Whats in a shoulder?
To take a step back your shoulder is the joint that is formed by your upper arm bone, (humerus) and a triangular shaped bone sitting on your rib cage which we call the shoulder blade or scapula to get all Latin about it.
Whats the role of the scapula?
Well glad you asked ,this complex of the two bones and the muscles working off it allow the shoulder to be the most mobile joint in the body. There are muscles working from the scapula to the rib cage, scapula to humerus and scapula to the neck.
This dynamic complex allows us to move our arm and hand in space in a wide arc and acts as a force transmitter for the upper limb. It also provides part of the platform for our neck to move on and is therefore really important in successful neck rehab.
Wow with all those muscles working off it surely its causing my shoulder pain?
Here in lies an issue that has to be dealt with. There is no doubt that shoulder pain can be caused or at least affected by the movement or starting position / posture of the scapula . This may be due to; weakness in the muscle system. Poor movement of the scapula when the arm moves. Tightness in muscles attaching to the scapula. However if you have changes in scapular strength, posture or movement that DOESN’T mean you will have or get shoulder pain. The science tell us it’s not that clear cut.
Ok, so how can i tell if its part of the problem?
I think this is relatively simple to assess but does need a bit of detective work . The fairly straight forward thinking is that if you can change how the scapula moves or change it’s start position and that improves your shoulder pain then it’s odds on favourite the scapula is villain in the story. If no change to the pain is made then I’d be hunting for another culprit to sort out before addressing that joker, ( see what I did there ? ).
So am I wasting my time squeezing my shoulders down to my opposite hip ?
Yes, yes and probably yes would be my answer to that.
Activating the lower fibres of trapezius is one of the go to exercises for lovers of all things scapula, or more likely those that blindly prescribe the same exercises to everyone regardless of what is going on . This is one of those bits of research from (quite) a few years ago that has been taken out of context, misused, poorly and inappropriately applied to countless shoulder pain sufferers ( in any case I always thought this exercise was more an attempt to get people playing the bagpipes as the action was like squeezing the bag with your arm).
So If it’s not taking the pain away I suggest it’s pointless and there are more effective things to do. (In the meantime here are some bagpipes and flamethrowers.)
Ok Smarty pants what should i do if playing the bagpipes won't fix me ?
Well glad you asked again , you’re quite the inquisitive soul aren’t you. Here is the philosophy held by ourselves at Arana Hills Physiotherapy; Identify what activities are aggravating your shoulder and can we remove them or find a better way to do it. Are there any techniques we can use to put the “the fire” out so to speak.
Is it how the shoulder blade moves or the humerus. Is it a bit of both. Do we need to get you moving better?
Is it more to do with the health & fitness of the shoulder rather than how it moves. In other words is it strong enough for what you want it to do?
Can we change your pain by increasing the strength of the shoulder or the length of the muscles around the shoulder or scapula? The answers to these questions will let us know where we should start and where we should be looking to go with your shoulder. So in a nutshell By looking at these points we can devise the best , most effective long lasting solution for you and your shoulder. Some shoulders need the scapula addressed and some don’t . It’s just got to be relevant to you and your problem , not a one size fits all approach . Some need move better, some need more strength and some need a little bit of everything . More than likely this will not involve you playing the bagpipes at any point in your recovery.
Thanks for reading, if you have any shoulder issues feel free to contact us at the clinic for help.
hope you liked the bagpipes