828.252.0920 • 862 Merrimon Avenue Asheville, NC 28804 [email protected]

Ouch! It’s the dreaded pain you experience while reaching for an overhead object that seems to come about for no particular reason. There was no fall or traumatic incident, so why does your shoulder hurt? Why does this happen and how can you prevent it? What do you do when it starts?

Shoulder impingement is a very common dysfunction that will affect many active and older adults. It is one of the most common non-traumatic injuries to the shoulder, and can be a very nagging and painful condition. Some of the factors involved in shoulder impingement can be a result of your genetics, other times it can be a result of poor movement habits and posture. To understand how this works, let’s talk about the anatomy of your shoulder.

The top portion of the shoulder joint is comprised of the area where the top of your shoulder blade or scapula – the acromion, and the collar bone join together. One of your rotator cuff muscles runs beneath this junction and above the top of the arm bone – the humerus – as does a fluid filled sac called a bursa. If this space becomes compromised, the tendon or the bursa can become pinched and result in impingement or pain. This space is called the sub-acromial space.

Sometimes this is a result of the anatomy of your acromion process; it can be hooked, which could decrease the space for the tendon to pass through. Unfortunately we cannot affect the anatomy of our shoulders without surgical intervention. However, what we can affect is good posture. When we sit or stand with a rounded shoulders and hunched over upper back, we are not doing our body any favors. When we round our shoulders forward, (often when we are sitting at a computer, reading, doing laundry, or the dishes) the amount of space in which the tendon can go through the space decreases. The good news is that this is the most common form of impingement syndrome of the shoulder and it can be affected by a practice of sitting and standing in good posture and allowing your shoulders to drop down and back in a relaxed position. Be aware of trying not to spend too much time in a rounded/hunched position.

Try this: sit or stand up erect with shoulder blades relaxed in good posture. Now reach overhead. Try again with poor posture (rounded shoulders, forward head). Notice anything different? Chances are you were able to reach up a lot higher with good posture than you were with poor posture. You might have also experienced pain while trying to reach overhead in the poor posture position.

This is why it is so important to pay attention to your posture. This means while you are here reading this post, reading the newspaper, at work, and at home, it is always important to check your posture. Slumped sitting and rounded shoulders will eventually lead to a decreased flexibility in the muscles in front of your shoulders and weakness of the muscles that help to hold you up in good posture. This combination leads to – a compromise in the sub-acromial space and potential impingement.

So, if you are experiencing shoulder pain, check your posture! Even if you aren’t experiencing pain right now, it could be in store for you if you constantly slump and slouch. The most common shoulder issues can be avoided if you practice a little prevention.

We thank Michael Root from Mountain Physical Therapy Services for this article for our newsletter.