Shoulder Mobility for Dummies

by Staff Contributor

SOFLETE Athlete, Dara Ching isn't just a lifting badass, she's also poised to graduate PT school this year, and brings a lot of useful human performance knowledge to the table. We thought the crew could benefit from some writeups on common trouble issues athletes might be experiencing and give you a better idea if you should seek professional care. Let's talk about the shoulder today:

Functional Anatomy of the Shoulder

Abduction: movement of the shoulder away from the midline of the body. Example: Extending your arm out to the side in order to put your jacket on.

Adduction: movement of the shoulder toward the midline of the body. Example: Holding a newspaper in place under your arm.

Flexion: movement of your arm from a resting position at your side to straight above your head. Example: Reaching for the doorknob to open a door.

Extension: movement of your arm from a resting position at your side to behind you. Example: Reaching behind the driver’s seat in the car.

Rotator Cuff Tendinopathy

Tendon injuries can develop in any tendon of the body. In this case, rotator cuff tendinopathy can arise from the tendons of the subscapularis, infraspinatus, supraspinatus, and/or teres minor. Athletes with a rotator cuff tendinopathy will present with gradual onset of pain in the shoulder. They may present with tenderness or swelling around the affected tendon. Athletes may have a constant dull achy pain and weakness with certain movements.

Tendon: tough connective tissue fibers that connect muscle to bone.

Tendinitis: Inflammation of a tendon.

Tendonosis: Chronic condition of a tendon involving wearing of the tendon’s collagen from overuse.

Tendinopathy: Disease of a tendon.

Signs and symptoms:

  • Constant pain in the area where the rotator cuff tendons attach
  • Night pain, especially when lying on the painful shoulder.
  • Pain followed by minimal activity
  • Tender, redness, warm to touch, or swollen on the affected tendon
  • Weakness with reaching overhead, behind your back, or lifting.
  • Decreased arm movements

Causes/Risk Factors:

  • Excessive loading of the tendon or general wear and tear of the tendon. For example, repetitive throwing or overhead movements that occur at work, sports, or daily activities.
  • Muscle imbalance of the rotator cuff muscles
  • Advanced aging
  • Diabetes
  • Obesity
  • Smoking
  • Metabolic syndrome

Treatment:

  • See your local physical therapist (PT) for active exercise therapy.
  • Identify aggravating movements or activities that reproduce symptoms.1
  • Reduce pain, inflammation, and swelling of the affected tendon.
  • Modify or avoid movements that cause pain so tendon can rest.
  • Strengthen specific rotator cuff muscles.
  • Increase movement of arm in all direction if motion was lost.

Sources:
Lewis J, McCreesh K, Roy J-S, Ginn K. Rotator Cuff Tendinopathy: Navigating the Diagnosis-Management Conundrum. J Orthop Sports Phys Ther. 2015;45(11):923-937. doi:10.2519/jospt.2015.5941.

Dara Ching is a competitive Olympic weightlifter and Crossfit athlete. She started competing in Olympic weightlifting in 2004, and since, has competed in numerous USAW National and American Open Championships. Dara has been competing in Crossfit competitions since 2011. She is a six time regional level Crossfit competitor. Dara is also a Navy Veteran, who served as a Naval Flight Officer. Currently, Dara is pursuing a doctorate in physical therapy at the University of St. Augustine for Health and Sciences, where she graduates in April.