How to Erase Shoulder Pain With Self-Myofascial Release

https://breakingmuscle.com/mobility-recovery/how-to-erase-shoulder-pain-with-self-myofascial-release

One of the most common pains and injuries I see in my clinic is shoulder pain.Ranging from pain that may simply be a minor annoyance during bench press to pain that completely limits range of motion leaving the client with limited function and discomfort all day long.

Either way, shoulder pain is affecting my clients’ workouts, but this is a pain that can be fixed - or better yet, prevented.

Lacrosse Balls to the Rescue

Obviously the best solution for shoulder pain is to go see a professional. A physical therapist can work with you and tell you exactly what the issue is - and exactly the steps you need to take to fix it.

RELATED: The New Age of Physical Therapy

But what about foam rolling, aka self-myofascial release (SMR)? Foam rolling works so well for the rest of your body, but how the heck are you supposed to get that same feeling in your shoulder using a huge foam roller?

Enter the lacrosse ball. This small, dense ball is the perfect size to release muscles in and around your shoulder, helping you feel awesome post release session. (Note: If the lacrosse ball is too hard and causes too much pain, try a tennis ball instead until you get used to it and can progress to the lacrosse ball.)

Check out these five simple and awesome ways to use the lacrosse ball to get you shoulder feeling top-notch.

SMR for Your Pecs

This is best done in a doorway or on a wall. Place the lacrosse ball on the wall and lean your chest into it, with your pecs against the ball. Then roll the length of your pecs. You can also rotate your shoulder externally and internally with the ball on the pecs.

SMR for Your Upper Traps

The upper traps are a muscle I often have to work on for my clients. This muscle gets notoriously tight and full of knots. This is particularly true for anyone who sits all day at a computer, is stressed out, or doesn’t always use the right form for pushing and pulling exercises. (Believe it or not, it is also a problem area for anyone who is always cold and shrugging the shoulders to try to keep warm.)

READ: I've Jacked Up My Shoulder: What Did I Damage and What Do I Do Now?

One of the problems with the upper traps is that it is a difficult muscle to release and work on by yourself - until now, that is. All you need is a barbell on a rack (or a pull up bar in your doorway), a lacrosse ball, and some tape.

What you do:

1. With the lacrosse ball taped to the bottom of the barbell, stand underneath it, driving your traps into the lacrosse ball.
2. Make a circle with your shoulder, bringing it all of the way up in the air, and back down.
3. You can also add intensity to this by stretching your bringing your opposite ear to your opposite shoulder, stretching out the traps at the same time. Trust me - you will know when you’ve found the spot you need to work on!

Note: If moving your arm in this way hurts you normally (without the lacrosse ball), don’t move your arm into the painful range. Just focus on a range that is pain-free or on moving only your neck.

SMR for your Rhomboids and Posterior Shoulder

Option One:

1. Place the lacrosse ball between your shoulder blade and your spine (make sure you’re not on bone) and lie down on the ground, relaxing your head on the ground, as well.
2. As with your traps, move your arm above your head and in a circle. Do this the whole length of your shoulder blade, making sure to spend extra time on the areas that are especially painful.

Remember: Just like with your traps, if the range of motion usually hurts, make sure you limit the size of your shoulder circle.

Option Two:

The second way to use the lacrosse ball for your rhomboids and posterior shoulder is to do it against the wall. This is a good position if the lying on the floor is too much pressure for you or if you can’t go through full range of motion with your shoulder circles.

RELATED: 5 Simple Solutions to Shoulder Pain

For this release, the lacrosse ball will go in the same position on your back, but you will be leaning into it against the wall. Then, you can either move up and down, do your arm circles, or both.

SMR for Your Lats

This can be done either on the floor or against the wall. Warning: Doing it against the floor will definitely hurt a little bit more.

1. Put the lacrosse ball on your lat, which is just under your armpit and toward your back.
2. Externally rotate your shoulder (palm out).
3. Roll backward and forward, or if it’s too painful to do so, just hang out for bit.

