Shoulder injuries need more attention
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By Lee Seung-hun
Nowadays, many people work regular exercise into their schedule in order to maintain or improve their health. While most people will experience some type of benefits such as a loss of weight or improved cardiovascular endurance, some unintentionally injure themselves and end up paying a visit to a clinic.
Although most body parts can be injured during a given exercise, the shoulder joint is one of the more injury-prone areas. Shoulder joints are frequently used and can be abused during swimming, tennis, baseball, weight-lifting and many other exercises, and thus they are exposed to various types of injuries.
Shoulder joints are structurally weak when load-bearing exercises are involved. If one can simplify the structure of a shoulder joint, it looks like a typical ball-and-socket structure. The socket is much smaller in comparison to the ball ― like a golf ball on a tee in an exaggerated fashion. Such a structure allows our shoulder to move and rotate in many different ways, but it inevitably has weak integrity.
If the shoulder joints are what connect our torso to the arms, the hip joints do the same for our torso to the legs, and are similar in structure. However, with hip joints the parts that act as sockets are larger and deeper in comparison to the corresponding parts of shoulder joints, and the surrounding muscles and tendons are stronger.
Therefore, the hip joints can bear more weight while allowing for various movements unlike the shoulder joints that can easily be injured with load-bearing movements. Structurally speaking, weight-lifting is a high-risk exercise for shoulder joint injuries as it overloads the joints if not done properly.
One of the more frequent damages to shoulder joints manifests in the form of shoulder impingement syndrome (SIS).
If you know someone who has injured their shoulder, you probably have heard them say that they tore their rotator cuff. A rotator cuff is not a single muscle, but a group of four muscles that surrounds the shoulder joint. Anatomically, a shoulder joint has a small gap among the humerus, scapula and acromion process through which the supraspinitus tendon of the rotator cuff passes along with the bursa that acts as a buffer.
For any number of reasons, the gap between the humerus and the scapula can narrow that can increase the friction with surrounding tissues with arm movements causing pain. This is SIS. Such friction can easily lead to inflammation such as supraspinatus tendinosis or subacromial bursitis. Prolonged friction can tear the tendon, which is called a rotator cuff tear and with a severe tear, surgery may be required.
People who repeatedly use their shoulders are naturally more prone to SIS. Exercises such as swimming, tennis and throwing motions involve lifting the arm overhead that can narrow the gap between the humerus and scapula. Also if someone’s bone structure naturally presents a small gap between the shoulder bones, they are also prone to SIS.
As the pain is localized in the shoulder joint area, most seek the root cause only in the shoulder areas, but even a general posture issue can cause SIS. When we are lifting our arms, it is not just the arms but also the shoulder blades that are involved.
If you stoop your back and lift your arm, and then straighten the back and lift the same arm, you can feel a difference in the arm movement. What this means is that the shoulder blades (the scapula) must be able to function normally in order to have a full range of motion in the arms.
Prolonged use of computers or smart phones can affect one’s posture to an extent where the back is stooped and the scapula can shift its position. If so, the gap becomes structurally narrow and any arm movement then involves more of the arm and less of the scapula, leading to increased friction.
Oriental treatments for SIS address decreasing the inflammation using bee venom or pharmacopuncture on the areas of inflammation while implementing Chuna-chiropractic and other corrective measures to remedy the posture and stabilize the scapula in order to resolve any issues involving back muscles.
If a patient is not responsive to general shoulder joint treatments and shows no other issues at the anatomical level upon inspection, it is important to treat the issues in the regions surrounding the scapula.
In order to prevent exercise related shoulder pain, it is essential that you perform stretching before and after performing the exercise. The stretching should not be limited to the shoulder muscles but also involve the overall back muscles. It is also helpful to maintain a correct posture in our daily activities while reducing the use of smart phones and other activities that can harm our posture.
The writer practices oriental medicine at the UN Oriental Medical Clinic in Hannam-dong, Seoul.