The shoulder is the most mobile joint in the body, which makes it susceptible to injury. Shoulder injuries can limit your exercise tolerance. It is difficult to avoid aggravating movements if the underlying injury is not well understood. The shoulder performs best when flexibility and strength are balanced within the muscles and tissues that surround it. Awareness of the specific imbalances in your shoulder can help you identify the most effective exercise strategy.
Considerations
Shoulder injuries have several potential sites. Determining the site of the injury is important to direct safe stretch routines. Different injuries require different precautions. Consulting with an orthopedic physician or physical therapist can help you identify the cause. Often a diagnosis can be made without X-ray or MRI. Avoid any exercise that causes pain to prevent aggravation of underlying injuries. If an injury is not resolving or is getting worse, you should seek medical advice.
Rotator Cuff
One of the common sites of injury is the rotator cuff. It is composed of four individual muscles that share a common tendon attachment at the top of the humerus, or arm bone. These muscles are the infraspinatus, supraspinatus, teres minor and subscapularis. Their primary role is stabilizing the shoulder and allowing proper movement patterns. Injury here could impair the ability to lift the arm above shoulder height, could cause pain with reaching movements or could result in pain at night while sleeping.
Impingement Syndrome
The rotator cuff muscles can become pinched or impinged under the bony bridge of the acromion when muscle patterning or joint flexibility is poor. Repetitive compression of the cuff results in pain and can gradually cause a rotator cuff tear. Cross-body stretches or lifting your arm above shoulder height with the palm turned down can increase impingement. You usually feel pain across the top of the shoulder that may travel down into the top of the biceps area.
Scapular Instability
The only attachment your shoulder has with the skeleton is where the collarbone meets the breastbone, or sternum. The entire arm and shoulder blade rely on muscular support and balance to maintain optimal positioning and stability. Scapular stability provides the foundation for a healthy shoulder. When the muscles that support the shoulder blade weaken or become tight, the shoulder joint can become strained.
Joint Capsule Restriction
The joint capsule comprises a group of ligaments that offer the first line of defense for stabilizing the shoulder joint. These ligaments can become easily stretched or lax after dislocation of the joint. Stretching into positions that expose this laxity can cause pain or lead to repeated dislocation. These ligaments can also become stiff and lead to increased impingement risk. Restriction of inward shoulder rotation is common and can alter normal joint motion.
Expert Insight
Restoring healthy strength, flexibility and balance to your shoulder girdle is essential to reduce pain. Continuing painful and improper stretching routines can lead to progression of injury. Professional assessment and management can identify the cause and help you design an effective and safe stretching and strengthening routine.