SMR for Your Triceps

This one is pretty simple. You can do this on a tabletop or plyo box, against the wall, or on the floor. Once in position, you simply roll your triceps with the lacrosse ball.

How Long Should You Do SMR?

There is no hard-and-fast rule when it comes to the length of time you do SMR on your shoulder. Doing some is step one. Doing a bit more, is step two. But realistically, it will depend on your tolerance and how painful the movements are.

"There is no hard-and-fast rule when it comes to the length of time you do SMR on your shoulder. Doing some is step one. Doing a bit more is step two."

About two minutes per muscle is a good goal, meaning this whole sequence should take about ten minutes. Honestly, though, even just spending a minute on each will give you some benefit, so being tight for time isn’t an excuse to skip this recovery session.

A Final Note

Doing these moves and releases are awesome for you and your shoulder, and you will feel great afterward. But this practice does not in any way replace the need for strengthening your shoulder. The sequence outlined above should be done in conjunction with shoulder strengthening exercises, not in lieu of. Now, get rolling!

How to Crawl Your Way Back to Shoulder Health

https://breakingmuscle.com/natural-movement/how-to-crawl-your-way-back-to-shoulder-health

The shoulder area is one of the most neglected areas of the body, especially when an injury occurs and therapy is implemented. Many therapists like to isolate certain muscles, especially the rotator cuffs, even though our bodies never move in such isolated ways.

Moving naturally is not only one of the best ways to develop strong, stable, and mobile shoulders, but also to rehabilitate them if you’re recovering from an injury. In this article, I will discuss how to create superior mobility, stability, and strength in your shoulders using highly effective MovNat techniques.

Crawling is a safe, fun, and effective way to build strong, mobile shoulders.

Dissecting the Shoulder

Most people think of the shoulder as a muscle, but it’s actually an area, much like your groin. It’s comprised of three joints, three bones, and a lot of different muscle groups. It’s a dynamic area that, unfortunately, most people don’t use very well.

If you think about it, you can go about most of your day without using your shoulders fully. You often don’t have to reach too far over your actual head if you’re washing or brushing your hair. You might not need to reach behind you unless you’ve got a back itch. And why reach too far across your body when you can just move your body a bit more - reaching is just too much work!

"Crawling movements can be quite physically strenuous as it’s easy to increase the complexity by crawling up or down an incline or crawling on a natural surface such as a log." 

Going through your day with limited range of motion and without full use of your shoulders is actually very easy - unless you’re doing some natural movements such as swimming, climbing, crawling, and throwing. If you want to improve your shoulders, your gait, and your entire body, then adding in these activities is ideal.

I’m going to focus on some specific muscles, as well as two of the three shoulder joints and how these relate to the natural movement skill of crawling. I’m going to discuss trigger points, too, as they are effective in healing injured muscles and fascia, as well as improving joint function even if there is no injury present.

The Orchesta of Shoulder Movement

When thinking of the shoulder joint, most people think of the rotator cuff muscles. The rotator cuff muscles are what most people injure, or at least think they injure. But there’s a lot more that can and does go wrong with the shoulder aside from a rotator cuff injury.

The three joints of the shoulder all need to work in harmony with one another, as they’re connected by fascia, ligaments, and muscles. Your right and left scapulas work for and against one another and, as I’ve mentioned in my articles on gait , your hips have a lot do with how your shoulders move - and, therefore, how you move.

Several muscles attach to and cross over the shoulder joint, making it one of the most complex areas of the body.

If you’re not moving well, then tendonitis, bursitis, and other ailments can arise. Maybe you suddenly can’t raise your arm above your head and there’s pain on the outside of your deltoid muscle. Typically, this is because the acromioclavicular (AC) joint is not moving freely. Of the three joints of the shoulder, the AC can most easily become problematic, resulting in inability to raise your arm over your head. If you can’t do that motion without pain, then that’s still a problem, too.

If you trace your collarbone (clavicle) to the outside toward your arm, you’re going to hit a little bump. This is the acromion of your scapula (shoulder blade). Now, if you come down and in a bit here at a 45-degree angle, you’ll find a dip. There you have what’s called your coracoid process. This coracoid process, along with the acromion, helps to stabilize your shoulder - and that’s important if you want to crawl and/or develop power in your shoulder.

