Shoulder Health. By Jordan Ruder, Physiotherapist

Get Your Head Around Your Shoulders this Summer!

With summer fast approaching, many of us are jumping back into one or more of our favourite fair weather activities, be it golfing with an orchard view, volleyball on the sandy beach, swimming in the crystal clear Okanagan lakes, playing tennis with friends or a little extra gardening for all of you green thumbs! Whatever the summer activity of choice, we all hope this warm weather finds us ready to tackle the ‘fun in the sun’ at full steam without having to worry about those pesky aches and pains that often set in over the winter.

One aspect that many summer activities have in common is that you will undoubtedly require a pair of healthy shoulders to fully enjoy them. As a practising physiotherapist treating patients with various conditions and injuries for almost a decade, I must say that shoulder pathology and dysfunction are some of the most common conditions walking in and out of our clinics on a daily basis.

When you dissect this shoulder issue further, there are a few key things that make the shoulder one of the most biomechanically impressive but also one of the most vulnerable regions to injury in our body.

First of all, the shoulder is the most mobile joint in the human body. The ‘ball and socket’ anatomy of the shoulder allow for movement that we see in no other body region. Whether it be flexing the shoulder 180 degrees overhead to smash a beach volleyball or fully externally rotating your shoulder during your golf swing follow-through, the shoulder girdle demonstrates phenomenal flexibility.

This fantastic mobility in the shoulder girdle however comes with a price. In order for this flexibility to be functional when teeing off with your driver on 18 or lifting heavy pot of flowers up on your deck, the shoulder requires a significant amount of dynamic stability. This dynamic stability is accomplished by work of a few important muscles that surround the very flexible shoulder joint…most notably, the rotator cuff as well as other scapular stabilizing muscles.

For our shoulders to remain healthy and function at the high levels required for our summer fun, this balance between flexibility and stability must be maintained.
Some common conditions and injuries that we as physiotherapists assess and treat where shoulder flexibility and stability become compromised include; Shoulder Impingement, Tendinitis/Tendinopathy, Bursitis, Rotator Cuff Tears, Shoulder Dislocations/Separations, Frozen Shoulder, and Scapulothoracic Dysfunction.

If your summer involves getting or staying active and you want your shoulders to be ready for the action, book a consultation and some treatment with your physiotherapist to ensure your shoulders are ready to shoulder the load!

Jordan Ruder is a Registered Physiotherapist and Associate at the Downtown location of Sun City Physiotherapy. He is a member of the Canadian Physiotherapy Association and is also a Fellow of the Canadian Academy of Manipulative Physical Therapists (FCAMPT). He can be contacted by phone at (250) 861-8056 or by email at downtown@suncityphysiotherapy.com.

Swimmer’s Shoulder by Tess Mihell, Physiotherapist

With the May-long weekend marking the unofficial start of summer, and the weather quickly heating up, many people are hitting up the lake to take their swimming practices outdoors. Like any sport, aches and pains can occur in swimming, with shoulder pain being the most common complaint. The term swimmer’s shoulder is used to describe painful shoulder overuse conditions that occur in the sport.
The shoulder is a ball-and-socket type of joint, which allows for a large amount of motion. This excessive mobility is balanced by surrounding tissues to make it more stable. Included in the structures that help stabilize the shoulder is a fibrous capsule that surrounds the head of the humerus (the arm bone), as well as the rotator cuff. Four muscles make up the rotator cuff, and serve to keep the humerus properly placed in the joint. The bony structure that you can feel on the top of your shoulder is called the acromion, where impingement can occur.
Many movements occur at the shoulder during swimming, a lot of which is overhead. Different swimming strokes involve different patterns of motion, but all have some combination of rotation, circumduction and scapular movements. These positions can put the swimmer at risk of impingement, especially if the biomechanics are off.
Injuries to the shoulder complex from swimming are typically microtrauma: small injuries over time from the repetitive activity rather than a macrotrauma from a one-time incident. There are many factors that can contribute to injury, typically described as intrinsic and extrinsic.
Intrinsic factors can include the positioning of the joint itself; if the capsule surrounding the joint is tight at the back, it pushes the humerus forward, increasing the likelihood of impingement of the tissues under the acromion, and placing more stress on the tendons of surrounding muscles. Opposite of that would be if the joint is lax, which creates more demand on the rotator cuff muscles to provide stability. Another intrinsic factor is posture, with rounded shoulders and an increased forward bend in the upper back being common amongst swimmers. This lengthens and weakens muscles that stabilize the scapulae, can contribute to a tight posterior capsule in the shoulder, and decreased mobility in the spine.
Extrinsic factors are related to the use of your shoulder: overuse (your training schedule), misuse (swimming form), abuse (too strong of demand placed on your shoulder), and disuse (time off from training).
To maximize your season, it is worthwhile to assess your shoulder mechanics, preferably before injury occurs to be preventative. Any impairments should be addressed, which can include mobilizing stiff or tight structures, strengthening the rotator cuff and other supporting musculature, and improving technique. Be cautious of overtraining – don’t increase your distance, intensity or frequency of training too quickly. Give yourself adequate time to make strength and endurance gains, as well as time to recover.
Consulting your physiotherapists to address shoulder and posture impairments, and a coach to look at your form, can help keep you swimming strong this summer.

Tess Mihell is a Registered Physiotherapist at Sun City Physiotherapy in Winfield