.....our super duper SHOULDERS shall we?
The other day I came across a video speaking about internal and external rotation of the shoulders. It was a conversation, a viewpoint that I have never entertained before. To summarize the author's main points:
- internal rotation is dangerous and done too often in yoga and at home while performing daily tasks such as reaching overhead.
- internal rotation creates soft spots and holes in your chest and armpits allowing injuries to happen.
- internal rotation provides you with zero muscular protection.
- only in external rotation do the muscles become active filling up the holes and soft spots.
- the only suggestion provided was to reach overhead and pull down in external rotation to prevent injuries.
Shortly after I watched this video I saw a post by a Pain Science Physiotherapist I admire speaking about what it meant to be a critical thinker. What he highlighted was that not only will your view points and biases shift over time, you will also end up being wrong. He continued that critical thinking is a journey with no destination. Once you think you have arrived at your destination you have failed as a critical thinker. I took that video as an opportunity to think critically, to question, to research and then to shout (and "let it all out") using the platforms I have available. A perfect opportunity to highlight how extraordinary the body is because too often the message we hear in the movement world is: this, that or the other thing is dangerous for you and if you do it you will likely get injured. Followed by the suggestion to avoid the ranges and movements that could potentially cause injury. When movement teachers come from a place of fear mongering, intentional or not, they not only strip students and clients of their human potential but also their movement dignity. Not to mention they really have no clue what is going to be harmful to each individual student, e s p e c i a l l y in a group class or via a publicly posted video. To state otherwise is totally insane because there are so many complex layers involved with pain and injury.
The narrative that our bodies and joints need protecting and that certain movements, postures and exercises are dangerous, is NOT the narrative I personally subscribe to. I believe that our bodies get really good at the things it does most frequently and consistently = adaptation. Our bodies are inherently robust, have a high magnitude for healing, have the capacity to increase and tolerate more loads and the movement possibilities......well THANKFULLY those are endless!
Exactly how super duper is the shoulder? The shoulder griddle, also called the shoulder complex, is made up of three bones: humerus, scapula and the clavicle, along with static stabilizing structures (ligaments) and dynamic structures (tendons, muscles) and other connective tissue that help form this highly mobile - shallow joint - known as the glenohumeral joint or ball and socket {Chang, 2020}. The humerus movements consist of flexion, extension, ADduction, ABduction, internal and external rotation. Once the humerus is at its end range of motion it gets help from the scapula. The scapula can elevate, depress, protract, retract and laterally rotates. The clavicle follows the scapula in most movements, although to a smaller degree, which also includes rotation. All of this movement happens because nothing works alone or independently from the other. Everything works together as a close-knit team. There is connectivity and continuity from the hard bone to the soft tissues (tendons, ligaments) of the shoulder joint. A super cool example on this continuity: surrounding nearly every bony structure is something called Periosteum. It's a wonderfully complex layer of soft tissue covering hard bone. (Histology is super cool!) This tissue has an outer collagen based fibrous layer and an inner synovial layer. The outer layer has the same structure as a ligament, which lends structural integrity to the joint/ball and socket. (If you like reading research papers, I recommend this paper.) The inner layer secretes synovial fluid which moves through that space binding with cartilage producing lubricant and friction which increases or decreases based on the load demands {Mitchell, 2019} {Dwek, 2010}. Raddest thing ever. Blows my mind. Not only is your shoulder qualified to manage many degrees of movement and motion including internal rotation, it is capable of adapting to load demands in those ranges because the body is a connected team. Team work really does make the dream work.
I am going to take it one more nerdy step further to really drive home the point of how everything is intertwined. This week I am doing Gil Hedley's integral anatomy course. Monday the dissection was on the skin layer, yesterday it was superficial fascia and today it was perifascia, deep fascia. Until you have seen or participated in a fresh tissue dissection you may not be aware of the fact that everything is threaded together. It's really quite amazing. The binding or threading of the texture we call skin and superficial fascia could be nerve threads, vessel threads but mainly its connective tissue connecting one thing to the next. Fun fact: ligaments and tendons are so similar in structure that you can put a ligament cell in with a tendon cell and YUP! it becomes a freaking tendon cell! (and vice versa) Isn't it reassuring to learn that our connective tissue, a giant sheet of biological fabric continuity, covers every inch of our beautiful human body serving the common purpose of managing stress and adapting to demands throughout the day?
Can we please stop for a minute, stomp our feet and pay respect to just how FREAKING AMAZING our bodies are?! Then go shout...let it all out because you know you want to.
I believe that misinformation can carry consequences when students/clients hang onto every word, every whisper their movement teacher or coach speak. The average student/client has zero desire to dig into research about the body and movement. That is why they come to us. It's our responsibility as teachers and coaches to thinking critically and to be able to back up the information we put out with evidence. I also believe that when we start to educate using the narrative that our bodies are strong and adaptable with tons of movement variability vs needing protection from X,Y,Z; we have the privilege of being a movement optimist. Circling back to the video, the information here in this post helps support the fact that there is nothing inherently wrong or dangerous with internal rotation. Understanding that injuries happen when the load or demand is more than what the tissues capacity can currently handle reinforces the need to move throughout all ranges of our movement arch. NOT to avoid those ranges or movements. Focusing on progressive overload to increase the capacity of our tissues which can also help with under loading injuries. Now go forth friends and train your shoulders accordingly!
*ALWAYS see you medical provider, physical therapist, chiro, etc. if you are experiencing pain/injury.