Shoulders have to deal with a lot. We constantly ask them to perform for us. Whether it be putting the shopping away in the top cupboards, turning the steering wheel whilst we are driving, pulling our socks on in the morning, maintaining a smooth golf swing or securing the reins as we ride horses.
There is a never-ending list of activities for which we require full, pain-free range of movement in our shoulders. Maintenance of this freedom of movement requires a reasonable knowledge of the shoulder anatomy and a fair amount of dedication to the cause.
The shoulder joint is the most mobile joint in the body. It is a ball and socket joint in design, although the ‘socket’ is barely that – it only covers one third of the surface area of the ball. The majority of the joint stability comes from cartilage, ligamentous and muscular control. This strange arrangement provides an enormous amount of mobility, for which we have accepted a significant degree on inherent instability.
The majority of limitation to mobility in the shoulder joint comes from the reduction of rotation available in the arm bone. This bone is called the humerus (literally – The Funny Bone!) and, because of the ball and socket joint arrangement, it is able to rotate within the joint. This allows you to place your hand behind your back amongst other things, such as wax on-wax off. Without this anatomical design, there would be no use for back pockets in trousers as we would be unable to reach them. There would also be no way to tuck in a shirt, feed a belt through loops or attach braces.
There is, however, a much more prevalent and often ignored reason for being able to rotate the humerus and place the hands behind the back – the brassiere. For many, this has become a huge problem. Either due to gradual reductions in mobility through life experience or via injury many people are unable to reach sufficiently behind their back to do up or undo their bra.
This should be such a simple task and yet, without the available mobility, it can be very painful and occasionally impossible. Some people experience only a temporary restriction in mobility leading to coping strategies that are short term.
A permanent loss of shoulder mobility can be devastating and incredibly restrictive in many activities of daily living. We use the shoulder joint in every activity we perform. Loss of any range of movement in this joint will undoubtedly change our approach to life in general. Maintenance of shoulder joint mobility is, therefore, essential to quality if life. Fortunately, maintenance of such an inherently mobile joint is relatively simple in the absence of trauma or pathology.
One of the best habits you can adopt for the maintenance of mobility in a healthy shoulder joint is to always have the palms of your hands facing forwards, especially when carrying a load. The shoulder joint is a perfect example of the adage ‘use it or lose it’. Maintenance of shoulder mobility is much, much easier than regaining it after it has become limited. So remember to always scratch your own back itch and regularly follow Mr Miyagi’s advice – “wax on, wax off”.