"If you’re having a problem crawling, then look for trigger points in the serratus muscle, which for the most part will be over the sides of your body over your ribs."

You’ve got three major muscles attaching to your coracoid process and, therefore, affecting your AC joint. One of your pectoralis muscles, your pec minor, spans up from your chest and inserts into that coracoid process. This muscle helps bring your arm forward and across your body. Also attaching to your coracoid process are your biceps, the short head of the biceps to be precise, responsible for flexion of the arm.

Finally, there is a very important muscle called your coracobrachialis. This is the muscle we associate when someone has pain while washing or combing his or her hair or if he or she just can’t get the arm up to that area. If your shoulder hurts when just raising your hand to your head, it’s probably this coracobrachialis muscle that’s to blame.

Locating Trigger Points

We can locate a trigger point that will help us when it comes to this coracobrachialis muscle. Again, come down from the end of your collarbone, dip down and in a bit, and right in the divot of your shoulder, where your pec comes into your shoulder joint, look for a tender area in there and rub that out. If you hold that area with some deep pressure and can move your arm more freely or with less pain, then you know you’re on the right track.

The Origin of Shoulder Stability

One major muscle that stabilizes the shoulder area is the serratus anterior muscle. It expands over the sides of the ribs and is responsible for a lot of pushing power - bringing your scapula forward. Think punching motions here, but also crawling. When crawling, you’re going to be using the serratus to support and stabilize your scapula and entire shoulder girdle.

The MovNat knee/elbow crawl is a fantastic way to restore scapular strength and stability.

If you’re having a problem crawling, then look for trigger points in the serratus muscle, which for the most part will be over the sides of your body over your ribs.You don’t have to go too far forward to find where the majority of the trigger points are, and you don’t have to go too far back. Like you did with the previous muscle, find that tender area and rub it out.

Crawling Techniques

So now that you know how your shoulder works and some techniques for freeing up both your muscle and movement. It’s time to get moving. One of the best ways to create some strength, mobility, and stability in the AC joint is to do some crawling. Crawling movements can be a great way to reestablish function and motor control, as well as improve core strength and posture.

The push/pull crawl is another excellent crawl variation for shoulder health.

Crawling movements can be quite physically strenuous as it’s easy to increase the complexity by crawling up or down an incline or crawling on a natural surface such as a log. The MovNat foot-hand crawl, which many think of as a bear crawl, is a great way to get some strength back in the shoulder area as well as stability.

There are also many other crawling motions to do, all of which will benefit your shoulder joints. So start crawling to regain your motion and strength in your shoulder joints.

The Dynamic Duo of Shoulder Impingement

Welcome back, fellow body-hackers. In my last article, we took a look at some common problem areas associated with shoulder pain and devised a few different ways to approach them. This time around I’m going to focus on the dynamic duo of shoulder impingement - the serratus anterior and the upper trap.

The Shoulder and Overhead Motion

Maybe you’ve heard someone say, “The shoulder isn’t really designed for overhead motion.” I’ve never been able to wrap my head around that idea. You’re telling me that the shoulder, the joint possessing the largest functional range of motion in the human body, simply wasn’t “designed” to use roughly 50% of that movement?

If that’s the case, then what exactly are these people talking about? Well, there happens to be an exceedingly strong correlation between individuals who spend a lot of time with their hands above their heads and shoulder injuries. However, any good scientist will tell you that correlation does not imply causation. If the link between overhead movement and shoulder injury is merely a correlation, then what’s the cause at the heart of it?

The Trapezius and Shoulder Impingement

The trapezius is a trapezoid-shaped muscle that sits in the center of your upper back. You can look at the trapezius as two triangle-shaped halves bisected by your vertebrae. There are three different sections of your trap, the upper, middle, and lower.

