The Shoulder Joint

This joint is very mobile with almost 3D movement, having 3 bones offered up to each other, no direct secure bone fixing in a ball and socket type fixing – they are held in place by muscles, rather than a solid joint of bone fitting into bone like the hip joint.

Aside from an impact or wrenching injury, many things in day to day life are affecting shoulder stability

• Using a mouse at the computer
• Leaning on the car window
• Carrying a bag on one shoulder
• Asymmetric sports such as tennis/golf
• General posture and habits on how to sit and stand

What these do is allow the shoulder to drop forwards, through tightening of the chest which causes the scapular (shoulder blade) to wing and hang away from the rib cage causing pain between the shoulder blades and in the neck. This, in turn, causes a drop or slouch in the upper body which will affect the neutral spine position, and so will cause lower back pain.

The shoulder blade should be allowed to swing flush against the rib cage, so if posture is poor, and the shoulders are rounded and the chest tight and pulling forwards then the shoulder will be compromised in function because the shoulder blade will not be able to rotate as it should on the ribs.  This can cause pain and tension in the muscles under the blade, as well as impingement in the shoulder joint itself leading to nerve aggravation. Aside from pain, it will lead to bad functionality and lower performance in racket or throwing sports, but also in sports or life requiring posture to hold the body in order to make a stable base and be able to create tension for recoil in movement and stability – like horse riding, cycling, running and quite simply walking.

Strapping can help to relieve discomfort and remind the patient where the shoulder should sit, however, first it should be applied by someone who knows how to do it and second it is an unrealistic long term option, the best solution is changing habits and do some corrective exercise work.

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There are various types of tape – one of the most popular these days is “Kinesio tape”. Also there are some support braces that encourage the shoulders to sit back and not pull forwards. See below for details.

Ideally one wants to open the chest and work the upper back muscles to support the upper body and hold strong, along with working on the core muscles to also join in with holding the trunk stable so that the shoulder blade can rotate as it needs to against the ribs. The rotator cuff exercises (where one is working on the rotation of the upper arm, keeping it close to the side, so works on holding the upper arm into the clavicle and scapular) are really important to encourage the humorous (upper arm bone) to hold strong and stable into the shoulder girdle. There are many examples of exercises that one can do online which is great because nowadays it is possible to sort problems out oneself, the only problem is making sure you are doing them correctly, and this is where guidance in the execution is key.

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Many sports need the shoulder to be incredibly active and move in a very 3D way in order to be able to excel and many jobs in life – such as scratching your back, putting on clothes, reaching the top shelf also require full shoulder mobility to be able to do.