1 THING THAT MIGHT NOT CAUSE YOUR SHOULDER PAIN.
I love this picture. The “de”-evolution of man as it would seem from ape, to strong upright biped to now kyphotic sedentary slave of technology.
For many health and fitness professionals this de-evolution of man seems to be the simple explanation for why we suffer many aches and pains that are so endemic in our society. After all you only need to look at the shape of that kyphotic spine to appreciate why such a posture would cause painful straining for your average office worker particularly around the back and shoulders. But is it really so simple?
Unfortunately the research would tend to suggest it isn’t. A recent systematic review titled “Is thoracic spine posture associated with shoulder pain, range of motion and function?” Barrett et al the effects of back position and how the shoulder worked and it’s risk of pain. They included 10 studies in their review.
Thoracic kyphosis may not be an important contributor to the development of shoulder pain. While there is evidence that reducing thoracic kyphosis facilitates greater shoulder ROM, this is based on single-session studies whose long-term clinical relevance is unclear. Higher quality research is warranted to fully explore the role of thoracic posture in shoulder pain.
Is it so simple?
The problem becomes that we’ve become accustomed with the mechanical idea that our posture and potential reduced range of motion are a causative factor for things such as shoulder pain. The reason for this is that it is likely easier to reduce a problem down to such a singular source. It’s something that patient and practitioner can easily relate to. This though doesn’t fit with our understanding of how pain works and doesn’t take into account the intricate relationship of how the biology, psychology, environment, and social settings affect patients’ pain perception.
A more objective form of assessment.
Rather than limit ourselves to just looking at postures, positions and range of motion when it comes to dealing with shoulder pain patients’, we consider all the possible components of function.
- Capacity: Strength, power, stamina, range of motion.
- Competency: Motor control skill, efficiency of movement.
- Variability: Different angles, heights, loads speeds etc.
This can be done using a host of easily accessible technology such as hand held strength dynamometers, gym equipment to perform rep maximum strength/stamina testing, simple hand held device applications for slow motion video analysis or portable clinical tools such as the M.A.T (Movement Assessment Tool).
Where does the M.A.T fit in?
At the Functional Movement Group we designed the M.A.T to be a convenient clinical tool for the collection of quantifiable data on patients’ such as those that suffer shoulder pain.
Utilising tests such the Closed Kinetic Chain Upper Extremity Test (strength/power test of the upper limb) and the Upper Quarter Y Balance Test (strength/motor control test of the upper limb) allows for a better understanding on an individuals ability to perform loaded tasks through the shoulder girdle in a way that:
- Sets baseline data that can be tracked over time to assess the effectiveness or treatment or training.
- Use data to calculate shoulder injury risk.
- Determine readiness to return to sport or activity.
Combined with a good clinical history, effective examination, quantitative assessment of strength, stamina, range of motion and a qualitative movement assessment, the M.A.T adds another dimension to the clinical assessment of shoulder pain patients that goes beyond the simple static assessment of posture and position.
If you would like to learn more about the M.A.T or how the Functional Movement Groups Functional Assessment Course can help you upgrade your practice click here.