For our purposes we are going to focus on the upper trap, which originates from the occipital protuberance, the upper third of the superior nuchal line of the occipital bone and the ligamentum nuchae (a strip of connective tissue that runs down your cervical vertebrae) and inserts on your clavicle. Those are some fancy science words for saying the upper trap starts in the back of your head and attaches to your collarbone. Over-activation of the upper trap and under activation of the middle and lower trap is one of the most common issues that leads to shoulder pain and impingement.

It happens something like this: Initially, when we spend a lot of time with our arms overhead we start with good mechanics. Unfortunately, after a while certain muscles get tired. It’s hard for your middle and lower traps to stabilize your shoulder for hours on end. So what happens? Your upper trap has to pick up the slack. It begins to shorten in order to passively hold your shoulder in the position you keep putting it into. This requires less energy and in some ways is “easier” on your shoulder.

The problem is that once your upper trap becomes short it pulls your shoulder out of a good position. When your upper trap is tight and your shoulders are elevated it becomes increasingly difficult to fire the middle and lower traps, which means they are no longer capable of stabilizing your shoulder or assisting in scapular motion. This means that all of the demand gets re-routed to the upper trap and the vicious cycle continues.

Despite overhead motion often being the scapegoat, over-firing upper traps are painfully common even in desk workers. When you sit hunched over with your shoulders scrunched up and your head forward you are placing your traps in a shortened position. Add to that rounding of the upper back and now you’ve placed your mid and lower traps in a lengthened, disadvantageous position.

In addition to the problems you get at the shoulder (anterior pain, overhead weakness, and a predisposition to labral and rotator cuff tears), upper trap tightness can also cause debilitating headaches. It’s really not fun. I don’t recommend it. Now combine bad posture, tight traps, and overhead motion and you’ve got a recipe for disaster.

The Added Problem of the Serratus Anterior

The other missing link of shoulder stability is often the serratus anterior (SA), also known as the finger muscle (due to it’s appearance) or the boxer’s muscle (due to it’s pronounced definition in prizefighters.) Your serratus anterior originates on your ribs and inserts on the medial border of your scapulae, meaning the side closer to your spine.

Your serratus essentially sits underneath your shoulder blade and is yet another muscle responsible for scapular motion and stability. When it fires properly, the serratus protracts your shoulder, basically sucking the scapulae right up against your ribcage. When it’s not working your scapulae can pop off your back (known as winging) and are significantly less stable.

As you can probably guess, when the SA are weak, the stabilization demand on the already over-taxed upper trap is increased yet again. Additionally, if you already have upper trap tightness your traps are probably pulling your scapulae in a position that makes it harder for the SA to fire properly. Can you see how all these problems feed into one another?

What You Can Do About It

You have to learn to stabilize your shoulders properly. If I asked you to stabilize your shoulders, what would you do? I tend to find that this is a commonly overlooked aspect of training. Knowing how to brace your shoulders is every bit as important as knowing how to brace your core. You can’t have a stable structure on a weak foundation.

My article on posture has a simple explanation of the bracing sequence to reclaim your posture. Once you’ve done that, stabilizing your shoulders is just about squeezing the muscles of your mid back (mid and lower traps and rhomboids) and using them to maintain the position of your scapulae. Remember, core integrity is the first step. If you can’t properly brace your core, it’s almost impossible to brace your shoulders.

Of course it’s easy to say that, but what if you’re having trouble actually feeling it and getting your body to respond? There are hundreds of corrective exercises designed to improve shoulder stability, but I’m going to give you a few utilizing equipment you can find at your gym or box.

Stretching Your Upper Trap

With your head facing forward, place one hand on the opposite side of your head and pull your ear towards your shoulder. Make sure you are not rotating your neck as you do this. If you want to get really nasty and you have a friend you can trust, have your friend pin down a particularly tight part of your trap either with his or her fingers or a golf ball or lacrosse ball - then stretch. You can also tape a lacrosse ball to the underside of a barbell in a squat rack and use that to self-stretch the trap. Same basic principle applies: pin the tissue, then move your arms and neck to stretch the muscle.

Physio-Ball or Ring Stabilizations

You can perform physio-ball stabilizations with either two arms or one. All you’re doing is getting your shoulders into good position, bracing them, and then placing your hands on top of a physio-ball against a wall in a push up position.

