Ever wondered why it might hurt

13 February 2012

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Shoulder and Pelvis Compensation and Injury – Part 1

Let us look at some examples of how the body compensates and can therefore ultimately limit performance or create pain, by analysing one specific ‘body movement chain’ – pelvis, spine, shoulder, neck and arm - with a view to better understanding compensations that can then help in sporting preparation, training, recovery, injury prevention and performance improvement.

Let’s begin at the shoulder.

The shoulder is the least stable joint in the body but it is also arguably the most mobile.  However the function and integrity of the shoulder is affected by every other part of the body – and vice versa - hence the concept of a ‘body movement chain’.
For example, a forward slumped upper body position, such as is evident whilst working at a PC or laptop, whilst driving or as a result of a sporting activity such as sailing or cycling, can result in the overuse of the neck and shoulder breathing muscles.  This is normally associated with stress and exertion and the use of the mouth to breathe - something very common in most sporting activities, whether they involve a slumped posture or not.

So, any slumped body position or regular and extended seated (and therefore a ‘compressed and restricted’) position as is possible in a sailing context, can exacerbate any shoulder and neck pain or cause some performance dysfunction in the upper body.

Another common cause of the above pain profile is regular ‘vibration’ through holding vibrating sporting equipment.

But how can the pelvis affect the shoulder?  Well, pelvis bones naturally rotate in opposing directions during walking and these bones can often become “stuck”, resulting in a leg length difference and a backward tiling pelvis.  The same can result from an “awkward” or twisted seating posture. When this occurs, weight is naturally placed onto the side with the shorter leg, which rotates the spine and causes one shoulder to be higher than the other.

The extremely powerful Latissimus Dorsi muscle pulls the lower shoulder downwards, potentially causing any overhead or arm raising exercise or sporting activity to experience pain or discomfort.  The shoulder that is higher is then very likely to become unstable with shoulder muscles needing to work much harder to maintain the required stability and range of motion. 

Simply strengthening the numerous shoulder muscles on each side might not actually rectify the underlying issue.

Putting all this together (and the essense of the pelvis, spine, shoulder, neck and arm movement chain), the spine has to work harder to maintain alignment, the shoulder joint works harder, the neck and shoulder muscles consequently have to work harder, the neck breathing muscles work harder, the nerves of the neck, shoulder and arm potentially become dysfunctional, and all this possibly with a locked and tilted pelvis, a leg length discrepancy and the spine rotated unnaturally like a corkscrew.  All as a result of a slumped body or regular and extended seated position.

However all this is entirely correctable.  So, next time you have neck, shoulder or back pain or a difficult to understand loss of performance, don’t just treat the immediate symptoms, get the entire functional movement chain of your body checked out by your therapist, joint-by-joint. Identify the root underlying cause and then you can focus remedial and corrective action where it is needed, which is not always where you feel the symptoms or loss of performance.

If anybody would like a copy of the full article on the above, with more detail of this ‘body movement chain’, then please get in touch and I will gladly send you a copy.

Simon @ Unity Sport Therapies

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