Preventing desk work pain 103:

Today we're going to take a deeper dive into the anatomy and mechanics of shoulder (dys)function that can lead to pain with over head movements. I will mostly be generalizing here but these findings are quite common with my shoulder folks. As I mentioned in my 101 post, dysfunction is typically a cooperation issue. Certain muscles are over worked while others are lazy.

Dr. Brock Easter described this idea to me today in a way that I felt illustrated this issue perfectly (probably because of my hockey bias). Picture the amount of work that five players have to do during a hockey game. When one of your players gets sent to the penalty box, does the overall amount of work change for your team? No. It stays exactly the same, but now you only have four players to try to prevent a goal! The same logic applies in the body when you imagine the penalized player as an under active muscle. The remaining muscles need to pick up the slack while the under active muscle sits in the penalty box. Similarly to hockey, having the same muscle in the penalty box for a long time can make its teammates pretty cranky.

Commonly Overactive Muscles:

Here we're looking at upper fibers of trapezius (UFT), pecs, and levator scapula. These muscles tend to hold on for dear life, ramping up the tension you feel in the upper back, shoulders, and into your neck. When these muscles compensate for other muscles around the shoulder, we tend to adopt an elevated (ears to shoulder) and protracted (rounded) shoulder position. This can lead to a pinching, painful feeling when trying to reach over your head or move your arm

Stretches for these muscles:

UFT and Lev Scap

Pecs

Under Active Muscles:

Deep neck flexors (DNF), mid/lower trapezius, serratus anterior are the usual suspects (GREAT movie). By working on exercises that re-train the brain to use these muscles appropriately we are able to create a better balance around the neck and shoulders, reducing the tension on their overactive friends.

Activation Exercises:

Serratus anterior and mid/low traps

DNF

The most effective way to rewire overactive and under active muscle pairings is to stretch the overactive muscle first and then strengthen the under active one. In order to be truly effective with this type of corrective exercise, an assessment with a physiotherapist is highly recommended. This post focuses on the common patterns that I see, however, everyone is unique and these corrections may not apply to you!

#correctiveexercise