4 truths about the shoulders

Interested in learning how to optimize USE of your shoulders? San Diego chiropractor, Dr. Travis, shares a story and demonstrates a few exercises to get you started. Read on and watch the videos.

a case of "bad" shoulder

Ella was 17 when she first came to me 3 years ago with shoulder pain. As we often do, I observed her hunched over her iPhone as she waited. Over the course of the past few years she has repetitively injured her shoulder.

Ella first came to us with bicipital tendonitis and weakness in several planes. Then it was a mild rotator cuff injury. Six months later she reported impingement on overhead activity.

rehab and prevention strategy

Each episode required pain management, rehab and then a re-injury prevention strategy. Our aim was to create long-term shoulder health and strength.

Due to pain, she was vigilant about her treatment and was mostly compliant during rehab. Once she was pain-free, regained full range of motion and strength, she went back to walking, sitting, and lifting with the same movement patterns that got her into this mess in the first place. 

Lesson Not Learned

However, she was not serious about the re-injury prevention strategy that followed.

Each time she would come in and say, "I did something again to that bad shoulder." 

Yet she didn’t originally have a sick shoulder that’s prone to injury. She HAD and continues to HAVE a movement and position problem that's causing the episodes.

a side effect of comfortable living

The comforts of our daily living create an interesting shoulder position and dynamic that is prominent in our youth. When I say "comforts of our daily living" this is what I mean: 

  1. As we sit and pour our attention over devices our upper back becomes hunched and the shoulder complex protracts forward.
  2. The muscles on our back become elongated and weak.
  3. Our bodies, being brilliantly efficient, will just glue us into this position, as it is the one we are in the most often.
  4. The problem lies in that this newly glued position is poorly adapted for an hour of circuit training,  competitive group classes, powerlifting, or long, repetitive movements—something as innocuous as painting your bathroom wall for example.
  5. We don't need to completely stop living comfortably and using devices. But there are ways to prevent injury despite our modern comforts.

the truths about the shoulders

The following 4 truths act as an overall guide from which we devised strategies to help Ella prevent re-injury. Each truth is accompanied with a demonstration on how to optimize shoulder movement. It is meant for anyone with a pain-free shoulder (regardless of age) interested in preventing injury or RE-INJURY.*

*Those with pain should be examined by a professional (sports chiropractor/physical therapist, or primary care physician).

Truth #1: Healthy shoulders need a strong anchor

Have you ever attempted pull-ups while keeping your body limp? Not so easy, is it? Every strong, mobile shoulder needs a strong base from which to anchor. So before doing any shoulder warm-up or going straight to intense training, we need to essentially turn-on the core first.

Here’s a good recipe for core strength and conditioning: Get into as many foot, hand, and hip positions as possible that challenge the core but allows you to breath well. Once you're breathing well in that position then we can play with movement. Eventually, if you can move well and breathe well, then we can start to load the shoulder with weight.

In our progression we are trying to relax the neck by rotating the head from side to side.

Core strength and conditioning exercise part 1/2.

Core strength & conditioning exercise part 2/2.

Truth #2: Shoulders love circles

Dr. Andreo Spina, one of the best chiropractors of our time, has been teaching this next approach to professional baseball players for years to prevent shoulder injuries and maximize performance.

Controlled Articular Rotations (CARs) is a mobility exercise meant to maximize the communication between the shoulder complex and the nervous system. The more information that we can send to the brain the more information (control) the brain can send back to the joint and surrounding structures.

The truth that shoulders love circles expands on the science behind the joint capsule. The joint capsule is loaded with sensory receptors that relay vital information and protect the shoulder from surpassing its mobility and movement limitations.

The shoulder, being the most mobile joint allows for a HUGE range of motion/rotation. Yet our daily living only requires us to use a small sample of this range. As the adage goes, "use it or lose it."

Controlled Articular Rotations (CARs)

Truth #3: Most people forget to train shoulders for power steering

So we’ve turned on our core, established a working range of motion, and now we are ready to start loading the shoulder. Yet in an ever-expanding database of exercises, where do we begin? We recommend starting with a drill that challenges your control or power-steering.

Bottoms-up kettlebell training will help us experience a principle called muscular irradiation. Irradiation refers to the ability of a muscle to generate more tension via the nervous system.

Taking a kettlebell and holding it bottoms-up instantly requires the muscles in the forearm, shoulder and core, to come online. The stimulus created by introducing instability (awkwardly holding & moving something heavy) will generate more and more control.

Power steering exercise: kettle bell bottom up.

Truth #4: Shoulders are often in poor positions without you knowing

Wherever the head goes, your shoulders are sure to follow. As we hunch over, the head moves forward, the mid-back curves and the shoulders round forward and in. That's what I call "funky posture." It takes a lot of energy to hold you in this position— so the body has adapted to lay down fascia to glue you in this position.

And what we know about glued-down position is that it cannot sustain your movement and it limits your mobility. Nothing screams "injury" better than a glued-down, immobile spine and weak shoulders.

Also the problem with funky posture is that it so aptly presents itself into daily locomotives like walking. How often have I caught myself browsing my emails while I am scurrying from this task to that.

The next 3 videos should help reverse this posture trend in two ways:

  1. Release tension on areas that are short and stiff
  2. Strengthen areas that are long and weak

Pec release mobility exercise.

Activating and strengthening exercise for the shoulders and back (part 1/2).

Activating and strengthening exercise for the shoulders and back (part 2/2).

What happened to Ella

Ella came back in recently. This time she was beaming. She finally had learned her lesson, was crushing her shoulder homework and had just beat her boyfriend in pull-ups. She wanted to know what other gems we might have up our sleeves...

Our goal is to have a lifetime of healthy shoulders by learning more through self-exploration, intuition and embodiment. Need a long-term strategy? Let's make you one.

Thank you and happy learning!

-Dr. Travis, Your Healthy Spine | San Diego Chiropractor

Ready to take better care of your shoulders? We can help you get out of pain, speed through rehab and prevent re-injury. Book a movement & mobility session with Dr.Travis today.