Wednesday, July 26, 2017 The Nugget Newspaper, Sisters, Oregon
Fit For
Sisters
Andrew Luscutoff
Columnist
Dealing with
common shoulder
problems
Shoulders are finicky
joints. There is a large degree
of movement, through all
planes of motion. Delicate
motor control must be pre-
cise when someone shoots a
basketball or catches a pass
on the football field. The
shoulder must be mobile,
yet hold strong when lifting
objects overhead. There are
small muscles and very large
ones that act on the joint.
It is a marvel of human
biomechanics.
This is why it’s impor-
tant to consider shoulder
hygiene to keep all of the
above actions in harmony.
One misaligned muscle can
throw the system into a pain-
ful spasm, or eventual injury
from compensatory behavior
The most common ail-
ment, especially among
weightlifting or working
populations is pain in the
front of the shoulder which,
when pressed, intensifies.
This is likely biceps tendon-
itis, which is an anatomical
way to say inflamed biceps
tendon. This often comes
about by overuse, and any
action where the arm is
being lifted in the front of
the body, especially under
load, is aggravating.
Rest is going to be
prescribed, followed by
NSAIDs then some rehabili-
tative movement. Use full
range of motion mobility
exercises to stimulate but not
overload the tendon until the
inflammation resides.
Then there is clicking,
stiff, or even frozen shoulder
caused by shoulder impinge-
ment syndrome. This usually
arises because much of the
musculature of the shoulder
is built stronger to internal
rotation. This internal rota-
tion bias pulls the external
rotator muscles into a pro-
tective spasm. Therefore
the rotator cuff muscles
are being overloaded and
injury may result. Once the
external rotators tighten, the
shoulder joint is hiked into
the socket. This is a problem
because the supraspinatus
muscle, which has to pass
under the clavicle, begins
to be pinched. Eventually, it
can wear like a rope frays.
To remedy this, stretching
the internal rotator muscles
will be called for first. These
are the chest, the lats, and
deltoid muscles. Stand in the
corner of a wall, and with
arms up in a “touchdown”
position stretch the chest.
Next working the external
rotators will be important to
balance out the bias towards
internal rotation. From a side
lying position, take a small
dumbbell and with the elbow
pinned to the side, rotate the
arm back as if raising the
hand. Keep the arm at 90
degrees. Repeat 15 or more
times, each side for multiple
sets.
The last condition to
consider is the glenoid
labrum. This often becomes
injured with a fall, land-
ing on the shoulder with an
outstretched arm or onto an
elbow. This jams the upper
arm into the socket, dam-
aging the glenoid labrum
which is a fibrous capsule
covering the shoulder joint.
It is also common to see this
injury with repetitive throw-
ing motions.
Treatment for this will be
rest, and possibly immobili-
zation of the shoulder until
painful movement subsides.
Usually, a painful shoulder
joint creates a protective
spasm of tight musculature
to protect the unstable shoul-
der. Mobility and stretching
will be important. Stretching
the shoulder overhead and
externally rotating the shoul-
der to stretch internal rota-
tors will be important.
The next phase of treat-
ment will be light shoulder
stability exercises. Using a
light weight or theraband,
start with basic external
rotations, and standing rows.
Once tolerated, begin press-
ing or “standing punches”
with the band or cable
machine. Along with these,
shoulder front raises may
also be tolerated at this time.
As strength progresses, stan-
dard shoulder strengthening
can be employed, with a dos-
age of therapeutic stability
exercises as a compliment.
Shoulder injury is com-
mon, and it’s a part of the
obstacles life throws into the
mix. Without proper mobil-
ity, stability, and strength,
the shoulder will underper-
form and will be at risk. This
is why striking the balance
is important. There are some
wonderful resources for
those reading who may have
some shoulder concerns
right here in town. Stop by
the physical therapist of your
choice; often a quick evalu-
ation can be scheduled for
a special rate, so ask about
these. Regardless of the
specific condition, shoulder
pains can be managed and
corrected with the proper
exercise. Don’t let shoulder
problems derail activity.
23
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