Every time you reach for your seatbelt or wave goodbye, you rely on the impressive range of motion (ROM) of your shoulder. Unfortunately, for all of its mobility, the shoulder is also the least stable joint in your body, making it a prime target for injury.
The shoulder complex consists of a ball and socket joint and shoulder girdle whose combined actions result in your shoulder ROM. Covering the shoulder is the three-part deltoid, a thick, triangular muscle that stabilizes the shoulder and gives it a rounded appearance. The shoulder ball rests in a shallow cup and is held together by inherently weak ligaments. Its stability, therefore, is dependent on the muscles and tendons running across the joint. The risk of injury is high if these muscles are weak and/or tight, particularly when there is an imbalance in the strength and/or flexibility in your opposing muscle groups.
The key to preventing shoulder injuries is to both strengthen and stretch the muscles, tendons and ligaments supporting your shoulders, including a deep layer of small muscles and tendons known as the rotator cuff. Though they are small, the rotator cuff muscles have a big job to do, acting as stabilizers for the humerus (upper arm bone) in the shoulder socket. Rotator cuff injuries typically result from overusing the shoulder in sports such as tennis, golf or swimming. Furthermore, when the rotator cuff muscles are weak, the deltoids must bear the brunt of the work, leaving the shoulder vulnerable to injury. Repetitive stress on the shoulder causes micro tears and subsequent inflammation of the tendons or the rotator cuff muscles. The inflammation then causes pain which leads to a decreased ROM which leads to a decline in strength from inactivity.
One of my aquatic therapy clients, “Anne” came to me with not just a torn rotator cuff, but, according to her MRI, it was damaged beyond repair and her orthopedist wouldn’t operate. Apparently, years of competitive tennis had taken its toll. After 2 months of 2 times per week of aquatic therapy, however, Anne’s pain was greatly reduced and her strength and pain-free ROM had greatly increased. Furthermore, after 5 months of aquatic therapy Anne is virtually pain-free - except if she overdoes it by throwing a football to her grandson! Aquatic therapy can be very effective in treating both acute and chronic shoulder conditions. For more information, go to www.bewellcoaching.com and check out the aquatic therapy/training page.
Preventative Exercises to Stretch/Strengthen the Rotator Cuff Muscles
- Stretch the back of your shoulder by reaching your arm across your chest toward the opposite shoulder. Holding your arm either above or below the elbow, gently stretch your arm for 20-30 seconds. Switch sides and repeat.
- Raise one arm and bend it behind your head to touch the opposite shoulder. Use your other hand to gently pull the arm downward. Hold for 20-30 seconds. Switch sides and repeat.
Strength Exercise for Rotator Cuff
Holding light dumbbells in each hand by your side, lift your slightly bent arms horizontally to shoulder height, keeping your thumbs pointed toward the floor. Slowly lower your arms and then return them to shoulder level. Repeat 8-12 times.
Tips to Reduce Shoulder Wear and Tear
1. If your sport is unilateral (such as golf or tennis), try practicing your strokes or swings on your non-dominant side.
2. Make an effort to use your non-dominant arm as much as your dominant arm in all activities of daily life.
3. Keep your neck and shoulder muscles relaxed when you’re exercising other muscle groups.
4. When performing water aerobics, avoid repeatedly reaching your arms over head, breaking the surface of the water.
Next time we’ll focus on another ball and socket joint, the hip. Until then…