A client came to see me recently complaining of a nagging shoulder problem. Her right shoulder ached ‘inside’ and she pointed to a spot in the middle of her deltoid muscle. It had been going on for some time and wasn’t showing any signs of getting better. We ran through some tests which were positive for a shoulder impingement (sometimes known as ‘swimmer’s shoulder’). Ironically, she’d first noticed it when swimming, although she’d be the first to admit that she’s no athlete!
Shoulder impingement typically affects athletes who make repetitive arm movements in or above the horizontal plane and is caused by trapping the soft tissues between the head of the humerus and the space under the acromion process and the coraco-acromial ligament.Lifting the arm forwards to an angle of 90 degrees to the body and rotating it inwards produces pain as the tendons of the rotator cuff muscles, the long tendon of the biceps and the bursa which overlies the supraspinatus tendon are compressed.
Forty five minutes of deep-tissue massage to the shoulder and scapula area, involving trigger point release within the infraspinatus and teres minor resulted in improved mobility and reduced pain over the following few days and treatment is still continuing. It’s not a debilitating problem, but shoulder issues such as this should be resolved as early as possible, as they can develop into tendinitis and bursitis as well as ‘frozen shoulder’. Part of that resolution is finding out what has caused the problem to arise and my client had an interesting theory; she thought it could be the result of the way in which she uses her ipad, propped up in front of her with her arm raised to touch the screen.
Not long afterwards, a report in the Daily Telegraph highlighted the problem of neck and shoulder pain caused by ipad users holding the devices in their lap or putting strain on hands and wrists if propped up too high. Whilst this wasn’t quite the same as my client’s experience, it does demonstrate the chronic effects of repetitive activity that we often don’t realise we are spending as much time on as we actually are. Scrolling down to the reader comments following the article, reveals an individual who himself complains that he is unable to raise his arm above halfway and puts it down to using his ipad. Coincidence, or might there be a connection between using an ipad propped up on a desk and shoulder impingement?
There are certain risk factors that may predispose an individual to shoulder impingement, such as age (typically more people over 40 are affected), imbalances in the scapular muscles, tightness or weakness of the posterior rotator cuff muscles and the biceps. Interestingly, my client is over 40 and has hypermobility of the shoulder joint, which is also a risk factor. At the end of the day it’s going to be a combination of such factors together with our uniquely individual ways of using our bodies that results in the onset of a chronic problem like this. However, it highlights the importance of being aware of our posture and how we maintain our bodies in order that they can cope not only with athletic activity, but also with activities that on the face of it appear unlikely to cause injury.