There’s lots of ways your shoulders can feel achy and sore, stiff and tight, but there’s one everyday motion that can really make you take notice and interfere with what you need and want to do…
The basic act of reaching above your head.
Whether you’ve had a recent injury or just always felt some level of tightness, overhead reaching problems creep up on us until BAM! it becomes significant.
I distinctly remember a patient that came into my office and could barely reach at the level of his head. He had no real aggravating incident that he could remember. He didn’t think of doing anything about it until he couldn’t reach up in cupboards for his coffee mug!
At first thought that seems nuts, but it’s a pretty natural thing to not notice an issue when it’s an activity or motion we don’t use too often. In this example, he said he didn’t do a lot of sports or exercise much, so it’s (fairly) reasonable that it didn’t affect him too much until the range of motion became so limited he couldn’t ignore it anymore.
For those of us that are much more active, it can be not so much that we don’t notice it, but instead we compensate by moving the rest of our body to make up for the shoulder, or simply just force our hands up and do what we need to do.
You know who you are!
Shoulder Assessment: How to Identify the 4 Most Common Shoulder Restrictions
There’s a lot of specific details on all that could be going on in your shoulder girdle and associated pain and movement restrictions, but in my experience over the past couple of decades, this assessment can help clear up the majority of minor issues.
Simply notice what you are experiencing when you reach for something up high.
When you reach up overhead as far as you can:
Do you feel like you have to arch your low back a lot?Do you feel a pinching in the front/top of your shoulder?Do you feel like the rest of your torso is hunched over as you lift up?Do you feel like your abdominals are tight, or it’s harder to breathe?
These are fundamental questions that will clue you in on what would be the best use of your time.
It may be feel good to work on all of the exercises we share. It certainly wouldn’t hurt. But we all have time and energy constraints, so knowing how to best allocate your time will make progress much smoother and make it much easier to be consistent in your efforts.
Shoulder restrictions usually aren’t an isolated issue. Use this systematic guide to assess and address the mobility of all your major joints:
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Below, I’ll give you more details on the tests and exercises in the video…
1. Low Back Arches a Lot
What This Could Mean
This could indicate decreased muscle flexibility, with the latissimus dorsi being the usual suspect. It attaches from the front of your upper arm to a very broad area of the last half of your mid back, the entire low back and into the top of the pelvis.
It’s a common compensation to arch your back when your lats aren’t able to lengthen enough as your arm raises higher. This is likely why a lot of people feel better when they spend a bit of time hanging.
The following couple of exercises encourage freeing up the lats with their big sidebending motions to open the area from origin to insertion.
On hands and knees, reach across yourself and “anchor” that hand down.Inhale and shrug your shoulders up.Breathe out as you sit back as far as you can.Breathe normally but with each exhale work on releasing more tension each time.Do this for 30 seconds to a minute on each side.
Tall Kneeling Arm Raises To Side
Kneel down, keeping your knees, hips and shoulders in a straight line.Place one hand on your hip and raise the other hand overhead. This now “anchors” your lower body as you lengthen through your hand.Inhale in this position and exhale as you reach up and to the side. Again, breathe normally and work on relaxing and lengthening on each exhale.Do this for 30 seconds to a minute on each side.
2. Pinching Sensation
What This Could Mean
This is another very common complaint, so much so that it spurred on the frightening name, “impingement syndrome”. The prior thinking was that there was a compression and actual pinching of soft tissues between the bones. Pretty scary!
Luckily it’s not so much that your bones are chomping at tendons as you lift your hand up, instead it’s more likely that movement restrictions and prior inflammation and pain make tissues in this area more sensitive.
This can become a kind of ingrained habit with less than ideal movement patterns and decreased motion in particular ranges of the shoulder blades, turning this into an unfortunately common chronic and recurring issue.
Some movements like these that emphasize scapular motion so you can “re-learn” would be a great addition to your regimen prior to pressing and reaching activities.
Quadruped Shoulder Circles
On hands and knees, get your knees in line with your hips and hands in line with your shoulders.The idea here is to make as wide of a circle as you can.Press through your hands to get your shoulders moving.Think of moving your shoulder blades up and down and around your ribcage.Do this for 30 seconds to a minute in each direction.
Prone Shoulder Opener
Kneel and place your elbow down on the ground at around the same line as the opposite shoulder.Holding on to your wrist can help you feel that “anchoring” at the elbow.Inhale as you drop your body down and away from that elbow to feel a tractioning as well as a stretch sensation in the back of the shoulder.Exhale and relax, working on relaxing further with each breath out.
3. Midback Feels Hunched
What This Could Mean
This is yet another very common issue and it’d be easy to jump on the “computers/phones/deskwork is slowly killing us all” bandwagon.
But in my opinion that’s more of an extreme soundbite to get people reading and riled up. “Sitting is the new smoking!”. Well I’m pretty sure smoking is still the new smoking…
Instead, a better way of thinking would be that staying in prolonged postures tends to limit your movement options and variability. Too much of being hunched forward all day without any breaks and your body “forgets” that there are other positions that it can go into.
And it’s up to us to break out of that, and keep moving in as many different ways as we can for the rest of our lives.
So here, it’d be great to spend some time encouraging our thoracic spine to extend and rotate better.
On hands and knees again, place a hand on a hip so you can lead your rotation with your elbow.Breathe out in this setup and inhale as you look and rotate upwards.The switch to inhalation when you stretch up here is to help with rib expansion. Which in my experience helps to improve rotation.It can be difficult to relax with the inhale but it gets better with practice.Do this for 30 seconds to a minute on each side.