You can progress from two arms to one arm on the wall, and when that becomes easy you can perform the exercise with two arms on the floor. Simply hold the position for as long as you can. Your set is over when your shoulders drop out of position, not when you can’t hold yourself up anymore. You have to be mindful of the difference or you could be simply reinforcing the issues that are already present. Build up to three sets of one minute.

If you want to get really nasty, gymnastics rings are fantastic for fostering shoulder stability. You can also easily adjust the angle and therefore the loading on your shoulder, all the way down to a full push up position. Again, work up to three sets of a minute, paying careful attention to the position of your shoulders.

The Strict Press

I think the best way to foster stable shoulders is the king of all shoulder exercises -the strict press. You might think I’m crazy, but think about it like a deadlift: yes, it can be terrible for your back when done incorrectly, but done properly the deadlift is arguably the most profound corrective exercise for posture. The strict press is the same for your shoulders. As long as you don’t have pain throughout the movement, starting light and paying strict attention to proper form will teach the shoulders how to stay stable in no time. Maybe you can even get those handstand pushups you’ve always wanted.

This concludes the second installment of my two-part series on how to deal with shoulder pain. Once again, mindfulness of your movements trumps all. The best solution for rounded shoulders and slouched posture is to not sit and walk around with rounded shoulders and a slouched posture.

Just remember, we should all be able to do basic maintenance on ourselves, but if you have persistent pain that is not changing at all and you have for weeks, you should seek proper medical attention. Make sure to take care of your shoulders and they will take care of you. Good luck.

How to Self-Diagnose Your Shoulder Pain

https://breakingmuscle.com/strength-conditioning/how-to-self-diagnose-your-shoulder-pain

The shoulder joint is one of the most vulnerable joints in the human body. There is so much range of movement that it is surprising more shoulder injuries don't occur.

If your shoulders are healthy, you must be doing the right things to strengthen them. If not, you are either performing compromising movements or are negligent on your strengthening protocols.

If you are experiencing shoulder pain during your training or competitions, it's time to step back and determine the root cause. What follows are simple hands-on tests that can determine why your shoulders are in pain. A partner is recommended to assist with each test.

Impingement 

1. While seated, have a partner raise the arm of your sore shoulder to the front and overhead as far as possible. 
2. Your partner should use one hand on your arm and the other hand supporting your shoulder blade (scapula).

The space where your rotator cuff tendons and shoulder bursa reside (the sub-acromial space) becomes smaller when your arm is raised overhead and pushed to the limit. If pain is felt in your shoulder, the test is considered positive. The pain is likely caused by impingement of the tendons or bursa in that area of your shoulder.

RELATED: Avoid Shoulder Injury By Strengthening the Rotator Cuff

Biceps Tendonitis Test

1. While seated, raise your painful arm (shoulder) forward to the front.
2. While holding your arm out straight in front of you, turn your palm up (e.g., forearm supinated).
3. You partner should then push your arm down, while you attempt to resist.

"There are multiple articulations (movements) at the shoulders, making it a challenge to directly pinpoint an injury. But proper assessment and movement tests to determine specific pain can narrow it down to specific injury issues."

Pain felt in the front of your shoulder while resisting your partner's arm push means biceps tendonitis is the probable cause of your shoulder pain.

Labrum Tear 

The Labrum tear test has two parts: the apprehension and relocation tests.

The Apprehension Test:

1. Begin by lying on your back on a flat, elevated surface (e.g., a bench or table).
2. Move your arm out to the side perpendicular to the torso.
3. Flex your elbow to a ninety-degree angle.
4. Your partner should slowly rotate your arm so your hand moves toward your ear with the partner pushing as far as possible. Maintain the ninetydegree elbow flexion.

If you are apprehensive (hesitant) about shoulder movement beyond the joint, this test is considered positive for a possible labrum tear.

The Relocation Test:

You may feel your shoulder is unstable and potentially wants to move out of place - or relocate - especially when your shoulder is in extreme external rotation. If this is the case, have your partner gently press on the front of your shoulder to relocate the joint.

