Nov 1, 20175 min
Take a walk outside or step inside the floor of an office building and the sight is the same. What you see is someone staring at a screen, whether it be a cell phone or a computer, with a slouched body and rounded shoulders. In biomechanics terms, that is a flexed cervical spine, protracted shoulders, and a flexed thoracic spine. To imagine what this position looks like, think of our upper back resembling a turtle’s shell. To most this is a harmless position, but from the lens of a healthcare practitioner, this position screams a myriad of ailments and potential injuries to come down the road. While the focus of this post is to talk about maintaining a healthy shoulder we must dive in a little deeper on the ramifications of the “turtle position”.
To start, let’s think about the role of the shoulder. It allows us to reach for items overhead, carry our groceries, and it allows us to throw an object. We’re constantly doing these actions over and over while ignoring the actual movement or role the shoulder’s playing at that moment. Some of us know the inconvenience of not being able to perform these actions when recovering from a surgery that has limited our mobility or to a lesser degree when dealing with shoulder pain or upper back pain that influences our ability to move the shoulder freely. For some people, these inconveniences are a constant in the case of having a frozen shoulder. Some cases of the frozen shoulder comes about from the infrequency of fully raising the arm overhead. After not doing so for a prolonged amount of time the neurological connection of that action is lost. Here we see the immense value in the simple action of raising the shoulder all the way overhead once a day. All it takes is one yoga pushup a day to not get a frozen shoulder from inactivity. Mind you, a frozen shoulder is just one example of the potential side effects of the “turtle position” (flexed cervical spine, protracted shoulders, and a flexed thoracic spine). Before we continue, it’s imperative to see the importance of daily practice.
For those of us who have a daily practice, it may consist of a stretch, thirty crunches, and meditation. There is no right or wrong daily practice. They can change daily or even weekly. The point is to have one. one with diligence each day we can save ourselves time, money, and most important a low quality of life. With regards to a daily practice for maintaining a healthy shoulder, we’ll focus on resolving the three positions many people have adoptedto point that it’s become their new default:
they’ve lost the capacity to extend their cervical spine,
they can no longer retract their shoulders,
they are unable to extend their thoracic spine.
To address these three situations, we offer you three exercises that are directly target and resolve the underlying mechanisms of the above deficiencies. It should be noted that these aren’t the only exercises you can do, but they give you the most bang for your time.
The scalene muscles are the fleshy muscles around our throat. Their job is to flex the cervical spine. Knowing this, we can see why they become short and locked in the flexed position if we’re constantly staring at a computer screen or typing away on our phone. By releasing the tension in the scalenes via manual stretching, we allow the head to shift back to its correct anatomical position stacked on top of the shoulders. This gives more relief for the shoulder to move and also takes pressure off the cervical spine. (For every inch of forward head posture, it can increase the weight of the head on the spine an additional ten pounds). The scalene stretch can be in done in three simple steps:
Find the inner (medial) part of the collar bone.
Place the fingertips on the muscle directly above the inner part of the collar bone. Well call this our pin
Keep the fingertips on the muscle and slowly tilt the head in the opposite direction to the pin.
This can be repeated for 5-8 reps on each side deepening on the tightness.
The doorway stretch targets the pectoralis muscles. When we round our shoulders to type away on our computer, the pectoralis muscles become short and overactive, leading to shoulder impingement issues if we stay in this position for too long. A great way to restore length in the pectoralis muscles is a doorway stretch. An advantage of the doorway stretch is that it allows us to target the different angles that the fibers are positioned in the muscle. This stretch can be performed in three positions:
Lean forward into the doorway in a split stance position (either leg forward is fine) with the elbows bent at ninety degrees and the shoulder abducted to sixty degrees. ( The arms should look like a W in this position)
Maintain the lean with a split stance position and abduct the shoulder to ninety degrees. (The arms should look like an L in this position)
Maintain the lean with a split stance position and increase the shoulder abduction to around one hundred degrees (elbow in line with the ears).
Oscillate back and forth with the lean. Slightly increase the lean each time for a deeper stretch.
This can be repeated for 5-8 reps at each position depending on tightness.
Performing the cat/cow exercise is a great way to increase thoracic mobility by countering the flexed thoracic position we see with people who sit at desks all day. Similar to the flexed cervical spine and rounded shoulder positions, a chronic flexed thoracic spine impedes scapular mechanics and limits shoulder mobility. Thoracic extension is our goal of this exercise for those who tend to be more rounded. The cat/cow exercise can be done in three steps:
Start in a neutral spine position (spine as flat as possible), and on all fours with hands placed shoulder width apart and feet placed hip width apart.
From this position, tuck the chin to the chest and slowly start to round the upper spine. Continue this rounding motion all the way to the pelvis. This is the cat position.
Starting at the pelvis slowly release the rounded position by extending the pelvis, bringing the chest to the floor while the thoracic spine extends, and raising the head so that you are looking straight ahead. This is the cow position.
-For those who have a dominance of a flexed thoracic spine going from neutral to just the cow position will be more purposeful. Moving at a slow pace, perform 3-5 reps.
It may not seem like a lot, but these three exercises, done once a day, can go a long way for improving the health our body. They allow our muscles to rest at their natural length, freeing up any upper extremity movement. Most importantly, we’ll significantly reduce the potential chronic issues from the slouched position we so often find ourselves in when on our computer or phone. As an added bonus, you’ll be walking and standing with more energy and confidence both in and outside of the office!
References
[1] Turtle shell. Pexels via Pixabay. https://pixabay.com/en/amphibian-animal-armor-blur-1850190/. Accessed September 2017.
[2] Scalene Muscles. Wikimedia commons. https://upload.wikimedia.org/wikipedia/commons/6/6e/Scalenus.png. Accessed September 2017.