Avoiding Shoulder Pain


Peter Falla, ATC/L, of ONS Physical Therapy in Greenwich, shares tips to avoid shoulder pain during the COVID-19  lock down.

Many of us have recently set goals to take advantage of downtime during isolation from coronavirus.  We have pledged to improve eating habits, get on track with our exercise routines, and even check off some household projects that have been hanging over our heads.  Additionally, stay-at-home orders have many of us working and schooling from home, presenting a whole new set of challenges including less than optimal workstation setups. Any and all of these situations can put you at risk for a shoulder injury.

Outlined below are steps you can take to help prevent or perhaps improve, pain in and around the shoulder.

Watch Your Posture!Poor work posture

Pay attention to your posture while using your laptop to work from home.  Fight the urge to sit cross-legged on the couch during long bouts of keyboarding, reading, or video conferencing.  Sitting in this position promotes a slouched thoracic spine and a forward head posture that stresses soft tissue structures in the neck, shoulders, and back, often leading to pain in these areas.

Instead, keep your feet on the ground, engage your core muscles to support your back, and do all that you can to elevate the height of the screen so that you are not looking down for long periods.  Activating certain muscles to maintain good posture can be considered a workout.  Over time it will become easier to do and also easier to notice when you are in a poor sitting position.  Check out this link for more detailed information: ONS Workstation Ergonomics

Be Careful with Home Exercises

Home exercise injuryThere are many home workouts circulating now that are tailored to people sheltering at home to avoid infection.  Evaluate these workouts carefully before starting.  Instructions for your body position during the exercises should be clear and make sure the program is issued by reputable sources.

Do not deviate too greatly from the workouts your body is familiar with.  New stressors and movements can be beneficial in some situations, however, this is not a time to develop a new injury or aggravate an old one.

Exercise-Related Shoulder Pain

When patients present to our physical therapy clinics with exercise-related shoulder pain, there are usually some common denominators we uncover in their exercise history.  Previous injury notwithstanding, one of the most common causes of acute shoulder pain occurs when an  individual increases the level of activity too quickly.  When starting an exercise plan at home, select a program that gradually increases the activity in a methodical manner to avoid over-straining the shoulder girdle.

Another exercise-related shoulder pain results from performing repetitive exercises that irritate the soft tissue surrounding the ball and socket joint in the shoulder, or the rotator cuff, which is a group of muscles that stabilise the joint and allow the arm to be raised overhead.

Common Culprits

One of the classic complaints patients have is shoulder pain when raising their arm fully overhead.  In the context of someone active in the gym, or with home-based weight training, certain exercises can be detrimental to your shoulder.  Overhead presses, dips, and push-ups are the top three exercises that may lead to shoulder pain.  If the shoulder muscles that stabilize the scapula (shoulder blade) are not strong, an individual may perform the exercise using improper mechanics at the shoulder joint, causing inflammation and discomfort.  Discontinue any exercise that causes discomfort during the movement.  Strengthening the same muscles can be done effectively with lifting the arms no higher than the shoulders.

Push-ups and dips are two exercises that, if done too deeply, (elbow angle >90°) can overload the ligaments of the shoulder joint, leading to pain.  Perform these exercises slowly and through a comfortable range of motion, avoiding the extreme ranges that uncomfortably stretch the front portion of the shoulder.  Lastly, when performing upper-body resistance training, remember to warm up adequately and incorporate some light stretches to prepare the shoulder for the demands it will encounter.

Go Easy On The To-Do List

Finding ways to stay busy and productive during these trying times has resulted in many of us tackling projects around the house that we normally have little time to do. Some of us find ourselves undertaking one project after another, which is great for one’s sense of pride and accomplishment, but it may take a toll on the shoulder or low-back.  Work slowly when faced with projects that require lifting, digging, or sustained overhead work.  If you feel any shoulder discomfort, space out the work and take breaks as needed to do other less strenuous tasks.  If the pain persists, put that project on the back burner until you’ve consulted with a physician or physical therapist.

General Instructions

The takeaway here is that you should have a plan in place to minimize stress to your shoulders and total body through careful exercise selection, good body mechanics, and a gradual, progressive approach to all types of strenuous work you undertake.

There are some useful general strengthening and stretching exercises included in the following link; RANGE OF MOTION EXERCISES.  As always, check with your doctor before beginning any new exercise routine.

If You Develop Shoulder Pain

If you are experiencing shoulder pain that is slow to improve or may even worsen, refrain from strenuous upper body exercise and household work until you can be properly evaluated by an ONS orthopedic shoulder specialist.  Due to the COVID-19 pandemic, ONS has limited office visits to urgent orthopedic and spine injuries, by appointment only. Patient evaluations and consultations with ONS specialists are available to all patients online through ONS Telehealth.  Call 203-869-114 to make an appointment or you can schedule your  telehealth visit at any time using our new self-scheduling feature.