February 15, 2006
Exercises for a healthy shoulder girdle
As mentioned in the December column, the shoulder joint is very mobile, but inherently unstable.
Relatively small ligaments, with very little bony connection, hold the entire shoulder girdle against the ribcage. It is important to maintain the strength and flexibility of the muscles, tendons and ligament of the neck, back, trunk and shoulder girdle.
This column will go through several exercises designed to improve the stability of the shoulder by maintaining proper alignment of the shoulder girdle. If you have ever dislocated your shoulder, do not attempt these exercises unless you have been seen by a physical therapist! This is especially important for anyone who has dislocated a shoulder in the past 5-6 months, or had a dislocation of the same shoulder more than once. Shoulder dislocations can leave the gleno-humeral joint with chronic instability, which can cause impingement problems when stretches are attempted. In addition, chronic laxity of the shoulder joint can allow the joint to dislocate when overstretched.
These stretches are safe for those who have not had any history of shoulder dislocation or subluxation (a partial dislocation that reduces by itself). As always, be smart when stretching, listen to your body and pay attention when it tells you to stop. Discomfort is OK, pain (greater than a “4” on a 0-10 scale) is a sign to back off or stop. Hold each stretch at least 6 deep, slow breaths. If you take short, shallow breaths, be sure to hold the stretch at least 30 seconds.
1. Lay on your back, hands clasped
behind your head. Lengthen your neck, flatten your back and stretch your elbows
toward the ceiling. Keeping some space in your shoulder joints, allow your elbows
to move out toward the floor. Keep your shoulders moving down away from your
ears, and the shoulder blades flat on the floor. Once you are relaxed with your
elbows on the floor, slowly move your hands out, straightening your elbows until
your arms are straight out from your shoulders. Keep lengthening your arms to
release the muscles in your chest. (For those of you who are looking for more
release, try rolling up a towel and laying with your spine along the roll –
GREAT STRETCH!).
2. For those of you with some chronic
stiffness in the shoulder joint, try sliding your hand (palm up) along a tabletop.
Sitting on a rolling stool or chair will allow you to more fully relax the muscles in the
shoulder and get a better stretch. If you have full range of motion in your shoulder,
and are not getting much of a stretch when sitting, try standing with your knees
straight, hands on top of the table and your hips at a 90-degree angle. Press your
chest toward the floor gently, until you feel a pull in your shoulder, back or legs.
Everything is connected, so you may feel a pull in more than one spot! This is a
good thing… Be sure to move out of this stretch slowly.
3. With your back and neck aligned
and relaxed, clasp your hands behind your back. Slide your shoulder blades along
your ribcage, bringing your shoulders back and down. Straighten your elbows, and
reach your hands toward the floor. Breathe deeply into your chest, or wherever you
feel the stretch the most. You do not have to lift your hands to get a good
stretch.
4. With your back and neck aligned
and relaxed, reach up with your left hand, then reach behind your head, trying to
touch the middle of your back. Gently grasp the left elbow with your right hand.
Press your left shoulder blade down toward your hip, and push your elbow toward
the ceiling. Your right hand is there to keep your left elbow up by your ear, and
prevent it from flying out to the side when the shoulder muscles are stretched.
5. Strengthening the muscles in the
back of the shoulder blade is important. Holding a 3-5 pound weight in each hand,
lay on your stomach with a towel folded up or rolled to allow for some breathing
room. Bend your elbows, squeezing your shoulder blades together. If you
can’t move your shoulder blades because your muscles are too tight, do the
first four stretches every day for a week, then try this one again. If it is too hard with
the weights, try it without any weight. Your arms can weigh up to 15 pound each,
depending on how much muscle you have.
6. This one may be familiar to you
– it is also a terrific neck release. The brachial plexus (remember what that
is?) runs through the muscles in the side of your neck. Keeping these muscles
loose is important for the health of all the muscles in the arm innervated by the
brachial plexus. With your back and neck aligned and relaxed, hold on to your
chair, or just reach down to the floor. Feel your shoulder moving down away from
your ear. Slowly let your head tip away from the side you are stretching. Tuck your
chin slightly. BREATHE into the stretch. Hold this one as long as you can. There is
no such thing as stretching these muscles too long. They work hard all day, and
need a LOT of TLC.7. To strengthen your rotator cuff, lay on your back with a 3-4 p ound weight in your hand. Position your elbow straight out from your shoulder, with the elbow at 90 degrees (so your hand is up in the air, pointed at the ceiling). SLOWLY let your hand move toward the floor, getting as close as you can to touching the floor. Once it is on the floor, slowly raise it back to the starting position then continue on to the floor on the other side of your elbow. Keep your elbow aligned with your shoulder and your wrist straight. DO NOT use a heavier weight than 5 pounds! You do not want to bulk up the rotator cuff muscles, as there is no extra space for the extra muscle tissue. Toning with low weights and high reps is the better option.
Have some fun. Get loose and limber! If you have any questions, feel free to call for an appointment to see a Physical Therapist. We are happy to answer your questions, and perhaps show you some other exercises specific to your needs.
Quyana caknek.