Recently a 26 year old female baseball player visited the clinic with right shoulder pain. She experienced pain with certain movements of her shoulder, mainly when she was taking off or putting on her t-shirt and any other movement of her arm over head (for example reaching for something on a high shelf). She had never experienced that kind of pain before and even though it wasn’t completely debilitating it was interfering with her daily life activities.
The only substantial change in her usual activities was the amount of time she was spending sitting down studying, reading and typing on her laptop. This had been increased substantially. When assessing her posture she presented with a right elevated shoulder and a bilateral shoulder protraction.
This posture creates a compromised position for the scapula and glenohumeral joint interaction, which in many cases narrows the subacromial space causing compression of soft tissue structures, leading to inflammation and resulting in pain.
Her treatment aims consisted of impacting on her shoulder position through treating the overactive tight muscles such as pectoralis major and minor, subscapularis, teres major and serratus anterior. We also used dry needling to reduce the pain around the subacromial space and supraspinatus. We then created a set of exercises that would help the muscles of shoulder and shoulder blade work better and become stronger by activating scapular retractors such as rhomboids and lower trapezius.
Lastly the most important piece of information shared was the need to alter and change the activities that were aggravating the client for example sitting for long periods of time. Instead we encouraged her to take breaks every 30 min, and perform specific stretches. We also addressed her sleeping position and introduced using a solid and thick pillow if she slept on her side for better head support, neck and shoulder position.
After her third visit she was pain free and still able to carry on with her study load and baseball participation. Her exercises are now part of her routine to help her keep moving and practising the sports she enjoys pain free.
Alvaro Torres – Elite Myotherapist