Today I am going to discuss some potential causes of shoulder pain. In particular, I will look at the affect of increased curvature and stiffness in the thoracic spine/poor posture on shoulder dysfunction and pain. Poor posture is a huge problem in the Myoskeletal world and it has a lot to do with shoulder pain and loss of range of motion.
Our spinal column is made up of many inward (lordotic and outward (kyphotic) curves to give us and 'S' shape for optimal movement. It starts with our cervical region which is lordotic, thoracic region which is kyphotic, lumbar region which is lordortic and sacral region which has a small kyphotic curve.
Here are some common causes that disrupt our curvatures:
-Long periods of sitting (Jobs that involve desk work-an average person sits around 6 or more hours a day)
-Amount of time we spend looking down at our phones
A disruption to the normal curvatures of the spine, can pose a disadvantage for shoulder and thoracic movements, causing the muscles and joints to work poorly
It has been found that increased thoracic kyphosis leads to rounded posture, with forward head and rounding of the shoulders. This results in:
1. The subscapularis muscle becomes shortened as the shoulder is internally rotated
2. The pectoralis muscle becomes shortened across the front of the chest
3. The scapula (shoulder blade) begins to lift off and rotate laterally
4. The rhomboid muscles which run between the shoulder blades to the spine, are on stretch and constantly working to bring the shoulders and scapula back downwards and inwards.
- Studies have shown a correlation between the thoracic spine and shoulder functioning
- The link has been quantified in a random controlled trial conducted in 2014 involving 2144 patients
- The RCT concluded that and increase in thoracic kyphosis can evoke the development of sub-acromion impingement syndrome, as it reduces shoulder elevation (Otoshi. K. et al, 2014)
Sub-acromial impingement syndrome:
-With an increased thoracic kyphosis and rounded posture, the sub-acromion space in our shoulder joint is narrowed
-The supraspinatus muscle runs through this space and when it is narrowed there is and increased chance it will jam and cause pain with shoulder movements
How can we address shoulder pain brought on by thoracic kyphosis?
- Thoracic mobilization exercises and self stretches
- Soft tissue work/mobilization to decrease pain and restore proper muscular function
- Thoracic mobilization from a Myoskeletal therapist
- Postural retraining-focusing on scapular positioning
- Strengthening exercises for muscles of the thoracic, shoulder and scapular region
- An assessment and implementation of changes to your ergonomic set up is an effective intervention in re-training posture.
Consider the prolonged time you spend in your working position...the average person spends approximately 6 hours sitting per day!!!
At Complete Body Alignment, our approach is on restoring optimal MOVEMENT...
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