Do you have shoulder pain? Has your shoulder ever ached, clicked or popped?

I have experienced shoulder pain. I swam competitively for about 16 years. Wear and tear resulting in tight shoulders I can still feel in yoga class. The gentle reminders of early morning swim workouts and time spend in the training room after practice.  Whether you are an athlete or not, repetitive reaching overhead, behind our back, lifting, reaching, carrying are all a part of our day to day routine. These activities, when done over and over again may eventually lead to an overuse injury especially if done improperly.

A common source of shoulder pain comes from the rotator cuff. Many people have heard of the rotator cuff, but most aren’t quite sure what it is. The name itself makes it sound like its one thing, one structure. The rotator cuff is actually a group of four muscles including the supraspinatus, infraspinatus, subscapularis and teres minor. Despite their long names, these muscles work together and are essential in providing support for the shoulder girdle.

The shoulder girdle itself is quite complex. There are four major joints that make up the girdle. The main one is the ball and socket joint that connects the arm bone (aka humerus) to the shoulder blade (aka glenoid fossa of the scapula). I often describe it as a golf ball sitting on a tee because it is quite unstable without the help of the rotator cuff, ligaments, cartilage and other muscles. Whether you are moving, or are at rest, all of these structures work together supporting the shoulder.

Because the shoulder joint is so reliant on muscles and ligaments for support, when muscle imbalances occur, it can often lead to pain, decreased range of motion, weakness and overall limited function.

Here are just a few suggestions I wanted to share that may help prevent excess muscle imbalances that can create or contribute to excess placed strain on your shoulders.

1. Squeeze your shoulder blades:

The muscles between your shoulder blades are very important in providing support for the shoulders. Squeeze and hold your shoulder blades together for several seconds as often as you can throughout the day when sitting at your desk, at a red light or while watching television. Make sure not to shrug your shoulders, rather squeeze. Strengthening the muscles between your shoulder blades (aka middle trapezius and rhomboids) can take pressure off your shoulders and neck while opening up your chest.

2. Take a break from bench press, push-ups and your computer:

Over strengthening the biceps and pec muscles in your chest can predispose you to a shoulder injury. If you are a gym rat, taking a break from bench press, military press, bicep curls and push-ups when recovering from a shoulder injury. This can help speed healing. These types of exercises can contribute to muscle imbalances in the shoulder girdle, and may be a major contributor to your injury. If you can’t help yourself, keep in mind, going for endurance by using lighter weight and increasing  your reps rather than pushing through heavy weight is safer.  Aside from physically strengthening your pecs and biceps, they also tend to be tight because we spend so much time performing activities directly in front of us, most commonly, sitting at our computers or in our car all of which have impact on our shoulder function. So, take a stretch break. Stand up. Walk around.

3. Stretch your hip flexors:

Your hip flexors? That’s right. It may sound strange, but when you think about reaching behind you or over your head, if the front of your hips are tight then your shoulders have to do most of the work. Our hips can tighten up easily whether you drive a lot, sit at a desk, in a classroom, or are on a computer. If you think about overhead athletes, like a volleyball or tennis player serving a ball, or a baseball pitcher, like the one in the picture above, they use their whole body to perform those powerful moves. That power doesn’t just come from the shoulders, it comes from their core, and their legs. Keep in mind our whole body needs to take part in most activities we do on a regular basis. It is sometimes the big picture not just the minor details that we need to be aware of in order to work more efficiently and safely, preventing injuries before they start.

4. Strengthen Your Core:

Your abdominal muscles need to be strong to provide support in any activity you do. Your “core” should kick in as soon as you reach overhead, lift, carry or bend. Your rotator cuff muscles are also considered the “core” muscles of your shoulder girdle. It’s a team effort. Strengthening both the abdominals and rotator cuff are essential as they help when you have to pick up a box, throw a ball or reach back to grab your purse in the back seat of your car. Without core strength, a small unexpected movement may throw you off potentially leading to an injury down the road.

When it comes to the shoulder, there is a lot to keep in mind. Aside from the all important rotator cuff, addressing other areas of weakness or stiffness in other parts of the body is essential. In general, shoulder injuries take time to recover. I speak from experience not only as a physical therapist but also as a patient. Be kind to your body. Be patient. Sometimes you dance when on the road to recovery. Taking two steps forward and one step back.  Whether you want to prevent an injury before it starts or are healing from a current injury, listen to your body, it might be telling you something.