Shoulder Pain and Injuries and How to Avoid Them

The shoulder is an elegant piece of machinery and is extremely complex. It happens to have the greatest range of motion of any joint in the body. However, this large range of motion can cause the shoulder to become unstable, leading to joint problems and the site of multiple injuries. Your shoulder joint is composed of four joints, over 30 muscles, 6 major ligaments, and three bones: the clavicle (collarbone), the scapula (shoulder blade), and the humorous (upper arm bone).  The edge of the scapula, called the acromion, forms the top of the shoulder. Some common shoulder injuries include, rotator cuff tendonitis, rotator cuff bursitis, rotator cuff tears, labral tears, shoulder contusions and ligament strains and tears.

Understanding the different layers of the shoulder and how it is built and connected can help you understand how the shoulder works and how it can become injured. When you realize all the different ways you use and position your hands and shoulders every day, it is easy to understand why they are vulnerable to injury and how hard daily life can be when the shoulder isn’t working well.

The shoulder can be prone to overuse and injury from poor technique when exercising, lifting heavy objects or weights, or if you are an athlete such as a swimmer, tennis player, golfer, or baseball player. In these sports in particular, you use the shoulder repeatedly and often. Athletes are especially susceptible to shoulder problems because of this.  Shoulder problems can also develop slowly through repetitive every day motion and intensive training routines. People may also underestimate the extent of their injury because steady pain, weakness in the arm, or limitation of joint motion becomes almost second nature to them. Luckily, there are ways to keep your shoulders strong and healthy.

Most problems in the shoulder, involve the muscles, ligaments, and tendons, rather than the bones. Arthritis, injury, and repetitive motions, such as those used during sports or work-related activities are leading causes of shoulder or elbow pain, stiffness, and restriction of movement.

Shoulder injuries can often be prevented, so here are some tips on how to avoid shoulder injury:

• Rotator-cuff strengthening: The rotator cuff is made up of four muscles and supplies circular motion for the arm. Each muscle works in conjunction with the others to provide the ease of motion essential for maintaining the muscular stability of the shoulder and preventing injuries such as rotator cuff tendonitis or rotator cuff tears. The rotator-cuff muscles are dependent on the positioning of the scapula for effective control. Strengthening your rotator cuff reduces the chances of shoulder impingement and pain. Exercises such as doorway stretches, side-lying external rotation, high to low rows, the reverse fly and lawn mower pulls can be very effective for strengthening the rotator cuff.
• Stretch the shoulder daily: Stretching is vital for shoulder health. Keep your arm below shoulder height while doing arm stretches. Pendulum stretching exercises relieve pressure on the rotator cuff. Allow your arm to swing back and forth in a small diameter (about 1 inch). Over time the diameter of the swing may be increased. Initially perform the exercise with just the weight of your arm. Then progressively add more weight—5 to 10 pounds. Perform exercise for five minutes once or twice a day.  Gradually increase movements during shoulder stretching as well—big circles, across-body movements, trunk twists, shoulder blade rolls and forward and backward squeezes work very well.
• Balance upper-body workouts: Make sure your upper-body strength workouts, such as weight-lifting are balanced. Taking care of the imbalance of your weaker back muscles is important for prevention and rehabilitation when a shoulder injury occurs.
• Plyometrics: Plyometrics are exercises in which muscles exert maximum force in short intervals of time, with the goal of increasing power and strength.  In the case of helping ease pain in the shoulder, it usually involves medicine balls of various weights. In particular, plyometric exercises are popular for athletes. These mimic sports-specific movements, improving shoulder control during the powerful movements such as throwing a baseball or serving a tennis ball. These are good at targeting the rear-shoulder and external rotator muscles, because they provide training for these muscles.
• Take it easy: The most important thing to note is patience! Shoulder strengthening takes time. It is important to remember that when it comes to introducing weight-training exercises, you must progress slowly. A good shoulder needs a good foundation, and your shoulder will gain strength with time.

If you are, or think you are suffering from extreme shoulder pain, visit or call Orthopaedic Associates of Central Maryland at (410) 644-1880. Visit www.mdbonedocs.com for more information.