Shouldering the Load

As with much in life that we take for granted, we are not usually concerned with the mechanisms of how our bodies work and how they do what they do. Such knowledge is not required for use of these magnificent machines that have been freely given to us. But just as a wise consumer will care for her or his car in terms of regular scheduled maintenance, our bodies require ongoing attention in order to maintain proper function. The shoulder joint, in particular, requires such proper care.

The shoulder has the greatest range of motion of any joint in the human body. The shoulder is capable of 360º of mobility from front to back (the sagittal plane), 360º of mobility in the frontal plane, and 180º of mobility to the right and the left (horizontal plane). Taken together, these optimal ranges are termed circumduction. But the shoulder's remarkable capabilities come at a price. The shoulder girdle is the least stable joint structure and is readily subject to sprains (of the acromioclavicular joint) and dislocation injuries (of the glenohumeral joint). Additionally, the rotator cuff, the group of muscles that protect the shoulder girdle and move the shoulder joints through three-dimensional space, is commonly injured, owing to the substantial mechanical stresses involved in such extensive motion.1

We can help prevent such injuries by engaging in regular physical exercise such as yoga and strength training. These activities place weightbearing loads on the shoulder, progressively training the muscles, tendons, and nerves that supply the shoulder joint structures to handle mechanical stresses.2,3 As a result of such training, when called upon to manage the shock of an unusual mechanical force, the shoulder will be able to respond effectively while likely preventing injury.

The choice of yoga versus strength training is not mutually exclusive. Many people will enjoy taking one yoga class per week and doing two strength training sessions per week. For persons taking yoga class, the two strength training sessions could focus on (1) the chest and back and (2) the shoulders and arms. Almost every yoga exercise involves weightbearing loads on the arms. Regarding strength training, a representative shoulder program includes seated dumbbell or barbell press (for the entire shoulder girdle), standing lateral raise (for the middle deltoids), and seated bent-over raise (for the rear deltoids). If you're doing yoga, strength training sessions for the legs may not be necessary. Of course, a complete exercise program includes specific cardiovascular exercise such as walking, swimming, bicycling, or running.

It may not be possible to prevent every shoulder injury. Engaging in a regular program of vigorous exercise, including yoga, strength training, and cardiovascular exercise, is the best means of ensuring optimal biomechanical health and wellness and the best overall method for preventing injury.

Sources

1Camargo PR, et al: Eccentric training as a new approach for rotator cuff tendinopathy: Review and perspectives. World J Orthop 5(5):634-644, 2014
2Miller RM, et al: Effects of exercise therapy for the treatment of symptomatic full-thickness supraspinatus tears on in vivo glenohumeral kinematics. J Shoulder Elbow Surg 2015 Nov 24. pii: S1058-2746(15)00485-1
3Awad A, et al: Effect of shoulder girdle strengthening on trunk alignment in patients with stroke. J Phys Ther Sci 27(7):2195-2200, 2015

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Testimonials

Reviews By Our Satisfied Patients

  • "I am writing this as a personal thank you to IHMS and their staff, partially Lisa Magdaleno. Since I have been involved with Lisa, IHMS and their staff of doctors. They have been nothing but professional and extremely response to anything needed for my mother. The doctors have incredible knowledge of geriatric patents and there special needs. I have found that Lisa has been very responsive at all times of the day or night. On getting back to me on any issues with my mother. The doctors that have had interaction with my mother have been excellent. I would always recommend IHMS and Lisa to anyone who wants and needs a highly professional medical team taking care of their love one when they need it most.
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    JW
  • "" Brooke was very warm and caring. Her examination was very thorough. Best of all it was all done in the comfort of my own home. Thank you.""
    Vivian P.
  • "I moved my 91 year old mother from an assisted living facility in Colorado to one in Arizona this spring. Moving can be hard for anyone, but especially for an older person. Brooke Eisenhart and her staff at Integrated Health Mobile Service have made the transistion so much easier. My mother found Brooke to be very considerate and respectful. I appreciate how thorough Brooke is. I have dealt with Lisa, the office manager, and she is very effecient and kind. Lisa answers my questions and returns phone calls in a timely manner and is very helpful. It is a blessing to find caring people like this group for mother and for me!
    Sincerely,"
    Marti Dozier
  • "I am so very pleased to write this testimonial for Integrated Healthcare MOBILE Solutions. My husband Ted had a major stroke three years ago. Needless to say, arranging transportation, medical appointments , blood and urine samples for the first two years has been a nightmare. About a year ago I contacted Lisa at IHMS. With in days every service including physical therapy and dental was coming to our home! What a relief, I cannot tell you how much we both appreciated the prompt service with prescriptions, letters to various medical equipment people as well as deferment letters for jury duty. Thank goodness that the entire staff as well as all the doctors are such caring and loving people. Homebound folks and seniors could not have better care today. IHMS is never too busy to help."
    Sincerely, Ted and Sandy Kyle