Shoulder pain - this is one of the most common areas where our clients experience roadblocks in their training, whether it’s trying to put more weight on the bar during the bench press, or trying to mirror Nicolas Cage’s handstand push-ups a la Con Air. “Put. The. Bunny. Down.” It can sideline you for weeks, months, and even create a sense of doubt as to whether you can throw a ball or disc (shout out to all you frolfers!), do a push-up, finish a pull-up, or lift overhead again without that nagging discomfort. Rest assured, there is hope. The purpose of this article is to outline an action plan and provide the most bang-for-the-buck mobilizations that we teach our clients so that you can get back in the game with confidence.
First, what IS the shoulder? The shoulder represents an area much broader and more important than just the ball-and-socket joint. It refers to an entire complex of interconnected and synergistic parts: the sternum, collarbone, the ball-and-socket joint, the shoulder blade, the rib cage, and the thoracic spine (or the area starting just below your neck). Big picture: if one of these links in the chain is not operating at full capacity, it can affect how well your shoulder moves and feels when raising your arm overhead or lifting weight.
So what do we do since so many parts and structures could be contributing to or causing shoulder pain? Well...there are several areas that are consistently stiff or tight in the majority of clients we see with shoulder pain. Put simply, address these areas first and determine whether that solves your problem. We will discuss how to mobilize them (i.e., get them moving well again) and apply a quick test/retest movement that you can perform to track for immediate improvement. If you notice quick and significant progress, then there is a good chance you could benefit from integrating these mobilizations into your daily routine.
Mobilization #1: Lateral Seam Smash
Test: Raise your arm overhead while in standing. The ideal overhead position should include the following: the elbow is straight, the palm faces toward your ear, the arm is close to or parallel with the side of your head. If possible, perform this one in front of a mirror to know what your baseline looks like and feels like.
Location: Lay on the side of the shoulder that you are trying to mobilize. Place a foam roller or lacrosse ball just below your armpit. Start with a foam roller. If this is too easy i.e., you don’t feel any tenderness or discomfort, then advance to using a lacrosse ball.
Method: Start with your elbow straight and arm at 90 degrees with your palm down. Slowly raise your arm overhead and switch your palm so that it faces toward your ear. Take one breath in/out with your arm overhead.
Duration: Focus on 10 arm raises in one area, then move farther down the lateral seam (i.e., muscle on the side of your trunk). Plan to spend 2-3 minutes on this area.
Retest: Raise your arm overhead.
Follow along with this video: https://youtu.be/59uRNCoIdLY
Mobilization #2: Thoracic Spine Extension
Test: Raise arm overhead (same one as with the lateral seam smash)
Location: Position a foam roller in the middle of your spine between the following two locations: the top of your shoulder blade and the base of your rib cage. Start with a foam roller. If this feels easy (i.e., you don’t experience any stiffness/tightness or tenderness), then try advancing to a double lacrosse ball.
Method: Lay on your back with your knees bent. Hug the sides of your trunk and pull the slack out of the area (i.e., with your grip, pull any loose tissue toward your palms). Take a breath in and exhale. If you do NOT experience any discomfort or tenderness, move up/down from that area and repeat. You can also test it by raising your head and back of your shoulders off the ground as you breathe in, then relax back to the ground as you breathe out. Focus on the areas that feel MOST stiff/tight. For the shoulder, you especially want to concentrate on your upper back (i.e., the area between the top and bottom of your shoulder blades).
Duration: Spend 2-5 minutes total on this one
Retest: Raise your arm overhead
Follow along with this video: https://youtu.be/Y5awxHX70z0
Mobilization #3: Pec Smash with Ball
Test: Reach your arm behind your head/neck. Ideally, you should be able to touch the top of your opposite shoulder blade (should feel like a prominent edge of the bone). Make sure you can do this without rounding your neck forward, arching your back, or feeling any kind of strain or cramp-sensation in your muscles.
Location: Position a ball (softball or something softer but of a similar size) in the meaty part of your chest (i.e., below your collarbone and away from the sternum).
Method: Lay face down and support your head on your opposite hand/fist. You have a couple options for mobilizing this area. First, start by reaching your arm behind your back (on the side that is laying over the ball). Keep your arm behind your back as you gently rock/roll side-to-side (i.e., moving your chest horizontally over the ball). Alternatively, you can slide your arm up and down just like if you were doing a reverse snow angel. If lying face down is too intense or uncomfortable, you can practice this mobilization in standing against a wall or door frame. If you perform it in standing, focus on simply applying pressure over the ball while rocking side-to-side.
Duration: Spend 1-2 minutes on each side
Retest: Reach arm behind your head/neck
Follow along with this video: https://youtu.be/pjcPZMCTFzA
Mobilization #4: Shoulder Rotator Smash and Floss with Ball
Test: Reach your arm behind your back. Ideally, you should be able to touch the bottom tip of your opposite shoulder blade. Make sure you can do this without straining or cramping a muscle, rounding your shoulder, or sticking the shoulder blade out. If someone notices that your shoulder blades look like bat wings when you do this (i.e., poke out behind you), then this is dysfunctional.
Location: Position a small ball (e.g., tennis ball or lacrosse ball) or large one (e.g., softball or something similar in size) in the area near the back of your armpit.
Method: Lay on your back with your knees bent. Bend and keep your elbow bent to 90 degrees. Position your arm so that it is 45 degrees or more away from the side of your trunk. Actively rotate your shoulder by trying to touch your palm toward the ground in one direction and the back of your hand toward the ground in the other direction.
Duration: Perform for 2 minutes on each arm
Retest: Reach arm behind back
Follow along with this video: https://youtu.be/wKs87t8HgmI
As a disclaimer, please recognize that if you are experiencing severe, debilitating pain or suffered a recent trauma, you need medical care first. If you have osteoporosis, focus on addressing the soft tissue mobilizations, but hold off on the thoracic extension over a roller/lacrosse ball. For everyone else, give these a try! Remember, consistency is one of the biggest keys to making progress. Focus on applying the mobilizations 5-6 days a week for a couple weeks. If they do not seem to address your shoulder pain issue, it could be that you need a more specific, hands-on examination to map out your path to healthy and strong shoulders. Email me at firstname.lastname@example.org to schedule a free 15-minute phone consultation or reach out at restorethrive.com.