What I learned about the Shoulder at a “Mini Medical School” Lecture
The other night I attended a lecture on the Shoulder, put on by physicians Michelle Pepper, MD and Cliff Granseth, MD of Spine West in Boulder, CO. Having wanted to better understand shoulder issues and how a yoga practice can be tailored to support shoulder health, I found the lecture to be very informative. I want to share a few points from the information I took away with me and add the Yoga Therapy perspective to it, as well.
Essentially, the shoulder joint, which is a ball and socket joint, is comprised of two bones (the Humerus, or arm bone and the Scapula, or Shoulder Blades, although the Clavicles, or Collar Bones, play a role in some shoulder issues, as well) and several muscles. The muscles can be grouped together as such: the “movers” – bigger muscles that move the arm in many directions and are found in either the front or the back of upper body, and the “fine tuners”- four muscles that comprise the Rotator Cuff on the back side of the body and help keep the ball in the socket.
This ball and socket joint is shallow, so it can be challenging to keep the ball in the socket. If the rotator cuff muscles are weak (due to lack of use, imbalanced use, a strain or a tear) one may experience pain that refers down the arm or a shoulder that hurts when raising the arm. One might also experience pain after sleeping on the side because weak muscles are not able to hold the ball in the socket during the night, so the arm bone slips up and pinches a nerve. The bone moving up out of the socket can also cause wear and tear of the boney surfaces, leading to arthritic conditions in the shoulder.
Shoulder pain may also be caused by a sprain or separation at the junction of the Acromion and Clavicular bones (AC joint) resulting in pain at the top of the shoulder; a dislocation which results in a “dead” sensation and loss of movement in the arm; or arthritis in the AC joint that causes a rubbing of the bones and leads to bone spurs. Bone spurs on the underside of the bone may tear the rotator cuff muscles (the supraspinatus, in particular) resulting in pain when the arm is moved overhead.
Stiffness in the shoulder joint may be caused by inflammation, commonly experienced with Diabetes. Inflammation results in a thickening of the joint capsule and stickiness to the joint known as adhesive capsulitis. This condition can be lessened through physical and/or yoga therapy where one learns and applies proper alignment techniques and gentle movement therapy, although it can take a year or more for the condition to subside.
Other reasons one might experience pain in the shoulder area include: -pain that is referred from the neck (pinched nerves weaken muscles)
-abdominal issues (gallstones, pancreatitis)
-heart problems (symptoms of heart attack may be felt in either shoulder) -lung conditions (pneumonia) -other – shingles may result in joint pain
So… How can we keep our shoulders happy and healthy, you might ask? Attention placed in three key areas is the answer. Posture, Strength, and Body Mechanics can all support healthy shoulders. Keeping active and taking the shoulders through the entire range of motion helps too, as gentle movements serve to lubricate the bone, break up adhesions and keep us healthy. That’s where an effective yoga practice can help.
Depending on his or her background, a Yoga Therapist can help us learn about body alignment and how to keep the bones where they should be. The therapist can tailor a practice that builds strength in a gentle way, supporting the movers and fine tuners in doing their job to keep the shoulder appropriately aligned. We take the joints of the body through a complete range of motion, and work with the core which supports the lever action of the arm. And yoga offers a gentle form of whole body activity while facilitating a deeper awareness of all the parts of ourselves. We are not just the physical body, but the breath, the emotions, the mind and our connection to universal energy that is all around us and is a part of us, as well.
Yoga Therapy (YT) may just be the key to help you release some of the burdens of life we carry in our shoulders, and support you in leading a wholesome, happy and healthy life with or without joint issues. Email Sharon today to find out how YT can help you: firstname.lastname@example.org.
Sharon Alexander, BS Nutrition, RYT is a Yoga Teacher, Yoga Therapist, and Health, Wellness and Lifestyle Coach working in and around the Boulder area. She is available for consultations in her studio and travels to clients’ homes or businesses, as well.