Shoulder Stabilizing and Stretching Exercises
Many shoulder problems can be prevented and treated with shoulder exercises.
Rotator cuff strengthening exercises help prevent shoulder impingement and rotator cuff injury. Strengthening exercises for the muscles that control the shoulder blade is also important, as the shoulder blade (scapula) helps the rotator cuff to dynamically stabilize the shoulder. Stretching exercises for the neck, shoulders, and upper back help relieve shoulder pain caused by poor posture.
The Importance of Strengthening the Rotator Cuff
Many muscles are involved in shoulder movement and all work together, but strengthening the rotator cuff is especially important. The rotator cuff is the main stabilizer of the shoulder joint during movement of the shoulder.
If the ball of the upper arm is not kept centered, abnormal stress is placed on surrounding tissue and may cause gradual injury. Strengthening the rotator cuff helps prevents common rotator cuff injuries including tendonitis, rotator cuff tears, and shoulder impingement syndrome.
Age-related changes in rotator cuff tendons leave them less elastic and more susceptible to injury. There is also a gradual loss of muscle mass that occurs with aging, which can be counteracted with strengthening exercises.
Rotator Cuff Muscles
The supraspinatus is located at the top of the shoulder and abducts the shoulder – it raises the upper arm and moves it away from the body.
The subscapularis is at the front of the shoulder – it internally rotates the shoulder.
The infraspinatus and teres minor are in the back of the shoulder – they externally rotate the shoulder.
Though each rotator cuff muscle moves the shoulder in a separate direction, though they all work together to stabilize the shoulder joint.
Strengthening all the muscles of the rotator cuff is important. The two small external rotator cuff muscles are often weaker than the larger internal rotator cuff muscle.
The rotator cuff muscle involved abduction (the supraspinatus) is the most commonly injured of the cuff muscles due to its position between two bones, which often squeeze this tendon during overhead movement.
Other Shoulder Stabilizers
The scapula (shoulder blade) helps the rotator cuff to stabilize the shoulder joint while in motion. The rotator cuff muscles arise from the scapula and attach to the head of the upper arm bone. If the shoulder blade is not stable, undue pressure may be placed on the rotator cuff. Strengthening the muscles that support the scapula is important.
The bicep tendon that runs over the top of the humerus and connects at the top of the shoulder joint also helps stabilize the shoulder joint. Overloading the biceps by lifting something heavy may cause biceps tendonitis (also called shoulder tendonitis). Strengthening the biceps helps prevent injury.
Exercise after Shoulder Injury
How long should the shoulder be rested?
The amount of time to rest an injured shoulder before starting rehabilitative exercises depends upon how quickly one heals, and the type and severity of the injury. A physician or physical therapist can provide guidance. Strengthening exercises done too soon may cause further damage. If the shoulder is not used enough, shoulder muscles weaken and strengthening exercises are an important part of rehabilitation. Stretching Exercises increase the range of motion of the shoulder. Stretching exercises can help prevent frozen shoulder from occurring after an injury that causes one to limit shoulder motion due to pain. Stretching exercises are often started after a couple of days of rest. Always consult a physician before starting exercises.
Warm up. Warming up with five minutes of aerobic exercise prepares the body for exercise by increasing heart rate and breathing rate, and increasing blood flow to the muscles, and raising body temperature. Warming muscles and tendons improve range of motion and decrease the risk of injury.
Build up Strength Slowly.
Be Patient. Doing too much too soon can cause overuse injuries. Strengthening a group of muscles should only be done every second day to give the muscles a chance to heal, unless otherwise instructed by a physician or physical therapist. Strengthening exercises load the muscles slightly beyond their limits and cause microscopic tears. If given a proper chance to heal, muscles become stronger. If not given a chance to heal, chronic inflammation and problems may develop.
If you do not have shoulder problems, you should use enough weight/resistance to feel mildly fatigued by the end of ten to twelve repetitions (a set). If you feel fatigued after just a few repetitions, decrease the difficulty of the exercise by lowering resistance (e.g. use lighter weights or no weights). If you do not feel fatigued after a set, increase the difficulty of the exercise by increasing resistance. Over time, add an extra set, resting about 30 – 60 seconds between sets. However, this does not apply to every situation.
People with weakness in the muscles that control motion of the shoulder and shoulder blade (e.g. those who have been unable to do regular activities due to a shoulder injury) should begin with higher repetitions (usually about twenty reps) using very low weights or resistance. Using heavier weights could result in injury.
If you have not exercised in a long time, start out conservatively in order to prevent injury. Also, do not exercise the rotator cuff muscles to complete fatigue as they are relatively small muscles and easily injured.
In exercises where the arms are straight, do not “lock” the elbows. Your elbows should be slightly bent. This makes the muscles work harder to increase the effectiveness of the exercise. Locking a joint while exercising also increases the chances of injuring the joint.
Move slowly and smoothly. Do not jerk. Move slowly and steadily to use the muscles, not momentum, to complete the exercises. For exercises involving lifting or pulling, take three seconds to lift or pull, hold for one second, and take three seconds to lower or return.
Breathe: Remember to breathe normally while exercising. Holding the breath during strengthening exercises causes blood pressure to rise. When lifting the arm, exhale; when lowering the arm inhale.
Proper Posture: As when standing or sitting, the shoulders blades should be kept back and down during exercise. (Slouching decreases the space the rotator cuff passes through and puts undue stress on the shoulder joint)
Warm muscles are more flexible than cold muscles. Warming up with five minutes of aerobics, such as walking around the block or riding a stationary bike, increases blood flow to the muscles and tendons and decreases the chance of injury.
A warm shower or bath also warms up muscles and prepares them for stretching exercises.
Stretch Gently. Avoid bouncing. Stretch until you feel a tug. Hold a stretch for about 30 seconds. Do not stretch to the point of pain. Over-stretching can tear muscles.
Breathe: Do not hold your breath during exercise. Breathe normally during stretching exercises.
Dumbbells (handheld weights) or resistance bands are often used to provide resistance in strengthening exercises. Handheld weights come in a series of weights, making it easy to gradually increase difficulty of exercises. Resistance bands provide resistance when stretched. Resistance bands come in a variety of thickness levels to provide different levels of resistance and are usually color-coded. Resistance bands are attached to a doorknob or other immovable object. When using resistance bands, increasing the distance you stand from the wall increases the resistance.