7 Key Points to Avoid Shoulder Injuries
Being on holiday is great fun but have you come back from your holiday with a heavy shoulder? In this second installment of the Holiday Pains article, we want to look at how your holiday pains could be presented in the form of shoulder pain.
Getting the weight off your shoulders
In our previous article on neck injuries due to holiday, our Senior Principal Physiotherapist, Chng Chye Tuan shared that during holidays, it is quite common to feel any strains or pain only upon a restful period or the problem can accumulate and carry over back to work. Shoulder injuries are common during holidays but often overlooked as the pain can be less acute as the injury accumulates over a period of time.
Common shoulder injuries are rotator cuff impingements or tendinosis. The former describes a “pinching” or compressive mechanism of a shoulder muscle. The latter is degenerative in nature or to put it simply – wear and tear. It is also possible for both to happen at the same time, e.g. a degenerated tendon gets pinched while lifting heavy bags overhead.
The Rotator Cuff – an introduction
The rotator cuff is best described as a muscular wrap made up of four key tendons that enables and supports arm movement at the shoulder by providing stability to the ball-and-socket joint. They are known to industry practitioners as S.I.T.S.
How the rotator cuff works
The S.I.T.S. is like a very strong hook that grips the ball-and-socket joint of the shoulder. Many other muscles around the shoulder blade and upper back works together with the rotator cuff to stabilise the ball and socket shoulder joint.
This array of muscles help facilitates the dynamic rotation of the ball joint within the socket, enabling it to have the greatest degree of movement available in our body. At the same time it also means this is the most unstable joint in our body.
If one muscle does not work in synch or congruently with the rest, the load will be shifted to other structures, and what usually takes up the brunt is the rotator cuff muscles themselves.
Explaining a rotator cuff injury
The most commonly injured member of the rotator cuff is the supraspinatus, one of the four stabilisers that hook the ball joint in the shoulder socket. It is placed in a vulnerable location, sandwiched between bony structures of the shoulder; this tapered space narrows further with overhead movements. During a holiday, it is common to lift heavy bags possibly during a shopping trip, moving bags from platform to platform when using trains, collecting luggage at the baggage carousel in the airport or bags up the overhead storage compartment on board the airplane.
Scale of a rotator cuff injury
A rotator cuff injury, most commonly in the supraspinatus muscle, can range from a mere impingement, a mild strain or inflammation to degenerative changes, a partial tear or a full rupture.
Common predisposing factors that could precipitate shoulder injuries are:
- Tight neck and shoulder muscles.
- Forward rounded posture – shoulder round forward, not able to use scapular stabilisers efficiently hence overload other structures.
- Poke chin posture caused by too much time on mobile devices or from other awkward deportment from office work.
Symptoms of a rotator cuff injury
If you feel any of the following sensations or discomfort, you’d most likely have sustained a rotator cuff injury and are highly recommended to seek professional advice:
- Pain in lifting arm overhead or behind the back
- Radiating pain or ache down the lateral upper arm
- Difficulty sleeping on the affected/injured side.
To summarise, without an existing strong muscle foundation, our body will find other ways and means to help stabilise the shoulder, such as recruiting other muscles, which often leads to injuries further down the road. These muscles may not be naturally built to cope with long-term compensation duties and might eventually result in further injury and pain. For these reasons, Chye Tuan advises that one should not take shoulder injury or discomfort lightly – seek professional help from a reputable physiotherapists.
In Core Concepts, all our physiotherapists are trained not only to properly diagnose the real problem by looking beyond the surface of the symptoms causing your pain but to treat your injury, alleviate the pain and teach you exercises to correct muscular memory to avoid further damage to this important muscle group.
7 Key Points to avoid shoulder injuries during your holiday:
- Distribute the weight of your luggage or shopping bags equally between both hands to avoid excessive strain on just one arm.
- Carry a backpack instead of shoulder sling bag whilst sight-seeing – this will avoid repetitive strain and pressure on just one shoulder. If there is a need to carry a shoulder sling bag, e.g. camera bag, ladies’ hand bags, change sides frequently or get use cushioned wider straps to avoid repetitive pressure points on just one shoulder.
- Avoid chills on your shoulder joints. Keep them covered when you are in drafty places.
- When in bed, If you are already feeling some shoulder discomfort, support your shoulders by placing pillow under your shoulder joints or arms as needed for comfort.
- With shoulder discomfort, avoid sleeping on your side as the compression into your should joint can increase the pain.
- Maintain good posture – enhance your shoulder motion by tucking in your chin and pulling your shoulder back. If someone were to look at yourself from a profile view, your ears shoulders, hips knees and ankle should all align.
- Targeted stretches: move regularly and engage in stretching exercises whilst on the plane which will instantly reduce muscular tension on your neck, shoulder and back. Here are some useful exercises Core Concepts has designed to keep you mobile and tension-free.