The shoulder is one of the biggest and most complex joints in the body. It’s actually three joints—the AC or acromioclavicular joint (the collar bone/acromion of the shoulder blade joint), the glenohumeral joint (the ball-and-socket joint), and the scapulothoracic joint (the shoulder blade/rib cage “joint”)—all of which involve the scapula to some degree.
The rotator cuff consists of four muscles, three of which sit on the back of the scapula and rotate the outer arm (external rotation) and one which rotates it inward (internal rotation.) The trapezius muscle is made up of three parts: the upper part pulls the shoulder blade up and in, the middle portion pulls the shoulder inward, and the lower section of the muscle pulls the scapula down and inward. The chest muscles rotate the arms inward. There is also a “bursa” or a fluid-filled sac that cushions, lubricates, and protects the rotator cuff tendon attachments. The “labrum” attaches to the rim of the “socket” or cup, to give it more depth and stability for the ball to sit in.
Since this structure allows the shoulder a wide range of motion, it also makes it less stable and more vulnerable to damage. There are many injuries that can affect the shoulder, with one of the most common being tearing of the rotator cuff tendons (called “tendinitis” or “tendinopathies”), which often lead to a bursitis, or swelling of the bursa sac, resulting in shoulder impingement (pain raising the arm). In fact, over half of people in their 80s have tearing of the rotator cuff.
There are several activities that aim to recover the function of the shoulder in both non-surgical and post-surgical situations. Exercises are intended to improve balance, reinforce weak muscles and support the shoulder. However, findings suggest that the best outcomes are obtained when stabilising scapula movements are used in the treatment phase.
One GREAT exercise for stabilising the scapulae is called the Push-Up Plus (PUP). This is performed by positioning yourself into a push-up position (either toes or knees—you choose based on strength) with your hands shoulder width apart, elbows locked straight, and the fingers pointed outward (thumbs at 12 o’clock). Instead of dropping the chest to the floor, PUSH the middle of the back upward toward the ceiling. Hold the position for three seconds and SLOWLY return to the start position. Repeat five to ten times and gradually increase reps as you’re able.
There are a range of variants to this. For example, turning the fingers inward increases the operation of the rotator cuff muscles (the most important muscle group for shoulder stabilisation) and decreases the action of the chest muscles (pectoralis major) and scapula elevators (levator scapula). You can also alter this by raising your feet to different heights, as the higher the feet, the greater the serratus anterior muscle activity!
We can inform you on which shoulder stabilisation exercises might be most helpful to your particular situation. If you would like to seek treatment for a range of services, book online here www.cramosteopaths.co.uk/book-online/ and we look forward to seeing you!