The Most Common Types of Shoulder Injury
1. Shoulder Impingement
(Arm is being pinched under the AC Joint while raising arm)
2. Tendinitis or Tendinosis in Biceps or Rotator cuff
(Tendons having accumulated scar tissues and irritated trigger points)
3. Rotator Cuff Tear (Rotator cuff consists of 4 muscles stabilizing your shoulder. If these muscles are partially torn, pain increases with limited range of motion)
4. AC (Acromioclavicular) Joint pain
(Pain can increase at the end range of elevation or while crossing your arm across your chest)
(Nerve bundles are compressed under the collarbone (Clavicle) by scalene and pectoralis muscles)
6. Post Surgical Rehab (Bankart, Labrum Repair, Rotator Cuff Repair)
(After the surgery, rehab program focuses on improving range of motion, strength and function)
Why Do I Have Rounded Shoulder and Pain even though I didn't have injury?
Upper Crossed Syndrome is a natural muscle imbalance pattern of human's upper body. People tends to develop tightness in their chest muscle (Pectoralis), upper trapezius, levator scapula and weakness in their lower trapezius, serratus anterior muscles. This pattern represents with forward head and rounded shoulder posture.
Thus, we should be careful about our posture and need to do proper matching exercise program with stretching and strengthening those muscle groups.
The Most Important Tips in Shoulder Rehabilitation
1. Release Scar Tissues and Deactivate Trigger Points
Scar Tissues and Trigger points inhibit activation of muscles. Once it is released with appropriate Manual Therapy, your muscles will be activated and coordinated naturally
Therapy: Trigger Point Therapy, Graston Instrument, Vibrocurssor Therapy, Stretching Therapy
2. Restore Flexiblity in your back & Improve Posture
Shoulder Girdle sits on rib cages and thoracic spine. If this pillar is slouched forward, it increases stress on shoulder joint while doing arm elevation. It can cause shoulder impingement.
Therapy: Upper/Mid Back Adjustment (Manipulation), Spine mobility & Posture exercise program
3. Shoulder Rehab should focus on scapula stabilization with arm elevation
Scapula bone should maintain vertical positioning without sliding up or tilting forward on the rib cage while raising your arm.
With arm elevation, healthy shoulder shows this movement:
- clavicle and arm turns outward (external rotation)
- scapula bone maintains vertical position on ribs with upward rotation
- mid-upper back is slightly bending backward (extension)
- No shoulder shrugging movement
If scapula is tilting forward due to muscle imbalance, the inferior tip of scapula is being lifted from the rib cages (Winging scapula) causing shoulder impingment.
4. Balance your muscle strength ratio
Too Strong or tight chest muscle and weak back muscle breaks the proper agonist-antagonist strength ratio resulting in rounded shoulder posture. Rehab should emphasize on:
Strengthening: Back muscles (Mid-lower trapezius, Rhomboid)
Stretching: Petoralis muscle groups
Anterior/Posterior Shoulder Capsules
5. Improve Core Strength
Dynamic core exercise with shoulder movement is very effective in the final stage of shoulder rehab. Strong trunk and scapula muscles enable arms to move easily with spending less energy.