Hidden causes of shoulder pain revealed...
If you've ever suffered from a shoulder injury, you'll know how incredibly
frustrating it can be. Training your arms, shoulders, chest and back becomes
almost impossible without a certain amount of tightness or pain.
The causes of shoulder pain aren't always obvious. But the symptoms are.
You'll feel pain due to impingement when your arms are raised upwards
and outwards. In some cases, the pain takes on a "nagging" quality
and is often troublesome at night.
Causes of shoulder pain
According to some, exercises such as the overhead press and lat pulldown
performed behind the neck are the real causes of shoulder pain.
However, swimmer's shoulder (also called impingement syndrome)
— which is one of the most common causes of shoulder pain
— usually occurs when some kind of problem already exists in
the shoulder joint or shoulder girdle. It isn't the exercise that causes
the shoulder impingement. Rather, a pre-existing condition is made worse
by the exercise.
Movement at the shoulder involves several joints and at least 20 different
muscles. Because your shoulders have such a wide range of motion, they're
also very easy to injure. In general, a greater degree of joint mobility
means less joint stability.
One of the causes of shoulder pain is a faulty training program that
ignores one or more of the muscles in the shoulder girdle or shoulder
joint. Over time, some muscles become stronger than others. This upsets
the delicate balance between stability and mobility.
Swimmers with painful shoulders, for example, often have increased muscle
activity in the internal rotators of the upper arm. This is accompanied
by decreased activity in the teres minor, supraspinatus, and the upper
trapezius muscle. These imbalances make it more likely that you'll suffer
from some form of shoulder pain [2].
There are also anatomical variations that increase your risk of impingement
syndrome. The acromion process (the bony bit on the top of your shoulder)
is grouped into three types. Type I is relatively flat, type II is curved,
and type III is hooked. There seems to be an increased risk of shoulder
problems with type II and III acromions [1]. Roughly 1 in 10 people also
have an accessory bone known as the Os acromiale. The presence
of this bone increases the risk of shoulder problems.
Balance
Of course, the best way to avoid shoulder pain is to make sure your training
program includes exercises for all of the muscles that create movement
at the shoulder. Pressing exercises, for example, such as the bench press
or overhead press should be balanced with an equal number of rowing exercises.
Don't make the mistake of neglecting muscles in your back just because
you can't see them.
It's easy to ignore the first signs of shoulder problems in the belief
you can "work through" or "loosen up" the tightness
or pain. This is a mistake. When a shoulder injury is ignored, it quickly
becomes a source of long-term problems.
If you do choose to perform the barbell press or pulldown behind the
neck, your shoulders need a certain amount of flexibility. If you need
to tilt your head forward or point your elbows back (rather than towards
the floor), then your shoulders lack sufficient flexibility or strength.
One alternative is to use a dumbbell rather than a barbell or machine
for overhead pressing movements. Dumbbells allow complete freedom of movement
so you can perform movements in a groove that's right for you. The lat
pulldown can also be performed to the front, rather than behind the neck.
References
1. Nicholson, G.P., Goodman, D.A., Flatow, E.L., & Bigliani,
L.U. (1996). The acromion: morphologic condition and age-related
changes. A study of 420 scapulas. Journal
of Shoulder and Elbow Surgery, 5, 1-11
2. Ruwe, P.A., Pink, M., Jobe, F.W., Perry, J., & Scovazzo,
M.L. (1994). The normal and the painful shoulders during the breaststroke.
Electromyographic and cinematographic analysis of twelve muscles.
American
Journal of Sports Medicine, 22, 789-796
|