EASY SHOULDER EXERCISES

Your neck and shoulder contains muscles, bones, nerves, arteries, and veins, as well as many ligaments and other supporting structures. Many conditions can cause pain in the neck and shoulder area. Some are life-threatening (such as heart attack and major trauma), and others are not so dangerous (such as simple strains or contusions).

The main joint in the shoulder is formed by the arm bone and the shoulder blade. The joint socket is shallow, allowing a wide range of motion in the arm. The rotator cuff is made up of 4 muscles that surround the arm bone. This cuff keeps the shoulder steady as the arm moves.

The supraspinatus muscle rests on top of the shoulder. Its tendon travels under the bone on the outside of the shoulder (the acromion). This tendon is the one most often injured because of its position between the bones. As the tendon becomes inflamed (sore and swollen), it can become pinched between the 2 bones. The sac of fluid that cushions the tendon can also be damaged.

What are the symptoms and signs of shoulder and neck pain?

• Pain: All pain seems sharp, but pain can also be described as dull, burning, crampy, shock-like, or stabbing. Pain can lead to a stiff neck or shoulder and loss of range of motion. Headache may result. The character of each symptom is important to your physician because the particular features can be clues to the cause of your pain.

• Weakness: Weakness can be due to severe pain from muscle or bone movement. The nerves that supply the muscles, however, also could be injured. It is important to distinguish true weakness (muscle or nerve damage) from inability or reluctance to move because of pain or inflammation.

• Numbness: If the nerves are pinched, bruised, or cut, you may not be able to feel things normally.

This may cause a burning or tingling sensation, a loss of sensation, or an altered sensation similar to having your arm “fall asleep.”

• Coolness: A cool arm or hand suggests that the arteries, veins, or both have been injured or blocked. This may mean that not enough blood is getting into the arm.

• Color changes: A blue or white tinge to the skin of your arm or shoulder is another sign that the arteries or veins could have been injured. Redness can indicate infection or inflammation. Rashes may be noted as well. Bruising may be evident.

• Swelling: This may be generalized to the whole arm or may be localized over the involved structures (a fracture area or an inflamed bursa, for example). Muscle spasms or tightness may simulate actual swelling. Dislocation or deformity may cause a swollen appearance or, paradoxically, a sunken area.

• Deformity: A deformity may be present if you have a fracture or a dislocation. Certain ligament tears can cause an abnormal positioning of the bony structures

If the rotator cuff is involved, the pain is usually in the front or outside of the shoulder. This pain is usually worse when you raise your arm or lift something above your head. The pain can be bad enough to keep you from doing even the simplest tasks. Pain at night is common, and it may be bad enough to wake you.

How is Neck and Shoulder Pain Diagnosed?

• X-rays: Plain X-rays can reveal narrowing of the space between two spinal bones, arthritis-like diseases, tumors, slipped discs, narrowing of the spinal canal, fractures and instability of the spinal column.
• MRI: Magnetic Resonance Imaging is a noninvasive procedure that can reveal the detail of neural (nerve-related) elements, as well as problems with the tendons and ligaments.
• Myelography/CT scanning: This is sometimes used as an alternative to MRI.
• Electrodiagnostic studies: Electromyography (EMG) and nerve conduction velocity (NCV) are sometimes used to diagnose neck and shoulder pain, arm pain, numbness and tingling.

Treatment options

Your physician can help you with a treatment plan to relieve the pain and help you restore your shoulder to normal function. Pain relief strategies include active rest. During active rest, you can and should move your shoulder. Avoid difficult activities like lifting heavy objects or playing tennis. You may also get relief by applying ice, taking non-steroidal anti-inflammatory treatments and occasionally, an injection of anti-inflammatory steroids. Special exercises may also help.

The first step of rehabilitation therapy is simple range-of-motion exercises. By bending over and moving (rotating) your shoulder in large circles, you will help to avoid the serious complication of rotator cuff injury, called a frozen shoulder. You should follow these range-of-motion exercises with resistance exercises using rubber tubing or light dumbbells. The final step is resistance training with weight machines or free weights.

The following exercises may help you. Ask your physician if you should do other exercises, too.

1. Range of motion

Stand up and lean over so you’re facing the floor. Let your sore arm dangle straight down. Draw circles in the air with your sore arm. Start with small circles, and then draw bigger ones. Repeat these exercises 5 to 10 times during the day. If you have pain, stop. You can try again later.

2. Rotator cuff strengthening

Use a piece of rubber tubing for these exercises. Stand next to a closed door with a doorknob. Loop the tubing around the knob. With your hand that is closest to the door, bend your arm at a 90° angle (at the elbow) and grab the loop of the tubing. Pull the band across your tummy. At first, do 1 set of 10 exercises. Try to increase the number of sets as your shoulder pain lessens. Do these exercises every day.

3. Upper extremity strengthening

As your pain goes away, try adding a general upper body weight-lifting program using weight machines or free weights. Lie on your right side with your left arm at your side. With a weight in your left hand and your forearm across your tummy, raise your forearm. Keep your elbow near your side.

Remember, it often takes a shoulder a long time to heal. The earlier you address the pain, the better. Depending on your injury, you should be able to make a full recovery. However, many people complain that even with a full recovery, their shoulder is not as strong as before.