Addressing Shoulder Pain (Part 1)
Lately, I’ve had so many complaints from students about shoulder aches and pains. So over the course of the next few weeks, I'm going to examine the most recurring shoulder issues I see with my students, why these issue can lead to pain and injury in the shoulders, share some ideas as to how we can prevent pain and also share some tips on how we can modify our yoga practice to accommodate injuries to the shoulder area.
Shoulder Anatomy 101
Did you know that what we think of as our “shoulders” is actually made up of 3 bones and 4 different joints? Together, these bones and joints are called the shoulder girdle or shoulder joint complex. The shoulder girdle is made up of:
- the scapula: a.k.a the shoulder blade – which is also the bone that provides the shoulder socket
- the humerus: a.k.a the upper arm – the part we typically think of as the round part of our shoulder
- the clavicle: a.k.a the collarbone - the part that transfers weight from our arms to the rest of our body
You can see in the animated image above how the three bones connect to each other. The scapula lies on top of the ribs in the back and the clavicle connects to the sternum (a.k.a breastbone) in the front. When we are at rest in an upright position (sitting or standing), the shoulder blades should lie snugly on the back ribs, the upper arms should connect snugly in the shoulder sockets and the shoulders should line up with the ear canals and the hips (see image below).
Why the Pain?
One of the reasons we develop pain in our shoulders (and neck) can be our tendency to have rounded shoulders. Rounded shoulders is when the scapulae rest more forward on the ribcage and are often tilted forward as well, causing the clavicles to also be more forward and tilted. The humerus bones (upper arms) turn inwards towards the body, and very often, the head and neck stick forward. Sometimes the shoulders are also scrunched up towards the ears. We tend to hold this position a lot when we are looking at our phones and computers but ESPECIALLY in the winter when we are bracing ourselves from the cold. We also tend to take this position when we feel vulnerable or down in some way; it’s our body’s way of instinctually protecting our vital organs – the heart and lungs. Cyclists, breast-feeding mothers, body-builders who work their chest more than their back, drivers, and large-breasted women are also likely to develop rounded shoulders.
So why do we get pain from this position? Well, when our shoulders are out of alignment, all the muscles that attach to our shoulders are out of alignment as well. There are 17 muscles that attach to each scapula alone! Many of the muscles of the shoulder joint complex pass through the narrow space under the collarbone. A large nerve bundle also passes through this area as do many blood vessels. Because of the number of muscles in the area, there are lots of bursae - little fluid filled cushions – in the area as well. When the shoulders are misaligned, it’s very easy for these structures to get compressed, inflamed, overworked or chronically shortened. It’s also harder for the muscles that keep the arm bone in place (the rotator cuff muscles) to do their job and it's harder for the collarbone to efficiently transfer weight from our arms to the rest of our body.
What Can We Do?
So how do we reshape our shoulders so that they are in optimal alignment? The key is in lengthening muscles in the front of the body, strengthening muscles in the back of the body and making sure the whole area has a healthy range of mobility. Stay tuned for the next post, where I'll recommend some specific ways in which to restore rounded shoulders to their optimal alignmet and reduce the occurance of aches and pains.