What's your core got to do with shoulder pain??

There’s no denying it, shoulder pain is generally caused by several factors. Most people have these things at play in their body for years before shoulder pain strikes. Throwing the dog ball, doing some DIY, or whilst doing your normal exercise regime can trigger your pain and play havoc with your daily routine.

As I always say to people, everything is connected in the body (and mind but that’s for another day!). In my last 3 blogs I’ve talked about the influences from the arm that can cause shoulder pain (click here to read if you haven’t already). Today it’s time to unpick the stuff going on in your ribcage and tummy that causes or contributes to shoulder pain.

Loads of you believe you need to improve your posture and core, but how will this get rid of shoulder pain? For many, their self-help efforts are making things worse so today I’m going to get you on the right path.

The Technical Bit

When using your shoulder in any way, the whole arm must work together to support it; hand, wrist, elbow, shoulder. Each doing their bit, co-ordinating together. But where do the forces or loads of activity go after they reach the shoulder?

Simply, they go to the next region, the upper ribcage, lower ribcage and then tummy muscles to pelvis. Your ribcage needs to absorb forces by moving. The muscles, ligaments, and joints around it can influence this movement or lack of it in most cases!

Your ribcage also protects your heart and lungs, but this doesn’t mean it stays like a rigid box. Think about how a ballet dancer would co-ordinate the movement of an arm with the trunk. Although this is often in an exaggerated way, the ribcage’s movement should co-ordinate with your arm. You are not a Lego figure, using your arm solely at the shoulder! Your body should move with your arm, even if it’s subtle.

Ribcage movement should be possible in all directions, forwards, backwards, sideways, and twisting. Depending on which direction you’re using your arm, different movements in your ribcage are needed along with different trunk muscle to work. Just because you can do an abdominal crunch, doesn’t mean you can co-ordinate your tummy muscles with your arm!

The 2 Things That Muck Up Ribcage Movement Most

Diving straight in, the 2 biggest things to muck up your ribcage are your postural beliefs and your breathing. Digging in a bit deeper;

1. Postural Beliefs

The age old “shoulders back, head up” cue lifts the front of the upper ribcage up. BUT being stuck in this rigid posture causes heaps of problems, because you also need to be able to drop the front of the upper ribcage down too. It needs to do both. Shoulder blade movement also gets mucked up by being stuck in the shoulders back posture. They too need to have the option of moving freely on your ribcage to transmit arm forces.

2. Breathing

Most folk are stuck in a stress breathing pattern where you shallow breathe, expanding the upper ribcage more than the lower ribcage. Muscles in the shoulders and front of the neck work overtime to do this whilst your diaphragm gets stiff from not working over it’s full range (it’s a muscle too). Over time, with this continued stress breathing cycle, the ribcage gets stiff and isn’t able to move down and round forwards, which affects how it works with the shoulder and shoulder blade. This can also reduce the amount of hip movement you get, but that’s a story for another day!

Why a Stiff Ribcage Makes It Hard to Work Your Core

Regardless of the cause, when the ribcage gets stuck in in this lifted, stiff position, it’s very hard to get your upper tummy muscles working properly. The flared position of the lower ribs means the upper tummy is in a more stretched, longer position. It should be resting in a “mid” length position and therefore takes more effort to get working.

Before you can get the tummy muscles back working properly with your shoulder and arm you need to restore the ribcage’s ability to move, particularly in this downwards direction. Can you also see how sucking in your tummy by taking a big breath in will cause the same position of the ribcage? Hopefully you can now join the dots and see how this technique for a slimmer waste isn’t doing you any favours. Sorry.

Now that you can understand the part your ribcage plays in your shoulder pain, I’m going to give you the best 3 exercises to get your ribcage moving and your tummy muscles back working again.

Exercise 1 – A Breathing One

Start getting your ribcage moving properly by getting your breathing back into “rest and digest” relaxed mode, and stop using the upper chest and neck muscles to breathe.

Get sitting and slump your posture, lower your head towards your chest. Allow the ribcage to soften down at the front, rounding your back.

Start breathing slowly in and out through your nose. Focus on breathing as slowly and quietly as you can. Notice where your breath in starts. Most of you will feel this in the upper chest. Over the next few breaths, let the upper chest quieten. Let the breath start low in your back. Try to keep your tummy quiet too.

Aim for a breath practice of 2 minutes or simply do 2 sets of 6-8 breaths. I often find with breathing, the best practice is to set a time limit, as if I must count, I can’t focus on the breath properly!

After, become aware of how relaxed you feel. You may need to do another round of breaths to get an even better effect. Also note any improvement in movement in your upper ribcage, neck and shoulder range of movement.

Exercise 2 – One to Stretch a Bit More

In the same relaxed sitting position, with chin on chest, reach your left hand towards your right foot. Exhale as you do this. Use the whole arm to reach, starting from your fingertips. Try to keep your ribcage quiet and let the movement come from your arm and shoulder blade. Do this 6-8 times on one side then switch to the other side and repeat. The aim of this exercise is to get the shoulder blades moving more which in turn will free up your upper ribcage.

Exercise 3 – Get the Tummy Muscles Joining In

In the same slumped sitting position, purse your lips and pretend to blow up a balloon. As you breath out with force, use your tummy muscles to get as much air out of your lungs as possible. When you think you can’t breathe out any more try a bit harder to get some more air out.

Do 2 sets of 6-8 exhales in this way. You can progress to using a real balloon for this exercise to add more resistance but for many of you, you need to build to blowing up a balloon!

Next Steps

So now you will have a much better understanding as to other factors causing your shoulder pain and what to do to get things moving and working better. The skill of a great therapist is identifying exactly which factors are involved in your particular case, putting together the right treatment plan to address them, slowly building the load you can tolerate in the direction that is needed.

If you have any questions or to would like to chat with one of our therapists to see if any of the above is relevant to your particular shoulder problem, simply call 01548 852355 or email [email protected]. We can arrange for you to either speak or see one of our therapists for a FREE Discovery Visit.