Most shoulder problems and pain are caused by the same thing: thoracic flexion which causes forward rounded shoulders.
A research group wanted to look at how different sitting postures affected shoulder range of motion. They studied 30 healthy young men, 18-35, with no recent history of shoulder problems and measured their shoulder range of motion in 3 different sitting postures.
Their analysis "demonstrated significant differences in all comparisons (p < 0.001)."
- "Changes in sitting posture affect shoulder ROMs in all directions tested"
- "Greater changes in shoulder ROMs were associated with greater increase in thoracic kyphosis"
- "Even subtle changes in thoracic kyphosis need to be considered during shoulder evaluation".
Individuals with thoracic kyphosis exhibit less than normal and ideal thoracic mobility especially thoracic extension. Thoracic extension is needed for any overhead arm movement (throwing a ball, pull-ups, overhead presses, changing a light bulb, reaching top shelf in kitchen/closet) and without proper thoracic extension, scapular positioning and rotation is compromised creating nerve, blood vessel, tendon and ligament impingement and compression along with muscular strain.
No matter whether you are dealing with supraspinatus tendon impingement in the subacromial space, bicipital tendinopathy, or peripheral nerve entrapment in the shoulder, these can all be resolved by restoring proper thoracic, scapular, clavicular, and humeral position and mobility and stability.
It is important to look at the underlying reason for the shoulder pain and dysfunction and address all related imbalances and not solely focus on the shoulder and associated muscles. The underlying reason for the faulty shoulder biomechanics can be pelvic position and lack of function which causes changes in thoracic extension and scapular positioning and movement. Without looking at and treating the entire posture and biomechanics of the body, we are simply treating symptoms and those same symptoms or related symptoms will return later. The client/patient might temporarily feel better but this false sense of confidence will lead to future injury and pain - often much worse than the original injury and pain.