Having a stiff shoulder not only affects the lines and form of an artist but also increases the risks of shoulder injuries. If you have pain/ stiffness in your shoulder, continue reading to learn how to assess your shoulder mobility and how to fix it.
Anatomy
The shoulder is a ball and socket joint which allows mobility in the joint. It is surrounded by a fibrous capsule on the outside which holds the joint together. The movement of the shoulder includes:
Flexion (bringing the arm up)
Abduction (bringing the arm to the side)
External rotation (outward rotation)
Internal rotation (inward rotation)
Extension (reaching back)
The 4 rotator cuff muscles: supraspinatus, infraspinatus, subscapularis and teres minor (see above) work together to stabilise the shoulder. Their main actions are flexion, external rotation and internal rotation of the shoulder.
Testing
Active Range of Motion
This is when you perform shoulder movements purely by power generated by your muscles without external aid.
Shoulder Flexion
Lean against a wall with hands by your side. Then bring both your arms up to the ceiling as far as you can without flaring your ribs. Ask a friend to measure the distance between your wrist/ elbow is from the wall and compare both sides.
Lean against a wall and bring your elbow in line with your shoulder at 90 degrees. Then rotate your shoulder upwards. Ask a friend to measure the distance between your wrist and the wall and compare both sides.
Passive Range of Movement
This is when you perform shoulder movements with external aid such that your muscles are relaxed. So all you need to do is ask a friend to see if they can push you further after you have performed the active range of motion tests!
What Does It Mean?
If you have more passive range than active range, this would be classified as a weak shoulder.
If your active and passive range are the same, then this will more likely be a stiff shoulder.
Overuse or injury of the rotator cuff muscles can lead to pain and stiffness. Therefore if these symptoms are stopping you from getting a full range of motion actively, this could mean that your rotator cuff muscles are weak and need strengthening.
On the other hand, if you are unable to gain full range on both passive and active range, this could mean there is tightness in the shoulder joint/ rotator cuff muscles, which will require stretching.
Exercises to Strengthen your shoulder
Shoulder flexion with resisted external rotation
Hold a band with both hands and slightly pull it apart. Maintain the tension in the band and bring your arms as far as you can up to the ceiling, making sure there is no flaring of your ribs.
This exercise activates your rotator cuff muscles by the proprioceptive feedback given by the band. The rotator cuff muscles also play a role in depressing the humeral head (head of your armbone), allowing more space in the ball and socket joint to complete the movement without pain.
Throw and catch in external rotation
In a standing position, lean your upper body forward and keep your back straight. Bring your elbows to 90 degrees to the side of your body. Throw and catch a tennis ball in this position for 30s.
This exercise is good for training stamina and speed of contraction of the rotator cuff. It can also improve the overall stability of your shoulder.
Exercises to Stretch your shoulder
Stand with your arms against a wall and walk backward. Lean your body forward until you can feel a stretch in your shoulders. Push your hands into the wall to activate the rotator cuff muscles. Hold for 30s.
External rotation wall stretch
Stand close to a wall and bring your affected arm onto the wall at 90 degrees. Turn away from the wall and go into a lunge position. You should be able to feel a stretch in the front of your shoulder. Hold for 30s.
Both of these stretches help with opening up the joint capsule and increasing your range of motion passively. Remember not to push into pain to avoid any exacerbation of any injuries in your shoulder!
Now that you've done a shoulder assessment tour, try it on yourself and start rehabbing! Check out our YouTube channel (@flexibility_matters) for more in-depth videos on shoulder assessments and mobility exercises, as well as tips to improve your performance.
Take key Home Messages
The rotator cuff muscles are important to shoulder function. Overuse of the muscles could lead to pain/ stiffness in the shoulder.
Both active and passive range of motion tests are important in investigating the cause of your symptoms in the shoulder.
A reduced active range of motion with a normal passive range would indicate a weak shoulder which requires strengthening.
Equally reduced active and passive range of motion would indicate a stiff shoulder which requires stretching.
References:
Abat, F., Alfredson, H., Cucchiarini, M., Madry, H., Marmotti, A., Mouton, C., Oliveira, J. M., Pereira, H., Peretti, G. M., Romero-Rodriguez, D., Spang, C., Stephen, J., van Bergen, C. J. A., & de Girolamo, L. (2017). Current trends in tendinopathy: consensus of the ESSKA basic science committee. Part I: biology, biomechanics, anatomy and an exercise-based approach. Journal of experimental orthopaedics, 4(1), 18. https://doi.org/10.1186/s40634-017-0092-6
Bateman, M., Osborne, S. E., & Smith, B. E. (2019). Physiotherapy treatment for atraumatic recurrent shoulder instability: updated results of the Derby Shoulder Instability Rehabilitation Programme. Journal of arthroscopy and joint surgery, 6(1), 35-41.
Lewis, J. S. (2009). Rotator cuff tendinopathy/subacromial impingement syndrome: is it time for a new method of assessment?. British journal of sports medicine, 43(4), 259-264.
Our blogs and articles are not designed to replace medical advice. If you have an injury, we recommend seeing a qualified health professional. We offer both in-person assessments and online consultations!
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