4 Keys To Healthy Shoulders

Photo by Mor Shani on Unsplash

Did you know there’s been a 600% increase in arthroscopic shoulder repairs over the last DECADE? Did you know the prevalence of a rotator cuff tear goes up ~10% with every decade after 30? So… 40% of 40 year olds, 50% of 50 year olds… etc. (DON’T WORRY — not all are painful, but all realistically a bit more compromised in tissue integrity!)

SO. Let’s talk about healthy shoulders! The shoulder region is an impressive area. It’s made up of 4 joints: the acromioclavicular, sternoclavicular, glenohumeral, and scapulothoracic joints. The glenohumeral joint is the more known ball-in-socket joint — a very, very mobile one. The “gleno-” part of this joint comes from the scapula, and the “humeral” part of it comes from the ball of the joint aka the humeral head. This joint is the MOST mobile joint in the body— like between 8–10 separate moves depending on how many you want to list. But the main ones: flexion/extension, abduction, internal/external rotation, horizontal ab/adduction.

But because the socket is relatively shallow, all that mobility is naturally compromised by lack of inherent bony stability, and which only increases the need for a solid foundational muscular strength to help lock in all that motion and protect the joint from injury. Muscles that control those two regions: the rotator cuff muscles (supraspinatus, infrapsinatus, subscapularis, and teres minor) and the scapular stabilizers (middle/lower trapezius, serratus anterior, levator scapulae). This leads me to my list…

4 Keys To Healthy Shoulders

1. Shoulder (glenohumeral) mobility — can the ball move enough?
2. Rotator cuff stability — is the ball secure enough while it moves? Is it moving cleanly?
3. Scapular mobility — does the socket move enough?
4. Scapular stability — is the socket secure enough while the ball moves?

See a theme? What needs to move a lot to achieve function, also needs to be stable with all that movement! Otherwise risk for injury goes up — biceps tendinitis, shoulder impingement, AC joint sprains, rotator cuff tears, the list goes on.

So… when might his affect you?
The shoulder needs to be strong enough to withstand physiological loads like those in and against the hand that go all the way through the shoulder and presses into the somewhat shallow socket without moving too much (cue “shoulder instability”).

Same thing applies when the shoulder is not against the floor, but instead being overhead or forcefully thrown around (i.e. pitching, weight lifting). With that said, while there are 4 key things, there are >4 key exercises. But a physical therapist can lead you through them — drop by the site to start YOUR plan for healthy shoulders and prevent injury!