If you feel less relocation and your shoulder feels more stable, believe it or not this test is considered positive and a torn labrum is the probable cause.

RELATED: 10 Methods to Prevent and Treat Shoulder Injuries

AC Joint Separation 

The test for an AC (acromial-clavicular) joint separation is called the AC joint compression test. The shoulder blade (scapula) connects to the collarbone (clavicle) at this joint.

1. While seated, have your partner place one hand at the front of your shoulder joint and one hand at the rear.
2. The partner should slowly, but firmly press on both sides of your shoulder to compress the AC joint.

"The aforementioned tests are simple protocol anyone can use to determine the possible cause of shoulder joint injuries." 

If there is a joint separation, pain will be felt at the joint between the downward pressing hands. In addition, pain while raising the arm upward and while sleeping are also indications of an AC joint separation.

Rotator Cuff Tear

1. While seated, have your partner raise the painful arm/shoulder to the side and parallel to the floor.
2. While you relax the arm, the partner lets your arm drop.

If your arm drops involuntarily and you are unable to maintain that parallel position you may have a rotator cuff tear. Some may compensate for a torn rotator cuff by elevating the scapula toward the ear. Be vigilant of this when performing the rotator cuff tear test.

RELATED: 5 Simple Solutions for Shoulder Pain

Supraspinatus Tear

The empty glass test is used to assess the status of the supraspinatus, one of the four rotator cuff muscles. The supraspinatus is located on the upper part of the shoulder joint and is involved in abduction (arm raising).

1. While seated or standing, lift the sore arm forward and to the side about thirty to 45 degrees.
2. Pronate your wrist so the palm of your hand faces down to the floor (as if you were trying to empty a glass of water).
3. In this position your partner should gently push your arm down.

If pain or weakness prevents you from maintaining your arm position, you may have a supraspinatus tear.

Frozen Shoulder

A frozen shoulder is also known as adhesive capsulitis. It occurs slowly over time and can limit functional use of your arm. A frozen shoulder manifests in pain and tightness. This makes it difficult to reach overhead, press a dumbbell, or scratch your back.

"It is imperative to strengthen all participating muscles and shoulder articulations to enhance shoulder joint health due to the vulnerability of the body part."

There is no special way of diagnosing a frozen shoulder, nor is there a diagnostic test to verify it (e.g., an X-ray or MRI). A frozen shoulder diagnosis is made by observing the specific shoulder moving through a range of motion.

Frozen Shoulder Procedure:

1. Stand in front of a mirror. A partner should observe you while moving the arm and shoulder. The partner should be noting the range and quality of motion of the shoulder joint.
2. Slowly raise both arms to the front and overhead. If you suffer from frozen shoulder, your painful arm may only come up to a point just past parallel with the floor. Additionally, as your scapula elevates towards your ear, you will feel general pain in the shoulder.
3. From this position, slowly lower the arm down, and then slowly lift the arm out to the side. Note the range of motion that occurs. If the arm only goes up to a point parallel to the ground - and it's painful - then you likely suffer from frozen shoulder syndrome.

A final test for frozen shoulder is to stand with both arms at the sides and the elbows flexed at ninety degrees. Externally rotate the arms outward. If the frozen shoulder syndrome is present, the painful arm will not rotate outward in comparison to the healthy shoulder.

RELATED: The Best Method for Talking to Your Doctor About Shoulder Injury

Assessing Your Shoulder Health

Shoulder joint injuries can be head-scratchers. There are multiple articulations (movements) at the shoulders, making it a challenge to directly pinpoint an injury. But proper assessment and movement tests to determine specific pain can narrow it down to specific injury issues.

The aforementioned tests are simple protocol anyone can use to determine the possible cause of shoulder joint injuries. You may discover one specific issue (e.g., only a rotator cuff tear) or multiple issues (e.g., biceps tendonitis and impingement).

Either way, multi-dimensional shoulder joint articulations can be problematic. It is imperative to strengthen all participating muscles and shoulder articulations to enhance shoulder joint health due to the vulnerability of the body part.