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How to Prevent Shoulder Pain

Have you been experiencing shoulder tightness and pain while doing "overhead" activities like throwing a ball, playing tennis, kayaking, rock climbing, or swimming?

If so, it's possible that your shoulder blade is not stable or that the back of your shoulder is tight, says orthopaedic surgeon James Ames, MD, MS, a sports medicine specialist at Dartmouth-Hitchcock (D-H). "Pain experienced in the outside part of the shoulder during these activities has long been referred to as 'impingement,'" he explains. "This occurs as the result of the rotator cuff rubbing against a part of the shoulder blade (scapula) called the acromion."

It's not uncommon for patients to experience this type of stiffness and pain soon after restarting an activity that they haven't done for a while. For example, the Nordic skier who is restarting "double-poling" during fall training. Or the kayaker who is getting back into paddling after a winter off.

"Most of this shoulder pain will improve with a simple approach," says Ames, who is an active member of the USSA (United States Ski and Snowboard Association) Physician Pool for the U.S. Ski Team, and serves as a Team Physician for Dartmouth Men's Soccer and Men's Lacrosse. "Try to warm up before exercising. Build up to things if you've been away from a sport for a while. If it's your first cross-country ski of the season, consider going for 20 to 30 minutes, instead of starting with the 90 minutes that you had built up to at the end of last season."

If simply warming up and starting slow doesn't fix the problem, there are some effective exercises that you can try, says Ames. "Baseball trainers have developed special stretching and strengthening exercises to treat and prevent shoulder troubles in pitchers," he says. "Two main components of this program are stretching the back of the shoulder and strengthening the muscles around the shoulder blade. These can be effective not just for the pitcher, but also for the recreational overhead athlete."

Here are some simple exercises to try:

Sleeper stretch:

  1. Lie on your side with the painful shoulder down. Similar to the position you might be in when sleeping on your side (hence the name).
  2. Place the affected arm directly in front of you, with the elbow bent 90 degrees.
  3. Using your other arm, push your hand down toward your feet, internally rotating your shoulder.
  4. Hold for 20 to 30 seconds. Repeat 2 to 3 times.

Scapular stabilizing exercise:

  1. Lie face down on the floor or exercise mat with a large pillow under your stomach. Rest your forehead on the floor.
  2. Bend your elbows at a 90 degree angle, and place your forearms on the floor.
  3. While keeping your forehead on the floor, slowly raise your arms as high as you comfortably can and hold this position for 5 to 10 seconds as you continue to breathe. Slowly return to the starting position.
  4. Build up to 8 to 10 repetitions.

You can perform these exercises either with dumbbells or wrist weights, or without weights. Start by using very light weights.

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