Friday, January 7, 2011

Injury Limits to Fat Loss: The Shoulder (Part 1)

When it comes to training, nothing can derail you faster than a nagging injury. In the past, I have reviewed low back pain as a major limit when it comes to exercise, and I have also reviewed anterior pelvic tilt as a postural limit to exercise. In fact, those are among my most read entries of all time! So, I've decided to continue the trend of discussing posture and injury in hopes that you stay healthy and can keep on training.

Today, I want to touch on shoulder pain, a common complaint among people just getting into a training program.

In Part 1, I am going to discuss what I believe is the most common cause of insidious-onset shoulder pain (pain that just starts, seemingly for no reason). This post is not meant to be an all-encompassing discussion of shoulder pathology. So, if you had a traumatic injury of some sort, this entry probably isn't for you.

When analyzing shoulder anatomy and movement, you'll realize any number of things. It is fairly obvious that the shoulder joint is a ball and socket joint. Any movements of your arm involve the head of the humerus (upper arm bone) rolling and sliding along the glenoid fossa (the socket) of the scapula (shoulder blade, that triangular shaped bone). What is less obvious to people is the role of this scapula in arm movements.

When you lift your arm completely overhead, only about 120 degrees of that range of motion come from the humerus. The other 60 degrees are supposed to come from upward rotation of the scapula. How the humerus and scapula work together (and the timing of it all) to bring your arm overhead (or move it anywhere really) is referred to as scapulohumeral rhythm.

Can you guess what happens when scapulohumeral rhythm is thrown off? That's right... it hurts!!! But not necessarily right away. Sometimes it takes days, weeks, or even months for shoulder pain to present itself after the natural mechanics of your shoulder are thrown off.

Why does it take so long? Well, think about it this way. If the wheel alignment of your car is out of whack... do the tires wear down in a day? No! It takes miles and miles of driving for them to present the wear pattern. The same happens at your shoulder. Repetitive movements at suboptimal alignments are a major cause of shoulder pain. If the scapulohumeral rhythm is thrown off, your muscles get worn down little by little until you experience symptoms. However, the symptoms simply tell you that there has been a problem for a long time! So, if one day you all of a sudden present with shoulder pain, it probably isn't a new problem... just an old one manifesting itself for the first time!

If pain is the symptom... then what is the cause? Is it the abnormal scapulohumeral rhythm? Actually, that is likely also a symptom! Treating symptoms is the last thing you ever want to do, so we have to delve deeper to figure out what exactly is causing the problem before we come up with a solution. Let's take a step back then... What causes abnormal rhythm?

Unfortunately, a lot can mess that rhythm... The most important to discuss, at least to me, are postural malalignments and muscle imbalances, which will be covered in Part 2. Also in Part 2, I'll discuss exactly what you can do during your warmups and during your workouts to prevent or correct these problems.

Stay tuned.

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