How many years did we have to listen to our parents nag us, “sit up straight”? If only we really did listen…we may have prevented some of our issues with our rotator cuff. Posture can greatly affect the pressure on our rotator cuff and good posture can help prevent issues later on in life.
Let’s get nerdy for a bit.
In the subacromial space of the shoulder, you can find the rotator cuff, one of the tendons of your bicep, a ligament, and a bursa (fluid filled sac that is supposed to help with movement when it is not inflamed). That is a lot of stuff in a small space. As you elevate the shoulder overhead or away from your body, this area can become compressed (impinged) especially if the surrounding muscles are not holding things in place.
One of the common reasons for impingement of the rotator cuff is from a muscle imbalance. There is not enough support to prevent this compression from irritating the tendons. Muscle imbalances can happen for many different reasons, but posture can play a huge role in either preventing or correcting the issue here.
As we slouch over time, our head drifts forward, our upper back starts to develop more of a curve and our shoulder blades creep forward, away from the spine. When speaking of muscle imbalances and muscle weakness, this is a chicken-or-the-egg scenario when looking at the development of posture issues and muscle imbalances. More importantly, they go together and both need to be addressed.
As our posture changes into this forward position, the shoulder blade muscles are weakened and stretched out while the front becomes shortened. This muscle imbalance in particular cannot support the shoulder to prevent impingement with movement. Once inflammation is added to this process, it can become chronic and debilitating, and hard to break out of without the muscle strength needed.
This common poor posture position can be from weakness in general, computer work, constant work in front of you (cook, caregiver/lifting, gardening, etc), or our new problem of time on our phones. You cannot support these positions without strength throughout those muscles in the back. They are the ones that will allow you to hold yourself there for longer periods of time. Working on your “posture” throughout the day can help reduce this forward pinch and let those shoulders breathe a bit more,
So when we say, “work on your posture”, what do we mean?
There are a few different techniques you can use to pull yourself out of this compressed position:
- Pulling your shoulder blades back – the most common people think of and it is truly very effective. Trying to squeeze your shoulder blades together without lifting them (keep your shoulders out of your ears) for a set of 20 or so a few times throughout the day can be helpful.
- Pull your head back – we call this one cervical retraction. You want to try and pull your chin straight back, the motion of trying to make a double chin. It’s a small motion, but if done correctly, can be effective. This one can be done 10-15 times in a row for a little longer of a hold up to 5-10 seconds, also a few times day.
- Rotate the shoulders open- keep your elbows by your side, elbows bent at 90 degrees, and rotate your hands out to the side.This one can be done for about 20 in a row a few times a day.
- Stretch the pecs – you’ve worked the back muscles a bit, now let’s stretch the front. Find a corner or a doorway and place one of your forearms on the frame (feel free to play around with the height of the arm, avoid pinching in the shoulder, and find a stretch in the front) and gently step forward. Hold for about 30 seconds, repeat twice. Do this a few times a day.
Please keep in mind that if you feel you have posture or impingement issues and want to take a more personalized approach, you can give your physical therapist a call. An in office evaluation can pick out your particular areas that need to be addressed and an individual program can be created for you.