Written By: James Hayes
Chiropractor

Did you know that the shoulder has the greatest range of motion of any joint in the human body? But it comes at a price; because of its high mobility it is susceptible to injury.

The shoulder is a “ball and socket joint” however as seen above, the ball is considerably larger than the cavity it sits in, think of it as a golf ball sitting on a tee.
You are now wondering how in the world does it stay in there and not continually pop out of the socket.

The answer is the glenoid labrum that increases the depth of the cavity for the ball to sit in, the ligamentous capsule that limits excessive movement of the shoulder and last but not least the rotator cuff muscles!

Lets save the importance of the labrum and the ligamentous capsule for another day and delve further into the importance of the rotator cuffs.

What are rotator cuff muscles?

The rotator cuff is comprised of 4 different muscles

  1. Supraspinatus
  2. Infraspinatus
  3. Teres Minor
  4. Subscapularis

All of these muscles have their own individual input to create movement of the shoulder however their primary function is to all work together in harmony to stabilise the shoulder.

The mechanics behind shoulder movement is very complex however to be able to move you shoulder throughout its full range of motion pain-free relies heavily on the strength of the rotator cuff muscles to “control” the movement and keep it in the socket.

Without this control you are susceptible to a range of painful disorders such as subacromial impingement, tendonitis, rotator cuff tears and bursitis.

Frequently a lot of people make the mistake of forgetting about these muscles when they go to the gym because they are more concerned about obtaining those cosmetic muscles such as a large chest, peaky biceps and bouldering deltoids.

Studies have shown that 68% of problems related to scapulohumeral (shoulder) instability have rotator cuff problems. If you neglect these muscles you could be in for a rude awakening when you wont be able to workout, perform daily tasks with ease or play you favourite sports due to the pain.

Are you on a fast track to shoulder pain?

Do you have a slouched posture with your shoulders rolling forward? Yes? Combine that with:

  • Desk work
  • Lots of driving
  • Using the mouse a lot
  • Highly stressed (tightened shoulders)
  • Go to the gym and only work on mirror muscles
  • History of shoulder trauma

If you continue doing nothing about the above, you most likely will experience shoulder pain somewhere down the line.
A lot of you will ignore the early warning signs of a shoulder injury such as limited mobility and pain. Don’t be that person!

If you are experiencing:

  • Pain with throwing or pushing actions
  • Pinching sensation at the front of the shoulder
  • Pain with lifting arms above head or to the side
  • An aching shoulder which may extend into the arm

Stop immediately it won’t disappear and you can cause some serious damage.

What can we do?

Typically shoulder pain and/or instability is a result of muscle imbalances. Some muscles will be strong/tight and some may be weak or inhibited. It is important to identify what muscles you need to stretch and what to strengthen in order to get the best results.

If you are unsure, please consult a professional, as they will identify what exercises you should be focusing on.

The most common shoulder muscular imbalances I see in clinic:

Tight:

  • Internal rotators
    • Pec Major
    • Subscapularis
  • Pec Minor

Weak:

  • Shoulder Retractors
    • Rhomboids
    • Lower and Middle Trapezius
  • External Rotators
  • Teres Minor
  • Infraspinatus

Once the muscle imbalances have been identified the solution is quiet simple… Stretch the tight muscles and strengthen the weaker ones.

Our advice

When the shoulder muscles become fatigued, the joint becomes hypermobile and hence is more susceptible to injury. The trick is to try and build “muscular endurance” to these “weak muscles”.

When doing shoulder stabilisation exercises try and use higher repetitions (15-20) at a longer duration (slow reps). Try and adopt a 4-second contraction and a slow 6-second controlled eccentric movement back to the starting position.

It is also important to encourage mid back extension during the rehabilitation process as it plays a major role in the shoulder biomechanics.