Peking Best

A shoulder injury, however caused, can cause months (or even years) of pain and restricted movement.You may not even remember the incident that caused it! Some injuries to the shoulder build up over a long time; repetitive movements can cause overuse injuries, much like those that happen to the wrist muscles (RSI). The muscles that sit on the top of the shoulder and extend for a handspan down the arm are called the deltoids. These are powerful muscles and lift your arms out to the sides and up, and assist with forehand and backhand movements. It is quite a feat to "pull" a deltoid (i.e cause a tear in the muscle), and most people who come to me with shoulder problems haven't actually damaged the deltoid, but one of the smaller muscles near it.

A pulled deltoid would give pain as the arm moved away from the side of the body; most people can complete at least part of an arc with the arm before pain kicks in. If the client winces as the arm passes above shoulder level, I suspect impingement shoulder - there is inflammation around the joint which is squeezing the nerves there.

Rotator cuff injury is a common cause of shoulder pain. The rotator cuff is made up of 4 small muscles called supraspinatus, infraspinatus, teres minor and subscapularis. Their actions are as follows:-

Supraspinatus - Brings arm out to the side (abduction) for the first 30*, then the deltoid kicks in. If the supraspinatus is torn, the arm will not lift away from the side.

Infraspinatus - Brings the arm down and out in a backhand motion (extension and lateral rotation). Often a muscle injured by tennis players.

Teres Minor - Assists infraspinatus.

If you have access to gym machines, rehabilitating the muscles is easier, but most strengthening exercises can be done with body weight and an elastic exercise band (called a flexiband in the UK, and available cheaply at most large stores).

Strengthening the Deltoids - Push-ups, Shoulder Press, Lateral Raises, Reverse flyes. Start by using no weights (for push-ups, do shallow, box push-ups to start), then progress to light hand weights.

Strengthening the Rotator Cuff - Mimic tennis fore-and-backhand moves holding a flexiband that has one end tied securely to a wall fitting or door handle (close the door!). The band should be at the level of your elbow when your arm is hanging by your side. Elbow should be bent at 90 degrees, palm facing up. Keep elbow close to your side throughout and do not allow your shoulders to shrug.

If you follow the above instructions, plus all those given by your health professional, a minor injury should be as good as new in 2 - 3 weeks. In fact, the shoulder will probably be stronger than before, and less likely to tear again. These exercises can then be added into your weekly fitness routine to improve your general condition.