6 Week Programme: Week 6 - Neck & Shoulders

One of the most common complaints I hear in regards to stiffness in the body is the neck and shoulders. We spend a lot of time with our hands out in front of us, whether that be from working long hours at a desk, cooking, lifting heavy objects or washing the dishes.

Consistent poor posture can lead to upper crossed syndrome, where muscles in the back of the neck and shoulders (upper trapezius and levator scapula) become very overactive and strained. The muscles in the front of the chest (major and minor pectorals) become tight and short. This tightness in the chest muscles causes an internal rotation in the upper arms. Therefore to release tension, rather than focusing on the upper back, we need to target the front of the body, deep within the shoulder area of the upper chest. Slumping also causes shoulder blades to move away from the spine, over stretching, and weakening the surrounding muscles. Eventually these muscles will harden to protect themselves from strain, leading to weak fibrous muscles, often causing pain along the shoulder blades and side of the neck.

We will take a look at stretches which focus on the tight muscles in arms and chest, with the aim to bring better alignment in the shoulder blades. One example is this standing stretch:

Standing stretch

- Stand next to a wall, feet are parallel and comfortably separated

- With one hand, place fingertips on the wall so that your arm is fully extended at shoulder height

- Place other hand on hip

- Cup fingers so that only the tips touch the wall, rotating arm outwards slightly, so that thumb points upwards (not index finger)

- Keep shoulders aligned with your hand, and begin to lift and open chest with the breath, roll collarbones back

- Repeat on other side

We will now bring our focus to the shoulder joint, it has an amazing range of movement, healthy shoulders allow 360 degree circles with movement forward/back and across the body. Shoulders are designed to be mobile, however this mobility can come at a cost of stability, as the main ball and socket joint is quite shallow. We want to ensure we work with the anatomy of the body and the scapula humeral rhythm - when the humerus (top arm bone) starts to abduct (move away from the body), at 30 degrees the scapula has to move with the humerus so the arm can to continue to lift in a healthy way to protect the rotator cuff.

The rotator cuff is a group of four muscles that wraps like a cuff around the scapula. The supraspinatus, infraspinatus, teres minor all provide external rotation, they are normally weak and underused, and the subscapularis provides internal rotation. We need to find a balance between external and internal rotation, if external rotation is turned off the head of the humerus rolls forwards, if this continually happens the head of the humerus can migrate up and hit up against the suprasinatus tendon over timing wearing it away, eventually leading to shoulder impingement. Many daily actions encourage the shoulder to roll forward, for example typing, texting, writing, even certain yoga poses if we are not holding them correctly. An example of a yoga pose where its easy to fall into this bad habit is Chaturanga Dandasana, if we cannot keep the head of the arm bone in line with elbows, ie chest collapses to the ground first, we should perform the pose on the knees first to build more strength in the rotator cuff. We will take a look at this in more detail during the class.

An example of a pose where the supraspinatus contracts is Warrior II:

Warrior II

- Come into Tadasana (Mountain Pose) at the top of your mat, feet hip distance apart

- Step the right foot back a stride and a half, turn right foot to face the long edge of the mat

- Heel of left foot is in line with arch of right foot

- Left knee is directly over left ankle

- Bring hips to the long edge of mat without compromising knee placement - don’t push this if hip flexibility isn't there yet

- Take arms out wide, palms face down, shoulders are relaxed, gaze towards to the left middle finger

Sources used to help create this blog:

Shoulder Biomechanics with Celest Pereira

https://www.yogajournal.com/lifestyle/wear-care

https://yogainternational.com/article/view/3-poses-for-neck-and-shoulder-pain

https://www.medicalnewstoday.com/articles/318897

https://yogainternational.com/article/view/realign-chaturanga

Note: Please ensure you warm up before completing activities listed above; by engaging in these activities you do so at your own risk.