MotionPlus Monthly: Lets talk about and issue that crops up in the shoulder
Subacominal - sub deltoid Bursitis (for this piece, Im going to refer to it as bursitis), yes this is a diagnosis that gets diagnosis in many practices, and clinics every day. It can be a depilating injury which can make simple tasks difficult. Some of the symptoms can be, as listed below.
Pain in the shoulder when doing an overhead task?
Is Pain made worse while laying on the arm?
Pain that refers to the elbow area?
Pain on the outside of the shoulder?
One of the population that I see who experiences bursitis of the shoulder are people who have repetitive tasks or movements overhead. However this is not the only population that can experience bursitis.
If you have shoulder pain and are reading this, I’m not diagnosing, but merely sharing some food for thought, as just reading the symptoms, and ticking these symptoms off isn’t a diagnosis. A FULL examination is needed to diagnose bursitis, and that may also include an ultrasound.
What is happening?
The humerus head (the arm bone), moves superior (up) inside the glenohumeral joint (the shoulder joint) which forces the rotator cuff muscle tendon into the smooth sliding bursa. This action of taking your arm up over head over time, combined with poor movement patterning, inflammation of the joint, and/or inflammation of surround connective tissue can lead to inflammation of the bursa. As this bursa becomes inflamed it has an overall negative domino effect.
The worse thing you can do is not listening to your body and carrying on repeatedly engaging in the aggravating activity. Listen, to the body as pain is the bodies way of saying something wrong is happening, so do something about it or suffer the consequences.
What can be done?
Limit the activity that aggravates. If that mean, no gymnastics, no throwing, no lifting, no carrying, whatever it may be. Listen to the body as this is the best communication tool. Too often we listen to so called experienced people who believe they know better and than we get hurt.
A little bit of sweat and grind, can help with improvements because as the saying goes " anything worth having is worth fighting for - Andrew Carnegie" however ask yourself this question ' Is injuring yourself really worth it?' If you answer No than go see someone about it, if the answer is "yes" good luck.
What can you do to prevent
Symptoms related to shoulder bursitis may take several weeks or more to improve. During this time it is important to create an environment that allows a return to normal use and furthermore, prevents a recurrence. Once again, listen to your body, limit the aggravating movements.
First things first, assess!
Scapulohumeral Rhythm
Posture
Muscles
Scapulohumeral Rhythm
This fancy phase, is how the shoulder complex moves. There are four joints of the shoulder complex, they are the Sternoclavicular Joint, the Acromioclavicular Joint, the Scapulothoracic Joint and the Glenohumeral Joint. These joints work in unison to coordinate movement pattern of the arm as it elevate.
This diagram represents the movement of the shoulder to indicate what movements are happening when the arm goes up to the side. Although the ranges and degrees can vary person to person, this diagram represents the scapulohumeral well, thus providing a base of what is happening when looking at the shoulder movement in abduction (moving the arm from the side of the body to an overhead position).
The first 30 degrees is represented by the Glenohumeral Joint (shoulder joint), as this range of movement is achieved, the Scapulothoracic Joint (where the shoulder blade articulates on the mid back area (thoracic spine) will start to move (20 degrees) thus giving the shoulder complex more range which allows the shoulder joint to also increase its range (70 degrees). As the arm ascends further up the scapulothoracic joint will increase its range giving raise to increased shoulder joint raise as shown above. However, this is a perfect world scenario and unfortunately there are environmental factors that will influence this movement. Eg predisposing and maintaining factors such as “tight" muscles (we will come back to this), posture eg.
Target the Predisposing factors and maintaining factor. Here is one solution to your problem work on that nasty posture of yours with exercises listed below.
What you need to start doing
Correct your POSTURE!
For example; If you stuck like this for the last 8-9 hours, than drive to the gym, roll around on a foam roller for 2-3 minutes, than stretch your calf’s for 30 seconds and expect that you are good to go and crush an overhead workout without consequences at some point in time. Being stuck in a predisposing factor such as this diagram can't be ignored and needs to be fixed with some accessory work.
Below are just some exercises that can help start the process of strengthening your posture and thus helping the shoulder.
Strengthen the Rhomboids through:
Scapular retraction
Scapular wall slides
Strengthen the Serratus anterior through:
banded push ups
Punches
Strength the lower traps through:
Seated cable Y raise
45 degree Y raises
As mention these are just some of the exercises that can be done as there are plenty more strengthening and stretching exercises which will assist in correcting posture.
Last but not least
Once as these posture issues have been corrected, look at how you move, as your original movements are flawed hence the injury! Create the correct neuro pathways, and go see someone who is experienced.
Take home message
Don't get use to pain that doesn't go away
This is not medical advice and if the pain persists go see your local healthcare provider about this issue!!