and mobility before any strength routine, that is if they plan to have a healthy season ahead.

So who really is the most at-risk when it comes to these injuries? Everyone. I’ve worked with people who have injured their shoulders from reaching in the cabinets, to putting a sock on, swinging a golf club or while working out. They’ve been as young as high school and as old as senior adults – the shoulder does not isolate itself to one population of people; however, I will say more often than not the middle-aged to senior population are more inclined to have injuries with aging and weakened joint health altogether. But that doesn’t mean injuries cannot be sustained by anyone.

If we’re all at-risk for a shoulder injury, what can we do to reduce the chances of experiencing or re-injuring the area?

Step 1: Focus on myofascial release of the muscles surrounding the shoulder complex. Myofascial release is breaking up the connective tissue that holds your muscle fibers together. When these get excessively tight, they can pull and manipulate the muscle to traction and move differently which can cause discomfort and/or pain. Best way to release the fascia is using a foam roller and a tennis ball. Look at trying to release your Latissimus Dorsi (and up towards the attachment of the scapula), Trapezius (the mid/upper back), Pectoralis muscles (major and minor), and Posterior Deltoid. These muscles are typically the biggest culprits to poor positioning of the upper arm (humerus) in the complex which can lead to improper positioning, movement and wear in the girdle. This should be done regularly, especially on the days that you plan on lifting any upper body (chest, back, shoulders, and core – yes). 

Step 2: Next, add in static stretching of those really tight muscle groups. This is to help lengthen the actual muscle fibers so that you can move more efficiently and engage the correct muscles in your lifts. Even if you do not plan on lifting, statis stretches held for 30-60 seconds has shown to help with optimal joint range of motion (ROM) and muscle extensibility.

 Step 3: Isolate your underactive muscles. This may involve the rotator cuff, and more often than not the back muscles and core. Continue to work on a variety of isolated movements (not just planks all day) to increase the stability and strength of the smaller muscles that are key players in the stabilization of the area.

Step 4: Integrate full ROM strength exercises. There are three planes of movement: Frontal Plane, Saggital Plane, and Transverse (Rotational) Plane. All muscle groups should be stressed in these different planes to maintain joint health and soft tissue strength and stability. If you are just getting back into a routine after an injury, take it slow. Keep your sets to no more than 3 and reps to no more than 8 and let your body adjust to the added stress of weight on the area. As you notice improvements in strength, continue to work on your flexibility and myofascial release so you can progress your routine further.

Truthfully, these are all the necessary steps to any muscle group you are either working back from an injury or are trying to prevent an injury. So if we're looking to reduce setbacks, consider these four primary steps.

 To sum this up - remember the shoulder is a complex web of both structure and soft tissues. It is a highly unstable area and should have a routine with flexibility, stability and strength integrated. And if at any point you experience an injury that does not seem to improve with the use of ice and/or heat, please seek the professional opinion of your Primary Care Physician or an Orthopedic Doctor.