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Shoulders – multipurpose, just like a Swiss Army knife
Do the ironing, blow dry your hair, hang up curtains, lift a crate full of bottles, hold a drill, paint a wall or throw a ball – these are just a few of the many movements that use our shoulders every day, in most cases without a problem. The muscles involved are strong and capable of precision control. They are also extremely mobile because the glenoid cavity is flat and only about a quarter the size of the head of the humerus (top of the acromion).
The shoulder joint enjoys contact
The shoulder joint is not an isolated part of the body. It has indirect contact with the sternum via the top of the acromion and clavicle; also, via the costo-vertebral joints, it has contact with the rib cage, which in turn results in contact with the thoracic and cervical vertebrae. The shoulder blade itself can move to and fro and rotate several centimetres against the ribs. In most cases, therefore, shoulder movements are composite movements.
As the top of the acromion is much larger than the glenoid cavity, stability is provided by the ligaments and muscles. The muscles – in what is known as the rotator cuff which surrounds the top of the acromion – provide protection in all directions and centre it in the cavity. The supraspinatus muscle plays a major role here, e.g. it prevents a dislocation of the joint if we throw something. Similarly, the other “rotators” help to move and protect the joint working together with the teres muscles, the pectoral muscles, the latissimus dorsi muscle, the deltoid and trapezius muscles, not forgetting the biceps and triceps muscles. In total, it requires 26 muscles to ensure that the shoulder works properly.
And what if the shoulder does not work properly?
It’s good to have that degree of flexibility but sometimes it comes at a price – in the form of inflammation, calcific deposits, chronic wear on the tendon with a partial or complete rupture of the tendon or even worse: the dreaded and painful “frozen shoulder”. Nowadays, shoulder problems are common in all age groups, but are most prevalent in the 50 - 60 age group. The best solution is to prevent them developing in the first place.
What effect does Kieser Training have on …
… shoulder stability?
Shoulder problems can be triggered by a wide range of factors. In everyday life, we tend to rotate our shoulders forwards and this causes a muscle imbalance. This imbalance can be intensified by repetitive movements or a sport-related strain. If we fall, we sometimes put out an arm to save ourselves and this impact or direct bruising can cause shoulder bursitis or a ruptured tendon. Sometimes, if there is previously undiagnosed damage, sleeping in a position that puts undue strain on the shoulder can be enough to trigger extreme symptoms.
Training combats these effects
In order to prevent shoulder problems, it’s worth taking a closer look at the various options offered by Kieser Training. The E4/5 exercise machine is an excellent tool for strengthening and stretching the rotator muscles. The seat height, angle and intensity of the exercises can be modified to suit your individual needs or as specified at the medical evaluation. However, with both exercises it’s important to start off at low intensity and only increase this gradually depending upon tolerance. However, not even the best rotator exercises can resolve the situation if you have round shoulders and the back is unduly curved. In this case, you will need to do additional exercises to help straighten the back.
Improve posture
For example, the C5 strengthens the muscles that pull the shoulders back and straighten the rib cage. The torso arm (C3) strengthens and stretches the entire spine. The seated dip (D7) exercises the muscles that pull the shoulders down towards the rear ribs and stabilises them. The 4-way neck rear (G5) completes the programme. The lateral raise (E2) helps to strengthen the deltoid muscle and so aids abduction. However, this exercise should not be done if the rotators are too weak or damaged. If you have shoulder problems, you will be told at the medical evaluation what exercises you should do and at what weight and intensity. Of course, Kieser Training offers several other exercises that help stabilise the shoulders and improve our posture. We just have to use them wisely.
Doctor’s Tip
What should you do for a shoulder impingement?
Sibylla Stecher was a doctor for
eight years in the MST department
in Frankfurt and now works in
rehabilitation medicine.
If your doctor says you have a shoulder impingement, this is not a diagnosis but merely a description of a condition. It means there is too little space in the tendon tunnel beneath the top of the acromion and so the bones, tendons and bursae are rubbing against each other. There are three stages of impingement: a spontaneously reversible inflammation; an advanced tendon degeneration that may include changes to the bone; and, finally, a rupture of the tendon. This mainly affects the supraspinatus muscle. A doctor can identify the cause by checking what movements are restricted, and consulting X-rays, ultrasound or an MRI scan.
You have probably already decided to avoid movements that involve raising the arms above the head. In addition, the doctor will prescribe medication to reduce the inflammation or may give you a cortisone injection into the joint cavity itself. Acupuncture, electrotherapy, shock-wave therapy, and low dosage radiotherapy are also used. However, if such conservative treatment is unsuccessful, surgery may be indicated.
What action can you take? Well, the strength of the muscles attaching to the humerus and which pull the top of the acromion downwards is extremely important. If these muscles are strong, more space beneath the top of the acromion is available. This reduces pressure and the inflammation subsides. As it is actually the latissimus dorsi muscle that pulls the humerus away from the glenoid cavity, the first exercise to consider is the C1, but only if the starting position is significantly limited. In addition, the C3 or C7 can be included – depending upon tolerance. The D7 strengthens the muscles that pull the shoulder blades down. The D6, with its vertical and horizontal handhold options, is useful for both strengthening and stretching. Sometimes, the gentle pressure exerted by the weight on the upper arm during the G1 can also be beneficial. The E2 is an option in certain cases, but particular care is required. In the medium to long term, the E4 and/or E5 can be introduced at low intensity.
It’s important to understand, however, that strength training for those with a shoulder impingement requires plenty of patience.
All texts on this page by Sibylla Stecher
