The shoulder joint is the most mobile joint in the body. This mobility is achieved by being the most complex joint in the body. The shoulder joint is made up of three bones, four joints with ligaments in each joint, and the subacromial bursa. Muscles in the back, neck, chest, upper arm, and shoulder allowing for movement with the deltoid being the most dominant, while the rotator cuff, which is made up of four small muscles, allows for rotation and stability.
This complexity makes the shoulder prone to injury and if ignored will lead to a significant disability in movement. It is important to understand the anatomy of the shoulder in order to truly identify the cause of pain
The scapula (shoulder-blade) makes up the back portion of the shoulder girdle and the processes of the scapula and the glenoid cavity help hold the humerus (upper arm) in place and allow for motion. The processes of the scapula are the acromion, coracoid, and the scapular spine. The glenoid cavity of the scapula is what most people consider the shoulder, but the other joints involving the shoulder are the acromioclavicular (AC) joint (where the collarbone meets the scapula), sternoclavicular (SC) joint (where the collarbone meets the chest bone), and the scapulothoracic joint (where the shoulder-blade meets the ribs). All these joints help to move the shoulder in different, complex ways, but this make the shoulder more susceptible to injury.
The glenohumeral joint is where the head of the humerus fits into a shallow socket called the glenoid cavity. This shallow socket allows for a great amount of movement, but this movement sacrifices stability. The rotator cuff are the muscles inside this socket that allow for rotation and stability.
These important muscles are often the site for pain within the joint. In shoulder rehab these muscles are most often the focus. Other major muscles of the upper body aid in shoulder mobility including the pectorals (chest), the trapezius (neck), both the bicep and triceps of the upper arm, the latissimus dorsi (back).
With such a complex joint, it is necessary to identify the cause of the pain and to focus on exercise for that portion of the shoulder. Although heat, ice, medication and rest can mask the pain for the short-term, ignoring the pain can lead to disability in the long-term. Long term pain relief and increase of range of motion will only come from effective exercise programs.
Exercise programs should focus on developing strength and flexibility in the injured portion of the shoulder. These programs should start with a range of motion exercise to help promote blood flow and relax the muscles in the shoulder. Low weight exercises can help strengthen and repair injured muscles. Stretching can help relieve tightness within the shoulder and prevent further injury.
Yoga can do wonders to increase flexibility of the shoulder while weight training can increase your overall shoulder strength. Although these programs have a good focus, no one program is perfect and understanding your deficit can help you excel in reaching your fitness goals.
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