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Second to back pain, shoulder pain is one of the most common complaints I receive as a clinician and rehabilitation specialist. While there may be many different causes of shoulder pain, the treatment is very similar.

Shoulder joints are naturally a very unstable joint. When we look at the specific bones that make up the shoulder joint, there is not much there. I like to equate the bony support to like a golf ball on a tee.

The main support in your shoulder comes from your labrum and rotator cuff. The rotator cuff tends to be the main culprit when it comes to general shoulder pain. The type of pain where you’re not really sure how it started, but it’s almost always there and has gradually gotten worse.

When we look at the shoulder joint, its important to look at the entire shoulder complex, which includes your scapula (shoulder blade). You have 17 different muscles that attach to your scapula, which is directly connected to your shoulder joint (aka: glenohumeral joint). With that many muscles pulling on this structure, it makes sense that this is where most problems originate.

Most of us are looking for ways to decrease our pain by either avoiding surgery or avoiding the doctor altogether. The first step in this process is to first identify any possible muscle imbalances and correct these first.

Most adults today suffer from some degree of “forward head, rounded shoulder” posture. This is developed over time from sitting in certain positions repeatedly. This includes sitting at a desk, looking down at your phone/laptop, reading, and driving a car. These are activities that most adults engage in for several hours a day. This leads to tightness or restriction in your neck and the front of your shoulder, and muscle weakness in the muscles on the back of your shoulder (scapula!).

These imbalances are what often leads to shoulder pain, because your rotator cuff ends up doing the work of all your scapular stabilizers in addition to their own job. Overtime, these muscles are overworked and can develop tendinopathies and impingements.

So, now that we understand the most common causes of shoulder pain, how do we fix it?

In theory, this can be quite simple. It only requires effort and consistency on your part (just like any other fitness goal!). The first step is to identify which tissues may be tight or overactive, and work on lengthening those muscles. The second is to strengthen the scapular stabilizers that may be weak. It MUST be a combination of these two things in order to see results!

First, how to stretch your pec:

Door stretch

Foam Roller stretch/mobility

Lacrosse Ball massage

Wall Angels

Second, how to strengthen your scapular stabilizers:

I’s, T’s, Y’s, W’s

Serratus Roll

Prone arm lifts

Serratus Punch

These exercises are fairly basic, and easy to include in your warmup, cooldown and/or recovery days.

The most important thing to focus on with any of these exercises, is to make sure you are keeping your shoulders down and pinching your shoulder blades together. The natural tendency is for your shoulders to shrug up, but don’t let them!

We’d love to hear from you! If you have any questions about this topic, or related topics, please send BodyWork an email here: rebecca.bodywork@outlook.com