STRENGTHEN & MAINTAIN A HEALTY SHOULDER
The human body is made up of 650 muscles, out of which, the shoulder is made up of 30 tissues, five involved joints, tendons and six significant ligaments. These muscles are attached to the upper arm bone called the humerus, and the collarbone or clavicle, and the shoulder blade which is called the scapula. Since the shoulder is a vital part of the arm which we use for all manual activities, it is most susceptible to injuries and weaknesses. Most of the injuries are caused due to repetitive and intensive routines while accidental damage to the shoulder is also prevalent. Unlike diseases, there are specific ways to prevent and repair these injuries by exercising.
THE MAIN MOVING SHOULDER MUSCLES:
Provide a gross motor ability to move the human arm. The Shoulder connects & allows the Scapula (shoulder blade),Clavicle (collar bone), & Humerus (Upper arm bone) to work cohesively.
4 Rotator Cuff Muscles
1. The Deltoid contains 3 groups of muscles:
Anterior (front delts), Lateral/Medial (side delts), and Posterior Deltoid (rear delts).
- Anterior Delts: Muscle helps move arm toward clavicle and toward sky (Flexion,Medial Rotation).
- Lateral Delts: With your arm fixed at side of your body, lateral deltoids help pick the arm straight up from your side to the sky.
- Posterior Delts:
Located beneath shoulder blade (Scapula), attaches to top of arm bone (humerus).
- Stabilizes shoulder joint
- Helps rotate arm out (externally)
3. Teres Minor:
Attaches from outer side of shoulder blade (later scapular border), to the top of your arm bone (proximal humerus.
- Helps rotate arm in shoulder socket outward (externally).
Located at the top of your shoulder blade, beneath the medial deltoid muscle.
- Aids medial deltoid to pick arm straight-up from side (Abduction).
4 AMAZING SHOULDER EXERCISES
There are variations of shoulder muscle exercises depending on your goals to strengthen the muscles, exercise the rotator cuffs, or work out for bodybuilding; some of the practices that you can focus on are:
Can be done seated or standing with dumbells or barbells. It emphasizes the front and lateral and posterior delt. The standing overhead press puts more emphasis on the core musculature and serratus anterior.
Emphasis on the lateral deltoids with a little involvement of the other two heads and upper traps.
Reverse Pec Deck
This exercise is essential for the development of the rear delts as they are the base of a shoulder and long-term shoulder health. It emphasizes on the posterior deltoids and involves various secondary muscles.
Lying Face Pulls
This variation is similar to the traditional standing face pull, but it lessens the involvement of the upper traps so you can focus on the rear delts.
COMMON SHOULDER INJURIES:
ROTATOR CUFF TEAR
Most shoulder injuries involve the ligaments, muscles, cartilage, and tendons. Because of repetitive and intensive routines, shoulder pain can develop over time. Manual workers and athletes are especially susceptible to issues involving shoulder blade pain or shoulder joint pain. When the shoulder muscles are not flexible and robust enough, it creates a faint pain that eventually affects the rotator cuff when it is left untreated for long.
ROTATOR CUFF TENDINITIS
Both young and old people can feel these symptoms. The pain is dull at first, and most people do not seek early treatment. The pain is usually noticeable only when it causes stiffness and difficulty in raising the arm or sudden pain during resting or while performing an activity. There is a sharp pain that radiates towards the division on the front shoulder when moving the arm. It also disrupts sleep and weakens the arm.
DISLOCATED SHOULDER / SHOULDER INSTABILITY
Since the shoulder is the most frequently used part of the body, the shoulder joint is most susceptible to dislocation, and about 25% of shoulder dislocations have associated fractures, and recurring disruptions could be an indication for surgery to repair or tighten torn tissues. Loose collagen fibers then cause the shoulder instability in the elderly patients.
Occuring when the head of the humerus is removed forcibly from the socket. There are two types of shoulder dislocation: anterior and posterior, depending on the direction where the humeral head is moved. Other types of shoulder dislocation are dislocation below the joint (luxatio erecta) and the situation where the humeral head is stuck between the ribs ( intrathoracic).
Anterior dislocation can happen when force is applied to a bent elbow pushed backward. Activities like throwing a ball and hitting a volley ball, are some of the positions that could cause anterior dislocations and are most common among young adults. Posterior dislocations are uncommon and usually associated with specific injuries like a seizure and electrical injuries.
A slap (Superior Labral Anterior to Posterior) tear is a torn piece of cartilage in the inner portion of the shoulder joint that limits overhead movement. It can be, and it occurs due to repetitive motions, acute trauma or age.
FROZEN SHOULDER (ADHESIVE CAPSULITIS)
This is characterised by shoulder pain, decreased range of motion and stiffness. About 20% of adults aged between 40 to 60 and people with diabetes are affected by frozen shoulder. When the ligaments that surround the shoulder joints get inflamed or thickens, it causes pain and limit movements causing scar tissue over time.
It is caused when the cartilage between the bones break down and rubs together, causing stiffness and pain while moving. Osteoarthritis can happen to any parts of the joints and is most common in the elderly population.
- Stretching: Required to give freedom of movement to the: Scapula, Trunk, Pelvis, Clavicle and Humerus.
- Core stability- A strong shoulder needs a strong foundation. If the spine is not stable while performing overhead activities, extra loading could strain the shoulder joint & back.
- Rotator Cuff Strength and Control- The shoulder should be moved through proper form, throughout overhead movement, so that the scapula is in a right position for effective control.
- Overall muscle strength: Athletes and fitness enthusiasts often overlook the total power of the body, and focus only on the shoulders. When the general muscle strength is not even in the rest of the body, especially the back and the chest, it often hinders the performance of the shoulder.
- Balanced upper body workouts
- Limit range of movement- Avoid range where the shoulder joint (sub-acromial space) is too compressed
- Correct positioning while exercising the scapula
- Plyometric- Exercises to give the hang of the movement and the strength required to perform certain sports
TREATING SHOULDER INJURY
Compression surgery for shoulder impingement
This procedure relieves the pressure caused on the soft tissue when the bones pinch the rotator tendons during shoulder movements.
Open surgery is recommended for people with large or complicated rotator tears and for people who need reconstruction procedures
Rotator Cuff Injections
Doctors recommend steroid or Platelet Rich Plasma (PRP) Injection for healing injured tendons. These injections do not improve healing but control the pain for patient’s comfort.
Rotator Cuff Tear
Experts do not recommend for people suffering from rotator cuff and shoulder stiffness. The stiffness should be treated first before surgery.
The three common types of rotator tear are:
- Open repair surgery
- Mini open repair surgery
- Arthroscopic repair
Proximal humerus fracture
Nonsurgical treatments are immobilization, pain control, range of motion exercises and Physical/Occupational Therapy.
Doctors recommend surgical procedures for dislocated fractures, open fractures, displaced fractures and humeral head-split fractures, injuries around the blood vessels and nerves
Using a shoulder immobilizer, taking pain medication, and regularly putting an ice pack in the area are some non-surgical treatment protocols.
Patients need surgical procedure when there is an angular deformity, anatomical displacement or when the glenoid socket is fractured.
Usually, this doesn’t require surgery, but when the bones are displaced that may be different.
Surgery for a clavicle fracture, is a controversial procedure as it involves plate fixation (or intramedullary fixation), where hardware is used to fix it. Patients often opt for removal of the equipment, as it sometimes causes discomfort.
In all cases, doctor-patient consultation is critical.