18 Apr Shoulder pain and muscular imbalance
The shoulder joint is an extremely mobile joint relying on muscular balance for good strength and movement. The muscles from the arm bone attach to the shoulder blade and to the ribs. The rib cage and shoulder blades are the scaffolding for the shoulder. So how they work will effect the shoulder function.
For example if one rib is rotated out of position, by a tight muscle, it will effect the muscle attachment for the shoulder and function will be compromised. If the shoulder blade is stuck to the rib cage, by tight muscles or perhaps scarring from radiotherapy, this will also effect the function of the shoulder.
An understanding of how the shoulder works can help you treat your shoulder and maintain good muscular balance for movement and strength.
When we lift the arm up the shoulder blade stays put until the arm is lifted to about 90 degrees, then the shoulder blade glides around the rib cage to give the arm the rest of its range of movement for reaching up. If we are reaching out the rib cage has to rotate as well. There is a rhythm between the ribs, the shoulder blade and arm bone. When this rhythm is disrupted by tight muscles or weakness or an injury the shoulder does not function well and pain can result.
We need to;
1. Balance the muscles
a. between the arm bone and shoulder blade ie. rotator cuff muscles – these are a group of muscles that hold the arm bone into the shoulder joint (like a hand holding a ball), they also rotate the shoulder joint
b. between the shoulder blade and rib cage, think of the shoulder blade sliding around the ribs, as though it is oiled underneath.
c. Maintain mobility of the rib cage or thoracic rings. A thoracic ring = pair of ribs right and left, the breast bone and vertebrae in the spine. There are 10 of them making up the rib cage. This may be done by rotating and side bending the trunk to stretch, breathing deeply, and Yoga or Pilates. Tension in the spine and poor posture effects the thoracic rings and must be addressed. We have a yoga class specifically for balancing the trunk region.
Nature provided a wonderful range of movement in our shoulders, however…lose just one area of mobility and the others have to compensate, over time this is when injury occurs for no apparent reason. Physio can help analyse which muscles are tight, which are weak and educate you to balance those muscles again.
See the article on Good Posture and Correction.