 Chronic shoulder pain is a common consequence of repetitive overhead
activity, such as serving and smashing in tennis, freestyle or
butterfly
swimming, javelin throwing, or bowling in cricket. The shoulder joint is a truly
remarkable creation. It's quite a complex formation of bones, muscles and
tendons and provides a great
range of motion to the arm. The shoulder is made up
of three bones, and the tendons of four muscles.
The bones are
called the "Scapula," the "Humerus" and the "Clavicle." Or, in layman's terms,
the shoulder blade, the upper arm bone and the collarbone, respectively. The four muscles that surround the ball and socket joint of the upper arm
bone and the shoulder blade are called the rotator cuff muscles . They all
attach around the top of the upper arm bone and lie on each side of the shoulder
blade providing strength and support for this joint . It is beneficial to know
these muscles supraspinatus (lifts the arms out to the side and up ) infraspinatus (outwardly rotates the upper arms) teres minor (same) and subscapularis (inwardly rotates the upper arm)
The tendons of the rotator
cuff muscles receive very little oxygen and nutrients from blood supply, and as
a result are especially vulnerable to degeneration with
aging. This is why
shoulder problems in the elderly are common. This lack of blood supply is also
the reason why a shoulder injury can take quite a lot of time to heal. In most
cases, the larger the tear or damage to the tendons, the harder it is to move
your arm and the injured area.
Stretching and
strengthening are the best defence against shoulder problems. Even if you don't
have a shoulder problem now, try incorporating the following stretching and
strengthening exercises (after
warming-up ) in your daily routine to save
yourself from a major headache in the future. If the exercise hurts, stop
exercising. Start again with a lighter weight.
To stretch: Simply stand
upright and clasp you hands behind your back. Keep your arms straight and slowly
lift your hands upwards. Hold this stretch for about 15 to 20 seconds, then
repeat it 3 to 4 times.
Exercise 1
Start by lying on your
stomach on a table or a bed. Put your left arm out at shoulder level with your
elbow bent to 90° and your hand down. Keep your elbow bent, and slowly raise
your left hand. Stop when your hand is level with your shoulder. Lower the hand
slowly. Repeat the exercise until your arm is tired. Then do the exercise with
your right arm.
 Exercise 2
Lie on your right side
with a rolled-up towel under your right armpit. Stretch your right arm above
your head. Keep your left arm at your side with your elbow bent to 90° and the
forearm resting against your chest, palm down. Roll your left shoulder out,
raising the left forearm until it's level with your shoulder. (Hint: This is
like the backhand swing in tennis.) Lower the arm slowly. Repeat the exercise
until your arm is tired. Then do the exercise with your right arm.
Exercise 3
Lie on your right side.
Keep your left arm along the upper side of your body. Bend your right elbow to
90°. Keep the right forearm resting on the table. Now roll your right shoulder
in, raising your right forearm up to your chest. (Hint: This is like the
forehand swing in tennis.) Lower the forearm slowly. Repeat the exercise until
your arm is tired. Then do the exercise with your left arm.
Exercise 4
In a standing position,
start with your right arm halfway between the front and side of your body, thumb
down. (You may need to raise your left arm for balance.)
Raise your right arm
until almost level (about a 45° angle). (Hint: This is like emptying a can.)
Don't lift beyond the point of pain. Slowly lower your arm. Repeat the exercise
until your arm is tired. Then do the exercise with your left arm. This
exercise is very popular and is commonly recommended as part of a
shoulder-injury rehabilitation programme.
The
prevention of shoulder injuries comes down the conditioning of the shoulder
muscles and tendons, which ultimately involves both stretching and strengthening
of the shoulder joint
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