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Healthy Shoulders: The Shoulder as a Complex for Injury Prevention and Maximum Performance Output

By: Ingo Zirpins, MSPT


Why do your shoulders hurt every time you reach overhead?  Why are you not getting stronger in your shoulders, despite working out a lot?  Maybe it is time to understand and train your shoulder as a complex unit to help you prevent repetitive injuries and allow tolerance to higher performance demands.


An anatomist might define the shoulder as a synovial ball-and-socket joint and functionally terming it a diarthrosis and multiaxial joint. As a physical therapist, I go further and honor the design of the shoulder complex as one of the most intricate, functionally multi-dimensional, and astoninglishly adaptable joint complexes of the human body. Modern technological advances have gone far in the ongoing desire to design systems that are  comparable to biological designs. Despite, current advancements are still far from what our biological make-up afforded us in terms of longevity, durability, regenerative ability, and adaptability.


The shoulder girdle is the most mobile joint complex in the human body. Its movement is not only coming from the connection between your arm and the shoulder blade, but also supported by a combination of numerous smaller joints, such as the articulations of the collarbone to your sternum, the collarbone to your shoulder blade, and the shoulder blade on the ribcage. All these articulations combined  allow you to move your arm in any direction you desire, which is unlike any other joint complex within your body.


However, mobility comes at a cost of stability. In order to afford such motion, all joint connections need to be open and unconfined. This demands stability from secondary structures, like the shoulder labrum, the joint capsules, ligaments, discs, and muscles and tendons for support. These structures are designed to maintain alignment of the shoulder within its joint perimeters, while being tasked to uphold significant torque forces.


Have you ever wondered how these circus artists hang from their shoulders while performing gravity defying acts?


In order to be able to accomplish such tasks, athletes need to assure that all elements of the shoulder complex are flexible and supported in strength. This requires due diligence in regular mobility training, as well as in directed workout programs that train the shoulder complex from the ground up.


Any load on the shoulder complex, whether it is lifting the arm overhead, or hanging horizontally off a streetlight in downtown Grass Valley, requires a synergetic collaboration between all joint articulations and muscles around the shoulder. The power-lifter in your shoulder, the deltoid, cannot lift anything unless your shoulder blade is held tightly to the rib cage, and your shoulder joint is held solidly in its socket by the rotator cuff.


The dysfunctions of these more subtle parts of the shoulder complex are often considered the cause why many athletes, or common folks, might find themselves having chronic shoulder problems.


There are many reasons why that could happen. You might have had an injury or slight trauma to your shoulder and, in the process of healing, never fully regained full function or mobility. This can result  in long-term compensatory patterns, which, after some time, could lead to secondary conditions such as chronic impingement syndromes, spontaneous rotator cuff tears, or instability syndromes.


Proper guidance and training in mobility, motor control, and strength, can assist in reducing pain, restoring function, maximizing output, and protecting you from injury now, and in the future.


If  you have regular shoulder pains,  or if you have tried to improve your strength in your shoulders for a long time without success, I highly encourage you to consult with your physical therapist, to assess the overall functionality and mobility of your shoulder complex. There is a good chance that some aspect of that amazing design is not fully participating and, therefore, limiting your maximum potential.


Come visit our brief workshop If you would like to learn more about the shoulder in relation to the athletic environment as well as in your daily life needs. Move better, live better!

In the Union: Healthy Shoulders 9/17/2018

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