Shoulder Health

Doctors call this area of your body the “shoulder complex” because it contains multiple bones, muscles, and joints that all work and move together. The diagram below shows the three bones of your shoulder complex: the humerus (upper arm bone), the scapula (shoulder blade), and the clavicle (collar bone). The clavicle attaches to your sternum at one end (at your chest), and attaches to the scapula at the other end (at your back). If you run your finger along your clavicle, you can feel how it’s positioned from the front of your body to the back.

The end of the humerus at the top of your arm is shaped like a ball. It fits with the end of the scapula, which is shaped like the inside of a shallow bowl. Together, the humerus and the scapula form a “ball-and-socket” joint. You can see how they fit together in the diagram below.

The muscles around the shoulder complex work together to produce the many types of arm movements we use in daily life. The larger muscles move the arm and help you lift, push, pull, and throw. In general, the smaller muscles help keep the joints stable. The smaller muscles that connect the scapula and the humerus are often called the “rotator cuff.” This group of four muscles (supraspinatus, infraspinatus, teres minor, and subscapularis) keeps the end of the humerus aligned with the scapula. In other words, it helps keep the ball firmly in the socket. You can see where these muscles attach to the bones in the diagram below.

When you lift your arm overhead, the rotator cuff muscles keep the humerus and scapula aligned. At the same time, other, larger muscles produce the force to lift your arm. As you can see in the diagram below, the larger muscles in this area have connections to the spine and ribs.

Anterior View (Front)

Posterior View (Back)

One very important but little known feature of the shoulder is the movement of the scapula. In order to raise your arm fully overhead, your scapula must also move. Even when you are using your arm at or below shoulder level, muscles around your scapula will contract to help hold it in place. This ability to “stabilize” your scapula is essential for a healthy shoulder.

The three animations below show how everything in the shoulder complex—the bones, muscles, and joints—move together when you move.

Practice Good Posture

These days, most people spend a lot of time sitting, with their backs rounded, shoulders hunched, head down, and chin poking forward. Long periods in this position can stress your muscles and contribute to stiffness in your joints.

Try the quick adjustments in the video below to reset your posture. The PDF is another great resource that explains step-by-step how to do the posture reset shown in the video.

Standing Posture Reset

If you have a resistance band, you can try the exercises in the video below. These will help with both your posture and your shoulder muscles.

Find Your Neutral Spine

There is a close relationship between the position of your spine and your shoulders. If your spine is in a good position, your shoulders will be too. Neutral spine is what we call the natural curve of your spine. Everyone has a different neutral position. Some people have more curve in their spine, others have less. Knowing where your neutral spine position is and holding that position helps prevent extra pressure on your back. It also lowers your risk of getting hurt when you exercise and do daily movements like reaching, stretching, lifting, and walking. 

Getting used to finding your neutral spine position and being able to hold it there is the goal. Finding it doesn’t mean you’re tense or holding your muscles tight. It’s not a workout, it’s just about finding that neutral position and feeling aligned in your body. The video and PDF below will help you find yours.

Finding Neutral Spine

Reduce Stress

You’ve probably heard the phrase, “We carry the weight of the world on our shoulders.” Well, there’s some truth to that! Stress and anxiety can cause the muscles in our neck and upper back to become tense, tight, and sore. A massage or heating pad may ease the soreness, but it’s best to find help with reducing the stress itself.

Be Kind to Your Shoulders

Don’t work for too long with your arms above shoulder height if you are not used to it. If you need to do something above your head, use a stool or ladder if possible. When carrying heavy objects, hold them as close to your body as possible. If you are doing the same movement over and over, take regular breaks.

Your body adapts to what you do. If you sit a lot and don’t get much activity, the “load” or physical demand on your body is low. Over time, your body will adapt to that low load and physical activity will feel difficult. But if you walk a little bit each day, your body will get used to it and walking will become easier. If you start slowly increasing the distance you walk, and add time to recover from those longer walks, your body will adapt and become stronger.

The same principles apply to the shoulders. If you move them each day, your shoulders will adapt and moving them will become easier. Depending on how you move them and whether or not you use resistance, the flexibility and strength of your shoulders can also increase. This process of building strength slowly over time is called “progressive loading.”

Recovery is an important part of progressive loading. Recovery includes eating healthy food, drinking water, and getting enough good-quality sleep. It’s also important to have “rest” days, where you do low-intensity activities such as a shorter, slower walk, or just stretching. The key is to add a little bit to your exercise routine over time, keep including time to recover, and do both these things consistently. Remember, you can get strong and recover from injury with the right approach. 

To work on your strength, you can begin with just body weight movements. Over time, your body will become used to the exercise and it will start to feel easy. That’s when you want to add in some extra weight or resistance. You can use exercise bands, free weights like dumbbells or barbells, kettlebells, medicine balls, machines, and other equipment. The key is to add a little bit over time, keep including time to recover, and do both consistently. This approach will give you the best chance to develop strength and avoid injury.

A Note on Pain: 

Pain in the muscles or joints can happen if you try to progress too fast. Usually, pain that develops gradually after starting or changing an exercise program is a signal that certain muscles are being overused. Increase your recovery time if needed. Pain does not necessarily mean that an exercise or activity is bad, it is just a signal indicating that the exercise or activity might need to be scaled back, or that more recovery time might be needed.

