Postural Abnormalities and Their Influence on Shoulder Injuries

The majority of shoulder injuries (labral injuries and rotator cuff injuries) are related to activities that involve repetitive overhead arm movement.  Examples include swimming, baseball, power lifting, and gymnastics.  The specific causes of these injuries are unknown. However, literature strongly suggests that the main source is altered movement of the arm in relation to the shoulder blade (i.e., improper muscle balance and recruitment patterns during repetitive activity) that leads to compensation and pain at the shoulder.  The majority of rotator cuff injuries are believed to be due to cumulative trauma from shoulder impingement. 
What causes shoulder impingement?  Abnormal position, motion, and/or motor control of the bones and muscles or the shoulder are major contributing factors.


  A recent review of current literature found that there is an association between abnormal shoulder position and shoulder injuries.  Specifically, if the scapula is tilted forward or downward or has reduced capacity to rotate upward as the arm elevates, then the person is at a higher risk of rotator cuff injuries.

   Further, these changes lead to compensatory motions and prevent many muscles of the shoulder from working effectively.  This leads to quick fatigue, decreased functional range of motion, muscle imbalance, and even larger postural abnormality down into the mid back, core, and legs.  And remember, abnormal static or dynamic motion will put the muscles in a vulnerable position for overuse, pain, breakdown (sprain/strain), and serious shoulder injury that may lead to surgery.
    Another consequence of poor posture is abnormal motor control (the ability of the brain and muscles to work together efficiently).  For example, studies have demonstrated that a person with abnormal shoulder position will activate important muscles in the shoulder girdle at a significantly slower rate and lower magnitude.  These abnormalities will lead to pain, injury and/or reduced performance!

During a Direct Performance evaluation, each patient will be examined comprehensively to correct biomechanical faults.  Corrective interventions are tailored to each client's impairments in order to optimize performance.
Article:
Ludewig PM, Reynold JF.  The association of Scapular Kinematics and Glenohumeral Joint Pathologies.  Journal of Orthopedic & Sports Physcial therapy. Feb 200, Vol 39(2). 90-103.