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Essential Movement Patterns for Preventing Shoulder Impingement, Frozen Shoulder, Bursitis, and General Shoulder Stiffness

Where there is shoulder pain due to impingement, frozen shoulder, or subacromial bursitis, an often overlooked root cause is a tight shoulder capsule.

What is your shoulder capsule?

It's a series of ligaments that surround and stabilize your shoulder joint, which is where your upper arm bone (humerus) attaches to your shoulder blade (scapula).

For a number of reasons, the back and lower portions of your shoulder capsule can become tight over time, which prevents proper downward gliding of the top of your arm bone whenever you elevate your arm, which can lead to pain and inflammation associated with impingement, adhesive capsulitis, and bursitis in this area.

It's a lot easier to show you how this works than to describe it, so before you read further into this post, I encourage you to take a moment to view the following video clip:

So let it be clear that the purpose of this post is to show you how to effectively stretch the posterior and inferior portions of your shoulder capsule, which will help ensure that your arm bone can go through normal downward gliding with all overhead activities, which is essential to preventing common shoulder ailments like impingement, frozen shoulder, and bursitis.

How to Stretch the Back and Lower Portions of Your Shoulder Capsule

Before reading any further, please take a moment to examine the three photos below. Seeing the steps involved in these photos should help you fully understand how to take your shoulder through this exercise.

To restore healthy tone and length to the posterior and inferior portions of your shoulder capsule, begin by lying on your side with your head resting comfortably on a few pillows or a foam roller.

Position your down-side shoulder so that your upper arm bone and your chest form a 90 degree angle along the floor, and have your forearm point right up to the ceiling to form another 90 degree angle between your upper arm and forearm, like the starting position for arm wrestling, but while you're lying on your side.

DSC07444

In most cases where there is tightness of the posterior and inferior shoulder capsule, there is also tightness of the muscles that lie on top of the capsule at the back of the shoulder - the primary muscles in question include the posterior belly of the deltoid, infraspinatus, and teres minor. Tightness in these muscles can inhibit your ability to stretch out the underlying capsule. So to loosen your posterior and inferior shoulder capsule, it's a good idea to begin by relaxing these muscles using the technique described below.

Use your other hand to provide resistance while you use about ten to twenty percent of your strength to push the hand of your down-side arm toward the ceiling. This will activate your posterior deltoid, infraspinatus, and teres minor, and after about a ten-second hold, allow your down-side arm to completely relax and use your other hand to gently push the hand of your down-side arm toward the ground in front of your abdomen. As you bring your down-side arm toward the ground, you'll likely feel some resistance in the back of your target shoulder, and once you feel a comfortable stretch, hold this position for however long is comfortable, anywhere from 10 seconds to a minute or two is fine, just go by what feels right in the moment. Be sure to maintain steady breathing throughout.

Keep your down-side arm in the same position, and resist again with your other hand while you use ten to twenty percent of your strength to push your down-side hand toward the ceiling. Apply enough resistance with your other hand to ensure that your arm doesn't actually move; the goal is to once again activate the muscles that surround the back of your shoulder. After a ten-second hold, relax your down-side arm and use your other hand to gently pull your target arm even closer to the ground in front of your abdomen.

DSC07446

The idea is to contract the muscles that surround your shoulder capsule, as this will allow them to more fully relax once you stop using your down-side arm and allow it to be pulled toward the ground in front of your abdomen. The more fully relaxed these muscles are, the more effectively you can stretch the ligamentous capsule that you're targeting.

Repeat this cycle, taking your target arm closer to the ground with each set. But never pull it so low that you experience significant pain or discomfort; the goal is to feel a solid stretch in the back of your target shoulder.

DSC07441

Once you get as low as you think you can realistically get per session, use your off-hand to hold your target arm in that position and maintain it for as long as you can, up to a maximum of 20 minutes. For lasting changes in capsule length and tone, you should aim to maintain this stretch for about 20 minutes per session when you are first beginning with this movement pattern.

If you ever feel pain or even cramping of any muscles, stop and allow your target arm to fully relax, and wait a few minutes before trying this stretch again. You want to aim for gradual improvement; in many cases, I find that it can take several months to see lasting change in this area. But once the posterior and inferior portion of your shoulder capsule is healthy, your humerus will be able to glide inferiorly as it should to allow for arm elevation without impingement and associated pain.

Please also note that after holding this stretch for up to 20 minutes, your shoulder muscles may feel like they want to cramp, so be sure to take your time in allowing your target arm to unravel from this position.

If you have any questions or comments on this technique, please use the comments section below.

Please note: If you have dislocated your shoulder before, or you know that you have hyper-flexible joints, be sure to consult with your physician before trying this stretch. Generally, I feel it is best to avoid this stretch when there is a history of shoulder dislocation(s).

 
 

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Comments

Thank you for an excellent explanation of the workings of the shoulder and the stretch to improve the range of motion. It was very clear and helpful. I would love to see more of these explanations; perhaps one for the neck? Again, thank you for such an informative article.

Thanks for an extremely easy to understand explanation on shoulder workings and mobility.

Thank you for this! I have been experiencing some discomfort in my shoulder lately. I cannot wait to try this at home tonight!