Upper Thoracic Extension
Kneeling in front of box/chair/coffee table. (You can also sit in a chair in front of a table, but this can be limiting.)Place the back of your elbows on the support. The close together the more it affects the lats, so find a comfortable width for you.Inhale and then drop your hips back and let your chest drop down to the floor as you exhale.Exhale fully and relax as usual.Do this for 30 seconds to a minute.
4. Breathing Feels Restricted
What This Could Mean
This common restriction tends to pair up with tightness in the thoracic spine.
This makes sense, since the ribs are attached to the thoracic spine and also being hunched over can also “teach” the abdominals that they don’t have to lengthen.
Seated Combined Motions
Seated in a chair or stool, you will rotate in one direction and then sidebend the other.So, if you start with twisting to your right, you’ll stay in that position and then bend to the left.Then breathe out as you rotate and inhale as you sidebend. Again this helps with ribcage expansion.Play around with how much you emphasize either the rotation or sidebending.That is you can rotate as far as possible first then sidebend. Or just twist moderately and focus on sidebending more.Do this for 30 seconds to a minute on each side.
Cobra (Elbows on Block)
Here you’ll need a sturdy block/step/low stool to place your elbows and forearms.This can be a tricky setup when you first start, but the keys are pushing through your forearms and feeling as if you are scooping your chest up and forward.Breathe out as you setup and take a slow, deep breath in as you scoop upwards and think of opening up your ribs as wide as you can.You may get a bit dizzy so it helps to take your time and some normal breaths in between until you get used to the exercise.Do this for 30 seconds to a minute.
The Limits of Self-Assessment for Shoulder Issues
A quick google search will uncover dozens of shoulder exercises with bands, cables, hanging, and all kinds of stuff. And any and all of it could be helpful for you, I’m not dissing on that at all. A great PT friend of mine used to joke that other therapists had a “shotgun” approach to treating patients. “Just give them 20 exercises and somethings gonna work!”
But instead of just throwing stuff at it and hoping for the best, I think it’s a good idea to figure out what might be the primary driver of the problem. There’s lots of interactions for why you are experiencing pain. Whether it’s a specific injury, stress, poor sleep, not a great diet, etc. But often if you can find a way to help the area move better, you’ll be well on your way to improving. And in my opinion, doing that efficiently will help you stay consistent and get you better faster.
Maybe it’s a controversial thing to say but a nuanced and analytical approach always wins over just trying someone else’s favorite exercises.
Indications You Might Need More Help
We aren’t teaching you a properly thorough musculoskeletal and neurological examination right now, because frankly unless you are a medical professional you aren’t qualified to do one. If you have any of the following please see a qualified pro about it:
Pain that just keeps getting worse: This chronic pain article can help you learn morePain that consistently wakes you up at nightWeakness, numbness, pins and needles sensationsTrauma (falls, car accidents): This post injury article can be a good resourceBut for most of us, most of the time, this troubleshooting sequence can help us to move and feel better.
Short-Term Interventions vs Long-Term Training
One of the concerns I have with sharing these, along with many other isolated and specific movements, is that it’s easy to get the idea that you have to do these forever.
And that’s absolutely not the case.
I do remember being in the clinic with other therapists who would intimate that to their patients though. I’m sure it was well meant, but I also disagreed with it. Isolated, “therapy like” exercises like this are meant to be transitional.
Now, I fully believe that we should all include regular movement and exercise in our lives for as long as possible. But that doesn’t mean that every exercise that is helpful in the current moment for you should always be in your routine.
Objectively that’s not even possible, your training would add up to several hours a day!
Instead, the spirit of this information is to give you insight into what movements would be helpful for you at this particular point in time. Try them out as part of your warm-up before the meat of your training, and judge how much benefit you get by how you are feeling and performing. Give it a few weeks of steady consistent effort, and you’ll retain what you’ve re-taught your body through “bigger” more integrated full body movements.
I’m not saying throw them away fully, you may really enjoy how they make you feel, and a few minutes of the exercises before training isn’t a waste of time. Just don’t make your warmup last longer than your primary workout!
Integrating Healthy Shoulder Movement Patterns
Once you’ve worked on these a few times and get a sense of what you need more of, we recommend adding whole body movement patterns into the mix.
You could do these at the same time as well, they work perfectly together. There’s no need to only do these for 3 months or anything like that. As said above, unless you have some major issues you can suss this out for yourself by heeding how you feel and perform. If you feel good about moving around more, you should move around more!
What kind of “whole body movement patterns”?
There’s a lot of complex exercises you could come up with to move your body through it’s full ranges of motion, but why reinvent the wheel?
You had this figured out when you were a baby, and crawling (if you wanna be fancy, you can call it “quadrupedal movement” or “locomotor exercise”) is still one of the very best ways to develop full-body, coordinated movement patterning.
👉 Our recommended locomotor movements
We generally call it locomotion, which simply means moving yourself around from one point to another. In our training programs, we use it as the general term for “quadrupedal” movement patterns, or even more simply, “crawling”. The definition itself is important though, because having an actual goal and intent in moving around matters quite a bit for motor learning and how much “transferability” there is from exercising to the activities that mean the most to you.
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These movements with the funny names – Bear, Frogger, Twisting Bear, Monkey 180 – all provide different aims and stimuli that fit really well with improving shoulder function.
Shoulder blade mobility, muscle lengthening and ribcage expansion are all a part of the performance cues we give for the movements and in essence “trick you” into working on all of these concepts while you move yourself along the floor.
Build Mobile and Strong Shoulders with Integrated Full Body Movements
With Elements, you’ll build and keep your shoulders healthy with a progressive variety of locomotion movements.
Your Foundation for Physical Autonomy