SCI and Shoulder Pain
I was recently asked what the biggest misconception is about exercising. For wheelchair users it’s “I don’t exercise because I don’t want toI was recently asked what the biggest misconception is about exercising. For wheelchair users it’s “I don’t exercise because I don’t want to hurt my shoulders” or “my shoulders hurt and I don’t want to do more breakdown or cause more pain.” I understand this. It is very natural to avoid pain. But we have to take a step back and look at the cause of the pain. Our arms are not made to move our bodies we were built to walk. You can see this in how stable the hip is – the head of the femur fits nicely into the socket of the pelvis. It is held in place by thick ligaments. Looking at the shoulder joint, we don’t have this bony stability. We rely on several muscles to support the joint. These muscles are much smaller than the muscles around the hip. Think about how massive your gluts are, your quads and the hamstrings. Even if yours are atrophied, they’re probably bigger than the muscles of your rotator cuff. Using this joint and muscles beyond the intended demand is unavoidable. But pain is exacerbated by muscular imbalances. If you spend all day pushing your wheelchair and pushing to transfer your body, it is clear that the pushing muscles are getting stronger. Given this consistent use, the muscles get tighter, and since they attach to your shoulder blade – it pulls the shoulder blades forward. This makes the space between the humerus and shoulder blade smaller, and in this space are the tendons of the rotator cuff, the nerves to the arm, and blood vessels. The smaller space means that all of these structures are rubbing against each other and against the bone. Can you see that keeping that joint space as big as possible will decrease pain? That is important. So stretching the muscles in the front every day is crucial! Stretch your pecs and open the chest! It’s also important to stretch the biceps – even those these are pulling muscles, the attach to that shoulder blade and get tight and short. For a video on how to stretch these muscles, watch this: Then you have to work the back muscles that don’t get enough exercise throughout daily activities. Strengthening these muscles will help keep the shoulder blade back in its optimal position. For some specific exercises, watch this video: Also, following the SCI Total Fitness program, you will be led through the exercises that will decrease your pain. Start today! Follow this link hurt my shoulders” or “my shoulders hurt and I don’t want to do more breakdown or cause more pain.”
I understand this. It is very natural to avoid pain. But we have to take a step back and look at the cause of the pain. Our arms are not made to move our bodies we were built to walk. You can see this in how stable the hip is – the head of the femur fits nicely into the socket of the pelvis. It is held in place by thick ligaments. Looking at the shoulder joint, we don’t have this bony stability. We rely on several muscles to support the joint. These muscles are much smaller than the muscles around the hip. Think about how massive your gluts are, your quads and the hamstrings. Even if yours are atrophied, they’re probably bigger than the muscles of your rotator cuff.
Using this joint and muscles beyond the intended demand is unavoidable. But pain is exacerbated by muscular imbalances. If you spend all day pushing your wheelchair and pushing to transfer your body, it is clear that the pushing muscles are getting stronger. Given this consistent use, the muscles get tighter, and since they attach to your shoulder blade – it pulls the shoulder blades forward. This makes the space between the humerus and shoulder blade smaller, and in this space are the tendons of the rotator cuff, the nerves to the arm, and blood vessels. The smaller space means that all of these structures are rubbing against each other and against the bone.
Can you see that keeping that joint space as big as possible will decrease pain? That is important. So stretching the muscles in the front every day is crucial! Stretch your pecs and open the chest! It’s also important to stretch the biceps – even those these are pulling muscles, the attach to that shoulder blade and get tight and short. For a video on how to stretch these muscles, watch this:
Then you have to work the back muscles that don’t get enough exercise throughout daily activities. Strengthening these muscles will help keep the shoulder blade back in its optimal position. For some specific exercises, watch this video: http://youtu.be/OKHnfjtVzxo
Also, following the SCI Total Fitness program, you will be led through the exercises that will decrease your pain. Start today! Follow this link: https://www.youtube.com/watch?v=OKHnfjtVzxo
For more information, please visit www.scitotalfitness.com
Kristin Mcnealus, PT, DPT, ATP
kristin@scitotalfitness.com
www.scitotalfitness.com
