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Shoulder Pain During Exercise

One of the most common things I see is shoulder pain that affects people's ability to exercise. Shoulder pain that comes on during military presses, push-ups, throwing a ball, that sort of thing. There is one main shoulder problem called impingement that causes pain to the top of the shoulder, side of the shoulder and sometimes down the arm.

It's truly a fixable problem, but it comes with effort on your end!

Unfortunately this problem is mis-managed and often times people are told by their primary MD to rest, stop exercising, ice or take medication. Over time the problem will become worse, the shoulder will get tight, you will become less mobile and avoid the exercise and activities you love to do. Eventually, the shoulder may even require surgery as the rotator cuff becomes impinged and torn under the acromian

There are many facets that lead to this impingement problem, all which are mechanical and fixable. I am going to present a few of the most common impairments I see in folks with this issue.

Often times people are very weak in there upper back muscles and leads to poor positioning of the shoulder complex. The shoulder will round and tip forward for instance. The lower trapezius, mid trapezius and rhomboids need to be strong to control movement and position of the shoulder. These muscles help further stabilize the shoulder during movement preventing the shoulder from being overworked.

The shoulder blade contains the roof of the shoulder called the acromian, and more often than not, the problem lies under that acromian; called the subacromial space. If this space is not positioned right during exercise, then more compression can take place under it. It's like suffocating the shoulder joint, and the roof is collapsing in.

Strengthening the upper back muscles will not only help stabilize the shoulder complex, but also improve the mechanics of the shoulder blade during exercise. There is a term called force coupling that requires synergy between muscles around the shoulder complex to complete a task or exercise properly. The shoulder is the most mobile joint in the body and relies heavily on proper muscle coordination, timing and strength.

So here are a few of my favorite group of exercises:

Rotator cuff strengthening:

Keep elbow bent to 90 deg, raise arm up to this position in picture and then slowly lower it down so hand goes down to the floor with shoulder rotating inward. Do 3 sets of 12-15 repetitions.

Upper back strengthening:

Do 3 sets of 12-15 repetitions. Try pinching shoulder blades into upper back while keeping the elbows fairly straight

Work on diaphragmatic breathing:

Lay on stomach and breath in expanding your abdomen. Let abdomen rise toward ceiling, then exhale through pursed lips.

Stretch the mid back:

Roll on foam roller to give the mid back a nice stretch, go slowly and keep abs engaged. Roll along entire mid back.

Get on hands and knees and reach through across your body rotating spine, then go opposite way with same arm reaching towards the ceiling

People also get tight in the chest muscles called the pectorals which will pull the shoulder blade forward leading again to decreased shoulder space. Stretching these muscles will help. hold this stretch for 30 seconds. Hold a exercise tube with handles, keep elbow fairly straight and rotate body away.

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