I hope everyone had a great Memorial Day weekend and enjoyed friends and family. Hopefully, we all took a moment to reflect on how fortunate we are to be able to spend time with them. So many of our service member’s lives have been lost and their family’s lives have been changed forever. These men and women paid the ultimate price which has afforded us our freedom, to which we are extremely grateful. […]
Today I would like to discuss the almighty shoulders. Besides spinal complaints, shoulder complaints are the #1 extremity condition that presents to my office. The reason for this may be due to the function of the shoulder; it needs to be a very mobile joint. Also, the anatomy of the shoulder is unique when compared to many other joints in the body. It is comprised of a round bone (head of the humerus) that stays in contact with a concave surface of the scapula. This is very much the opposite of the hip joint anatomy where there is a round bone (head of the femur) in contact with a deep socket of the pelvis. This makes for a mobile but also stable contact point.
Due to the anatomy of the shoulder, the stability relies heavily on the rotator cuff (supraspinatus, infraspinatus, teres minor and subscapularis) and the scapula muscles. The goal of these muscles together is to maintain a central point of the humerus to the glenoid portion of the scapula bone. Think of it this way, the stronger these muscles are, the more secure/stable the contact point will be while you throw a baseball, carry a child, lift weights overhead or to simply grab something out of the pantry.
Conditions such as shoulder impingement syndrome present when these muscles over time begin to not do the job I described above. The muscles fatigue, atrophy and fail to work in unison. Hence, when you reach for something, the rotator cuff loses the ability to keep the head of the humerus centralized. When this occurs, the shoulder joint becomes “sloppy”, therefore other tissue structures also begin to start breaking down.
Careful attention needs to be paid to reducing inflammation and further damage to these muscles. Modifying activities is important as well as conditioning of the rotator cuff and scapula stabilizers, and improving flexibility in the thoracic spine via spinal adjustments and exercises.
In all cases, the painful point of the shoulder is merely a “symptom”, however, the “cause” is faulty movement patterns in the thoracic spine, rotator cuff and scapula muscle weakness and/or improper coordination of the scapula (shoulder blade).
Here are a few exercises to help strengthen the almighty shoulder and associated scapula muscles. Also remember, everyone is at a different point in their journey so, not all exercises are right for everyone at the same time. There are progressions and regressions of these exercises depending on the patient’s condition.
Please refer to the attached Youtube video for a full demonstration.
—Dr. Marc Fondino