Impinge Me Not

In preparation for my last workshop, Bulletproof Shoulders, I spent a lot of time researching shoulder injuries to craft my syllabus. Sad news – shoulder injuries are incredibly common. I’m sure you’d be hard pressed to find someone who has never experienced a shoulder injury or pain at some time in their life. I injured my shoulders after a poorly executed bench press almost two years ago and I am STILL constantly working on rehabilitating and restoring function.

Image from www.shoulderdoc.co.uk

Why is it so easy to injure shoulders? Part of it is the anatomy of the joint and another piece of the puzzle is what we do most often with our shoulders – a whole lot of the same thing. The shoulder is really three separate bones (the clavicle, scapula and humerus) that are connected at 4 different joints. The sternoclavicular joint is located between the clavicle and sternum, the acromioclavicular joint is located between the scapula and the clavicle, the glenohumeral joint is located between the humerus and the glenoid fossa of the scapula and the scapulothoracic joint is the sliding surface between your scapula and the back of your ribcage. The ball and socket joint that most people think of when they think “shoulder” is the glenohumeral (GH) joint. All 4 of these joints need to be both stable and mobile for full shoulder range of motion.

We get ourselves into trouble because we use our shoulders to do the same thing day in and day out. The exact thing I am doing now as I type this – work/sit at computers for hours on end each day. Even if you are not bound to a desk each day, chances are the motions your shoulders go through are repetitive.

Your body is intelligently designed but just a little bit lazy. What I mean by that is when you do the same motions day in and day out, your tissues stiffen in the directions you are not using and are subject to repetitive strain in the ways you do move. Why expend energy maintaining a movement you never do? Slap on top of this slouchy posture with rounded shoulders and you’ve successfully created the perfect storm for shoulder dysfunction.

Shoulder issues don’t rear their head until you do something crazy like take your arm overhead. A simple action that you probably do without thinking as you grab something off a high shelf or close your trunk. Overhead athletes are those whose sport of activity of choice includes throwing and taking the arms overhead, like in swimming. Considering that even CrossFit is an overhead sport – (while you’re not throwing something overhead, you are repetitively lifting heavy things) its no wonder so many CrossFitters have shoulder issues! Even common yoga poses like downdog are overhead positions, all of which, when done improperly, can cause repetitive stress, strain and impingement issues.

Image from http://what-when-how.com/

The space between the head of the humerus and the acromion process is quite small and the joint space is further decreased by shoulders that are rounded forward. The supraspinatus, one of the 4 rotator cuff muscles that help to keep the head of the humerus centered in the GH joint, has to pass through this tiny space. While it does have a fluid filled sac called the subacromial bursa imbedded into its tendon for lubrication, the recurring compression from the head of your humerus during poorly executed moves can begin to irritate the tissues. Think about it – in a battle of bones vs. soft tissues, who is going to win every single time? Which is why bursitis, tendonitis and impingement (narrowing of the joint space) are far more common than bone issues in the shoulder. That’s not to say that years and ignoring the clicks, snaps and pops in your shoulders won’t lead to bone spurs and other bony issues, they just take longer to develop.

So how to help save your shoulders? First of all, know your blind spots – know where you are weak, strong, tight, over stretched so you can continually work to improve your limitations. This way, you can intelligently warm up and prepare your shoulders as THEY need, not just as the workout dictates. If you’re not sure where to start, internal rotation tends to be the range of motion that many people are missing because we spend so much time locked in internal rotation at our computers. The next piece of advice is to MOVE your shoulders as often as possible into novel positions. The Yoga Tune Up® exercise Hitchhiking Pizzas is a super simple exercise that is easy to pepper throughout your work day to break up the monotony of working at your computer.

If this sounds like too much work and you’d rather just wait for your shoulders to break down to then have surgery, chew on this: surgical interventions will only put a bandaid on the issue, but will not solve the mechanics that led to the issue in the first place. If you just put a patch on it but don’t solve the problem, you may be setting yourself up for further injuries down the line. This is similar to replacing the one tire on your car that is wearing unevenly instead of getting your tires realigned. Plus, rolling on YTU Balls and taking care of your shoulders on a daily basis is a lot cheaper and easier than surgery. Just sayin’.

In the video below, Skelly Kapowski and I explain the anatomy of shoulder impingement.

Keep tuned for some shoulders savers coming your way – I finally have a chance to get some videos recorded and out to you as soon as possible!