We Don’t Pay Attention to Spinal Posture
One of the most common reasons for low-grade, gradual onset shoulder pain is the lack of proper posture in the neck and upper back. As you can imagine, poor posture in the upper spine can often lead to neck pain, headaches, and upper back pain and tension. What’s not obvious are the consequences of poor upper body posture on the shoulder blade and ultimately the shoulder joint. When you look at the anatomy of the shoulder blade that sits on the rib cage, the shape of the rib cage is essential for the normal movement of the shoulder blade, known as scapulothoracic kinesis. This is considered one of the three joints that make up the shoulder girdle, and the shoulder blade mobility has a direct impact on how the shoulder joint can move. Take a second and visualize the following scenario: you’re sitting at your laptop computer, having a hard time seeing the screen, and the desktop is lower than it should be. Your neck flexes forward, your upper back collapses, and your head extends at the upper neck. When the upper thoracic spine collapses into excessive flexion, known as hyperkyphosis, the shape of the ribcage also changes. The angles of the muscles supporting the shoulder blade also change, leading to decreased movement and a change in the socket position at the shoulder joint. Now, when the shoulder blade is not providing the movement it should be contributing and you need to perform an activity with your arm, the body uses the shoulder joint excessively and with abnormal movement patterns to achieve the movement. Eventually, repeated use of the shoulder joint in this unnatural position leads to repetitive, slow-onset injuries such as rotator cuff tendonitis, subacromial bursitis, or joint capsulitis, to name a few. In this case, the shoulder joint is the pain-causing structure but ultimately the root cause of the problem is the spinal posture and shoulder blade mobility.