NSCA’s Performance Training Journal: A free publication of the NSCA.

Flexibility Exercises to Maintain Shoulder Health

By Jason Brumitt, MSPT, CSCS, SCS, ATC

Introduction

Almost everyone will agree that proper posture is important for musculoskeletal health, but how many people maintain good posture throughout the day? Poor posture may be due to postural adaptations from everyday life. For example, I frequently observe rounded shoulder and forward head postures in individuals who sit all day in front of a computer.

The way we work out may also influence our posture. Athletes who overtrain the chest (as well undertrain the back) and fail to adequately stretch often demonstrate a rounded shoulder posture. This article will discuss how lack of shoulder flexibility may contribute to injury and provide examples of stretching exercises to combat poor shoulder posture.

Proper Posture

It is generally easy to recognize less-than-ideal posture. Some examples of poor upper body posture include a forward head (loss of the natural cervical curve), rounded shoulders, and a rounded or kyphotic midback (figure 1). Proper posture of the upper body entails sitting or standing erect with your head and neck upright and shoulders positioned back and relaxed (figure 2). Postural muscle groups that benefit from stretching exercises include the midback (thoracic spine), the posterior shoulder, and the chest (pectoralis major and minor).

Stretching Exercises

Loss of thoracic or midback flexibility may be due to either postural adaptations or poor training in the weight room. Forward shoulder posturing affects both one's scapular position and the ability to extend through the thoracic spine. Two exercises can help to improve your thoracic extension. The cat and camel stretch is performed on your hands and knees. During the "cat" portion of the stretch (figure 3a) round your upper back assuming a pose like an angry cat. After holding the cat portion for 30 seconds reverse the pose into the "camel" (figure 3b) by allowing your upper back to sag through your shoulders. Another way to increase thoracic extension is to lie supine (face up) on a small rolled towel placed across your midback (figure 4). You will feel a stretch at or near where the towel is placed. Repositioning the towel along the back can allow one to target multiple segments of the spine.

Overtraining the chest can contribute to forward shoulder posturing. Pectoralis major and minor tightness can affect shoulder posture and mechanics. The classic doorway stretch performed with both arms (figure 5) or one arm can increase pectoral flexibility.

For a variety reasons, internal rotation (IR) at the shoulder may become restricted. Overhead athletes often demonstrate a loss of shoulder IR on their dominant shoulder. A loss of IR may affect normal shoulder biomechanics and possibly contribute to shoulder injury. The "sleeper" stretch should be performed to improve shoulder IR. As demonstrated (figure 6), lay on the side you want to stretch. Using your opposite arm slowly rotate your arm inward (or toward the surface).

Each stretch should be held for 30 seconds and repeated 2 to 3 times. Additional repetitions of each stretch may be performed as needed. While it is difficult to say how many times a week stretching is necessary to prevent postural changes, you should stretch daily if you have identified within yourself any of the aforementioned postural deviations.

Conclusion

After reading this article, assess your sitting or standing posture. Are you tight in any of the aforementioned areas? Take a look around at others at your school or work; how many do you see with proper posture? While some injuries sustained at work or during sport are unavoidable, the stretching exercises described within this article will help you to maintain and improve your upper extremity flexibility.

About the Author

Jason Brumitt is a board-certified sports physical therapist practicing at Willamette Falls Hospital in Oregon City, OR. His clientele include both orthopedic and sports injury patients. He also serves as adjunct faculty for Pacific University's school of physical therapy program. To contact the author email him at jbrumitt72@hotmail.com.

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