A Note on Frequency: 

When beginning a new exercise routine, it can be helpful to alternate exercise and rest days to avoid excessive soreness. For example, you could exercise on Mondays, Wednesdays, and Fridays, with rest days in between (and an extra one on Sunday). Then, as your body adapts and the exercises become easier, you might be able to change your schedule and exercise several days in a row before taking a rest day. The key is to find the right balance between exercise days and rest days so that you give yourself enough recovery time and develop strength over time.

Another strategy is to do exercises that target one area of the body one day, and then exercises that target a different area of the body the following day. This strategy allows you to exercise every day without working the same muscle groups in the same way two days in a row.

Your body is designed to move. Finding time for exercise can be difficult, but don’t think the only thing that counts is hour-long sessions at the gym. Taking short breaks to move or stretch and doing a few repetitions of an exercise during a break or while brushing your teeth can be a great way to fit physical activity into your day. 

Schedule Movement Breaks 

If you sit for long periods of time, set an alarm for every half hour to remind you to get up and take a few steps around the room. If you stand for long periods, set an alarm for every half hour to sit down (if possible) or stretch. The key is to avoid long stretches of time spent in the same position.

Start Anywhere

Below you will find videos of strengthening and stretching exercises for your shoulders. Choose exercises that you can do without pain and do them in a way that feels right to you. If the movement doesn’t feel good today, don’t do it and try again later. The most important thing is to get started with whatever you’re able to do today. You can always adjust the exercises and/or intensity as you build strength and increase flexibility.

For a strength exercise, consider starting with a set of 5–10 repetitions. You can add more repetitions or more sets as you build strength. For the stretches, only stretch to a point that’s comfortable and doesn’t cause pain. Start with a 20–30 second hold for each type of stretch. 

Stretches

The stretches below will help ensure your shoulders, scapulae, and upper back move freely in their full range of motion, in all directions.

Chest Stretch

Open Book Stretch

Wall Angels for Chest and Shoulders

Mid-Back Mobility

Exercises

Focus on developing the stabilizing muscles first—these provide the foundation for healthy joints and good movement patterns. Strengthening the stabilizing muscles will require lighter weights and more repetitions than what’s required when training the larger muscle groups.

You can also include both the stabilizing and larger muscle groups in your exercise program. The key is to ensure that you give the stabilizing muscles enough attention, so that they improve along with your larger muscles.

Here are some great examples of exercises for the stabilizing muscles.

Three Minutes to Health: Rotator Cuff Strengthening

No-Weight Exercises

The video below shows great exercises for the shoulders and upper back muscles that can be done without any weights or bands.

I’s, T’s, Y’s

Exercises with Resistance Bands 

If you have resistance bands and you want to challenge yourself, the two videos below show exercises for the front and back of your shoulder.

Single Arm Split Stance Row

Band Resisted Chest Press

Functional Exercise 

If you do a lot of overhead lifting at work, the exercise in the video below is a great way to strengthen your legs and shoulders at the same time.

Double Arm Push Press

Another great whole body functional exercise is the push-up. It’s a great way to strengthen the chest, shoulders and abdominal muscles. The video below talks you through a gradual way to develop your ability to do push-ups. If you’ve never done push-ups before, or you just don’t know where to start, this video is for you.

Three Minutes to Health: Push-Up Progression

Massages

Sometimes, muscles can get tight in certain areas. You can release tension in a targeted way with things like a foam roller, tennis ball, or electronic massager. Remember, when using these tools, more pressure is not necessarily better! The goal is to loosen any “knots” and help your muscles feel more flexible. Mild to moderate discomfort is normal while you are applying pressure, but these tools should make you feel better and not cause any lingering pain.

Foam Roll Massage

There are a lot of different foam rollers you can use, and they can be used in many ways. When rolling out your muscles, use a comfortable amount of pressure and adjust as you go. The videos below show how to use foam rollers on specific muscles.

Foam Roller Massage – Lats

Foam Roller Massage – Mid-Back

Tennis or Lacrosse Ball Massage 

Sometimes, it’s more helpful to massage a muscle using a tennis ball or lacrosse ball. These will help apply deeper pressure to tight muscles. Remember, more isn’t always better! Watch the video below to learn how to massage your shoulder muscles with a tennis or lacrosse ball.

Electronic Massagers

There are many types of electronic massage devices. Just like when using a foam roller or massage ball, use a comfortable amount of pressure for a limited amount of time. The goal is to feel better, not worse, after using it. Make sure to read and follow all instructions and safety warnings associated with any product you use.

• For smaller muscles, such as those along your forearms, start with a shorter length of massage time, such as 30-60 seconds. Pause, see how things feel, and then continue if you feel more time would be helpful. 
• For larger muscles, such as those in your chest and back, you might start with 1-2 minutes of massage time. You can move the massager up and down along the muscle if you are using a hand-held device. 

As you get comfortable using these devices, take note of how much time and pressure work best for you; these will likely vary with different muscles.

Your Crossover care team is here to help. We have coaches who can make a plan so you know where to start. Our mental health team can talk you through your stress and anxiety. Your physical therapy team can help you recover from injury with safe movement. Or you can start with a physical for a full picture of your overall health. Wherever and whenever you’re ready to begin, just connect with your Crossover care team. We want you to be well.