Resistance training (aka strength training) for you shoulder may be key…. but not only for the reason you think!
How many of us have been sidelined by shoulder pain?
Did the pain hold you back from throwing a ball, exercising, picking up a heavy piece of luggage, reaching into a high cabinet, or washing your car?
One possible source of shoulder pain is rotator cuff-related shoulder pain (RCRSP). This category not only includes pain from things like rotator cuff tendonitis and tendon tears, but also from other sources in the shoulder like bursitis.
In their recent article Powell, J. and Lewis J. highlight that with RCRSP there are often multiple structures within the shoulder that can contribute to a person experiencing pain, versus just one primary structure.
So, what exactly is the rotator cuff and what does it do?
The rotator cuff is comprised of four muscles that assist in stabilizing the ball and socket of the shoulder at rest and during movements. The four rotator cuff muscles include the supraspinatus, subscapularis, infraspinatus, and teres minor.
These four muscles work synchronously whenever we do a movement with our shoulder, keeping the ball firmly in the socket of the shoulder.
What is a bursa?
A bursa is a fluid filled sac that acts as a cushion between two structures to help reduce friction. There are a number of places throughout the body that need this kind of help and as a result we have tons of bursa throughout our bodies.
In your shoulder an example of this is the bursa between your acromion (a bone) and your supraspinatus tendon. The bursa here helps the supraspinatus tendon from rubbing on the under surface of the acromion during arm movements.
Now that we know what some of the structures in the shoulder are, what Can we do about shoulder pain?
Recent clinical practice guidelines recommend non-surgical management and education as the main treatment method for RCRSP (Powell and Lewis) (Vandvik, Lahdeoja, Ardern, et al.).
This is great news because we know our body has the amazing ability to heal itself.
One form of Non-Surgical management for shoulder pain is resisted exercise, or strength training.
There are so many ways in which strength training can benefit your shoulder including improving muscle mass and strength, improving muscle coordination and timing, and improving mechanics at the shoulder.
But resisted exercise can do so much more:
Strength training helps to reduce pain itself, improve confidence, influence systemic inflammatory chemicals, improve quality of life, and changes the way we think about pain (Powell and Lewis).
Who knew strength training could have so many benefits?
Here are some simple exercises for the shoulder that you can try yourself:
Serratus slide: First place a looped band around your wrists. Then, pull your wrists apart so that they are shoulder-width apart. Your elbows should also be shoulder width. Keep your elbows bent at a 90 degree angle during the entire exercise. You should be pressing the band outwards, pressing the wrists away from each other and holding this same distance during the entire exercise. Start with your wrists at the level of your elbows. Slowly move your arms so that your wrists are now at the level of your shoulders. Then lower your arms back down to the starting position. Repeat 15-20 times, 2-3 sets.
Rows: Anchor a resistance band to a stable object. Hold one side of the band in each hand. Pull the arms back with the elbows leading and slightly squeeze your shoulder blades together. Do not allow your elbows to go very far past your body. Then slowly return to the starting position. Repeat 15-20 times, 2-3 sets.
Y’s: Lying on your stomach with your arm hanging off of a bed, lift your arm up on a diagonal with your thumb pointing towards the ceiling. Think about your shoulder blade moving down and back towards your opposite back pocket. Repeat 15-20 times, 2-3 sets.
These three exercises are great exercises for improving muscle strength, timing, and coordination of the entire shoulder girdle.
Powell JK and Lewis JS. Rotator Cuff-Related Shoulder pain: Is it Time to Reframe the Advice, “ You Need to Strengthen Your Shoulder”? J Orthop Sports Ther 2021, 51:4, 156-158.
Vandvik P O, Lähdeoja T, Ardern C, Buchbinder R, Moro J, Brox J I et al. Subacromial decompression surgery for adults with shoulder pain: a clinical practice guideline BMJ 2019; 364 :l294 doi:10.1136/bmj.l294