DO YOU OWN YOUR SHOULDERS? (And Where Are They Supposed To Be?)
When you think about your shoulders, what is the first thing you picture in your mind? Obviously you know where they are situated as part of your body, but how deeply do you really understand the components? Do you picture the ”ball-and-socket” and that’s it, or do you include your sternum, clavicle, scapula, and ribs in your definition? Regardless of where you fall in this continuum of shoulder understanding, this post is for you.
The shoulder is the most complicated, unstable, and vulnerable joint in the body, so its no surprise that it is misunderstood and commonly injured. Yet such a large number of well-meaning instructors and students tend to “breeze by” dedicating time to understand it more fully, and repeat simplified cues such as “down and back” (not always wrong – more on that later) in an attempt to “save” shoulders instead of addressing the specific dysfunctions and training necessary to correct them. I tend to see so many people “shrugging off” their “bad shoulder” (pun intended!) as something that they have resigned themselves to, like a genetic disorder. My intention is to shed a bit more light on this important structure and briefly describe proper placement in a way that can be applied to any activity: whether you’re the casual gym-goer, competitive athlete, aerialist, climber, or yogi. With this better understanding, you can expect to begin the process of not only increasing the longevity of your shoulders, but also their function and mobility; ultimately leading to improved performance in any of your physical endeavors.
I’m not going to go too into detail about anatomy, physiology, and pathology here, instead saving that for in-person workshops where I can demonstrate more thoroughly, and give more visual, personalized, manual cues on shoulder function. However, I feel it is important to briefly describe the general components as a reference, especially if you are a current or potential student.
Your shoulder is much more than just a single “joint”, and is understood correctly as a “shoulder complex”, or “shoulder girdle”. This includes the articulations between your sternum, clavicle, scapula, ribs, and humerus, and actually comprises FOUR joints: Sternoclavicular, scapulothoracic, acromioclavicular, and glenohumeral. These joint structures and functions between them are ultimately what determines your shoulder function, and that’s pretty daunting information!
The huge amount of subtle differences between these structures and how they interact (also determined by the individual state of your connective tissue) is so incredibly nuanced. Even further, the function of your shoulder is also intrinsically tied to the function of your spine, hips, and much more. It not only takes a considerable amount of time and education to even begin to master this information, but it is also highly difficult to apply the knowledge to your own body, let alone the bodies of others. The responsibility of trainers and instructors to amass this knowledge and reduce potential for injury is vastly unrecognized, and a respect for, and commitment to knowledge of this responsibility is necessary. Yes, we have physiotherapists, orthopedists, chiropractors etc. that are responsible for this high level of understanding and care, but wouldn’t it be great if, through the process of developing our own understanding as instructors and students, we required less acute care, and/or made their jobs a bit easier by allowing them to use their in-depth knowledge to address the complex, specific issues they are capable of tackling, instead of spot-treating and having to do the job of generally educating their patients? Adjustments and body work, at that level, would be much easier to maintain and integrate, and ultimately would cost you less money, too! Ultimately, I’m advocating embodiment!
The tendency of focusing on the larger mover muscles on the outermost parts of our shoulder structure that you can “see” (traps, lats, delts, biceps etc.), and relying on developing them too heavily is harmful. Neglecting the smaller, “fine-tuning” muscles of rotator cuff (there’s four of them! Subscapularis, Supraspinatus, Supraspinatus, and Teres Minor), or the serratus, intercostals, levators etc. eventually renders them ineffective, and extremely vulnerable to injury. The biggest issue that I see is that in an unconscious attempt to foster stability in the joint, the scapula becomes “stuck” to the ribcage, and, as a result, cannot move freely along the ribcage as it is designed to do: elevate, depress, protract, retract and rotate upwards and downwards, placing too much stress on the other components of the shoulder complex. Yet another common problem is lack of mobility around the clavicle: if you are one of the many people who have had it pounded in their head that “good posture” means “shoulders down and back”, your clavicle is most likely also “stuck”. The mechanism of this “stuck”-ness is another topic entirely, but put those two problems together, and you have a recipe for shoulder disaster! It’s like trying to operate a bicycle with one wheel unable to turn and unattached by the chain to the rest of the structure.
That being said, I want to make it clear that there is no “one size fits all approach” to understanding and mastering shoulder function. Therein lies the error of the “down and back” cue: it doesn’t apply to everyone, but it does apply to some! Mindlessly doing “theraband exercises” could help someone to a certain degree, but it is the mindful application of mobility work and targeted strengthening exercises that will be most beneficial, and that requires a certain degree of understanding of the joint, where you are at, and where you are trying to go.
Even if you think you have good shoulder mobility, the hard truth is most of us are horribly wrong about it. If you have flexibility in a certain direction you could have simply stretched a certain muscle or group of muscles so much that it is now less effective at contracting, and could also possibly be inhibiting opposing groups. This means that the joint complex is not functioning correctly as a whole, and will eventually cause problems somewhere along the way. The importance of having an educated, experienced professional that can work with you on the journey of pinpointing your areas that need work cannot be stressed enough.
Change is hard, more for some than others. But, if you have shoulder pain or dysfunction, you DO have to do something about it – nobody else can make it go away entirely! Making changes to your body is not an external experience like taking a pill, it is entirely up to you to make your treatment work. This is clearly a much larger psychological and social issue than shoulders or bodies, but personal responsibility is ultimately key. This means: if you go to a good chiropractor, body worker, instructor, etc., they will urge you to take their cues – and you should. If it is uncomfortable to put into action what they are recommending, then that adjustment is probably the best thing for you, even if it its hard or uncomfortable. Keep in mind the difference between discomfort and pain here – and (disclaimer) always follow the advice of your doctors.
These two following photos are great examples of the points I have made thus far. The first photo illustrates how an immobile scapula can cause impingement and pain with overhead motion. The second photo is a good example of the dysfunctional rotational patterns that develop as a result of our lifestyles, and illustrates the relationship between spine, hips, and more with shoulder issues.
Shoulder work requires you to “work smarter, not harder”, in every aspect of your life that uses them. Consider as well how your lifestyle conditions your body in specific ways to perform what it’s repeatedly asked to do. Don’t blame a “different” activity for causing you pain, blame the activity you repeatedly do that contradicts it. Sit in a chair, or in front of a computer often? Ever hang out in a mindless position with your nose in a phone or book? It shouldn’t be a surprise that your body doesn’t like holding a plank or hanging from a bar! That doesn’t mean that you need to adjust for doing that activity entirely because you suddenly deem it “bad for you”, it means you need to be doing MORE of that activity, in a safe, productive, properly progressed manner, and increasing the amount of, and mindfulness in, the movement you perform in your daily life. This will improve your quality of life and performance in whatever it is you enjoy doing!
If you are experiencing pain in your shoulders or any other area of your body, your first action should always be to see a doctor. However, if you are interested in learning more about your specific shoulder function or want to learn more, be sure to look out for the “Shoulder Health & Longevity Workshop” at The Aerial Lab. You can also contact Krista Yazzolino directly for private movement consultations and more at firstname.lastname@example.org or 530-444-0717.