Save your shoulders

Save your shoulders
by Annie Smit

Strong and stable shoulders are equally essential for simple tasks (such as opening a jar) and a myriad of sporting activities. Grit to golf, swimming to sword fighting; no shoulder, no show.
Early one morning in 2016, as I picked up my hair brush, a sharp pain in my shoulder and neck halted my elbow at shoulder height. When you can’t lift an arm, even driving or dressing yourself becomes a feat. It soon became evident that performing repetitive low planks in yoga led to my shoulder injury—but this type of injury can arise from overload and overuse in physical activities, or sleeping at a bad angle. The fragile rotator cuff does not want to be burdened with excessive pressure; it’s there to stabilise the shoulder within a healthy range of motion.
The shoulder is the most mobile joint in the body, as illustrated by Dr Ray Long in the video  Scapulohumeral Rhythm
There are simple exercises to build shoulder integrity, no matter your gender, age or activity. Rotator raises and Y-lifts will strengthen the rotator cuff muscles, using light weights or a resistance band, as illustrated in this 7-minute routine: 

Bodybuilders can use similar exercises as a warm-up or between sets, using a band or cable. Marine Corps veteran and strength trainer, Alan Thralldescribes his approach here.
Some effective prone (lying face down) shoulder strengthening exercise are illustrated in the article  Exercises to Strengthen the Rotator Cuff Muscles in the ShoulderHere, physical therapist Marc Bernier writes it’s important to emphasise “…strengthening the scapular (shoulder blade) stabilisers; weakness of these muscles will result in a shoulder blade that tilts downward… contributing to instability of the shoulder. … The rotator cuff is an endurance type of muscle group, and therefore requires the use of lighter weights and high repetitions.”
In yoga, it’s crucial to perform asanas with attention to alignment to protect the fragile shoulder joint. Quoting Dr Ray Long (The Daily Bandha): “Particularly in Vinyasa, there is a tendency to do the same movement many times, which can lead to repetitive stress injury, such as inflammation of the subacromial bursa and supraspinatus tendon—‘rotator cuff syndrome’... You can help to avoid this by engaging the infraspinatus and teres minor muscles and, to a lesser extent, the deltoid. These muscles act to externally rotate the humerus and bring the greater tuberosity away from the undersurface of the acromion.”
Tips to protect the shoulder in yoga in low plank/low four-limbed staff pose (Chaturanga Dandasana).
·         Bend your elbows no lower than 90° when lowering to plank (and less than to 90° if you do not have the strength in your triceps or shoulders to go lower, or if you are tired).
·         Bend your knees to the mat as soon as the elbows reach 90° (or close to 90°), before taking cobra/upward dog pose. Alternatively, lift straight into upward dog from elbows at 90°.
·         Strengthen the shoulders with arm balances and inversions (such as Dolphin pose).
The following 23-minute yoga routine focuses on strengthening and stretching the shoulders:
Here’s to shouldering the journey with ease.
More videos can be found here.

References:
Bernier, M, Exercises to Strengthen the Rotator Cuff Muscles in the Shoulder, http://www.physioroom.com/experts/asktheexperts/answers/qa_mb_20050225.php, 2005.
Long, R, Preventing Yoga Injuries vs Preventing Yoga, Part II: Joint Hypermobility http://www.dailybandha.com/search?q=shoulder, 2013 (excellent tips on alignment in side plank).
Long, R, Shoulder Kinematics in Yoga, Part I http://www.dailybandha.com/2011/04/shoulder-kinematics-in-yoga.html, 2011 (an in-depth description of shoulder kinematics [pure motion]).

Thrall, A. Reduce Shoulder Pain with This Simple Drill (video), https://www.youtube.com/user/athrall7/search?query=shoulder+impingement, 2016.

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