I've been dealing with what appears to be a nerve issue that started with a "crick" in my neck and affected the nerves in my shoulder. A couple of months ago the shoulder issue started to cause a tingling in my hand when my arm was in certain positions.

I've been going to a chiropractor and that's helped some. Then I rec'd this article and after the very first stretch session I noticed relief in the tingling. Now after 3 sessions my tingling is basically gone and the shoulder pain has diminished significantly - and I've only been holding the stretch for about 30 seconds!

It's still early and the pain and tingling could return; but right now it sure appears the stretch is helping.

Thank you Dr. Kim!

This stretching exercise resulted in a turning point in my recovery from a stroke that I experienced on September 23rd, 2011.
I have been suffering from unbearable pain in the left shoulder, which was the side that was paralyzed for nearly two months.It was impossible to sleep in any position.I was miserable. X-rays showed no damage, but my sister, who is a massage therapist, looked at my copy of the x-rays, and noted that there was "no clearance" in the back of my shoulder.
Then when she mentioned the possibility of "impingement" I remembered reading that word in your article about shoulder exercises. The first time I tried this one, within two minutes the pain in my shoulder decreased by about 90%.The relief lasted for hours. I have been stretching according to your directions every day and after about two weeks there is very little pain and I am able to work on regaining mobility of that arm. There are no adequate words to thank you.
I wish you much happiness in life.

I just hurt my shoulder intensely over the weekend so this is providential!! Thanx. What I also notice is that I can no longer put my arm behind my back to reach the spine, between the shoulder blades. The front of my shoulder inhibits that, so painful, and sometimes I can put it behind me but cannot raise it up to the rhomboids area of the spine, and I cannot rotate it to make the palm flat at all, which is something I could always do to wash my back. I think this happened from using my mower for 3 hours a day 2 days in a row wherein I had to push it a lot due to very wet and high grass as a result of constant rain here in FL. But it did not hurt while I was doing it. Ice helps a lot but I have a lot of pain and it feels like something is popping out of the shoulder some of the times I move it. Thanx again for your excellent info emails and recipes. You are wonderful.

Would your shoulder exercises be suitable for one who has already had shoulder surgery?

My question is the same as Betty's, can these exercises be done after shoulder surgery? The shoulder surgery I'm referring to is a Reverse Shoulder surgery. A friend of mine had this surgery a couple months ago and is still unable to lift her arm all the way out from the side. She can only lift from the elbow to the hand. She wonders if anyone has had this surgery and regained the nerve function that was lost during surgery or as a result. Her arm is now attached under her arm, not over, like most us. She had 20 yrs of She's just wondering how long the paralysis will last? What's the normal outcome of such a surgery? Too many questions?

Oops. I meant: She is just wondering how long the paralysis will last. What's the normal outcome of such a surgery?

Dr. Kim,
Great stretches for the shoulder. There are some great exercises at Mark Verstegen's web site. He calls these exercises "Pre-Hab" movements to help prevent injuries. When my shoulders have felt "off" in the past, doing these really helps. There is a video demonstration for each of the exercises.
http://www.coreperformance.com/knowledge/movements/ls-stability-ball.html
http://www.coreperformance.com/knowledge/movements/ts-stability-ball.html
http://www.coreperformance.com/knowledge/movements/ys-stability-ball.html
http://www.coreperformance.com/knowledge/movements/Ws-Stability-Ball.html
Hope this may be useful for preventing future shoulder pains for anyone.
Joe B

Dr. Kim,

Thank you so much for taking the time to post these wonderful articles and stretches. The hip and these shoulder exercises are simply priceless. My right shoulder joint is always problematic and chronic and I can hear those joint cracking sounds when I lift my arm. Just recently, it was starting to hurt and your article came at a very timely manner. I started stretching it for the past 2 days and my pain has reduced. Thanks Dr. Kim.

Additionally, I also want others to know that since Dr. Kim also sells the organic virgin coconut oil, it will be helpful for those with joint, tendon, ligament, cartilage or muscle stiffness to use coconut oil to heal inflamed tendons and just about any other soft or bone tissue problem there is. As Dr. Kim mentioned, coconut oil is nature's healthiest oil. It is also nature's richest source of MCFA (medium chain fatty acids), which accelerate cellular activity including healing damaged tissues. MCFA virgin coconut oil quickens the healing process, preventing further swelling and it also provides an immediate source of energy to the cells, stimulating metabolism and boosting your body's capacity to heal. I had trigger thumb problems last year and it was the coconut oil that helped healed my thumb. Massage warm coconut oil into affected area. For this case, you can apply it on your shoulder joint, it will help lubricate and heal the muscles around your shoulder capsule.

Thank you so much this is very helpful. I have problem at my shoulder and joint of bone connected to shoulder. I will try to follow this article and tell you later the result, thank you!

How many times a day should I do the stretch for my tight shoulder capsule?

As often as you can without hurting yourself. But at a minimum, Dr. Kim would aim for twice daily, with more intensity later on in the day when blood flow is better.

Thank you so much for the great video on shoulder stretching and strengthening. So clear, easy to follow and well explained. I am going to start tonight.

My shoulder is tight but it seems like the tightness stems from the muscles/ligaments going down my upper arm to my elbow. Will these shoulder exercises help my problem/