Strong shoulders and arms are a vital part of our fitness. Ball sports, racket sports, swimming and gymnastics all need good upper body strength. In everyday life, we are always reaching up and sideways, lifting children and objects and making the most of the upright posture that frees our arms.  If you take your shoulders for granted, read on for some ideas on why you should look after them.

For most of us, our shoulders are just a convenient place to hang our arms until they do something to attract our attention. That ‘something’ may be an injury, a gradual onset of pain or maybe just a desire to look better in a sleeveless top. How can we look after this important part of the body?

Why are shoulders vulnerable?

The shoulder joint is designed to function in a certain way, allowing for the way that the bones interact. Most of the time, we don’t even notice how our shoulders work. As an example, try raising your straight arm out to your side and then above your head, and watch what happens. As the arm goes up, the humerus (upper arm bone) will automatically turn once the arm is above the horizontal.  The turn is so smooth that it goes unnoticed, and the flexibility of the wrist means that the hand can still be placed in the desired position. The shoulder is an amazing piece of design.

Shoulders are prone to problems because the joint is mainly supported by soft tissues, not the bones that hold together the weight-bearing lower limb joints. There are four main muscles which operate the shoulder. These muscles are not very big and they work in a cramped environment, having to pass through or over projections in the bones. Wear and tear from everyday activities or sport can injure these muscles, causing them to swell. The muscle then doesn’t fit properly into the gap between the bones, causing further wear and tear. The tendons of the joint also have to fit into gaps and designed spaces between bones, and are similarly exposed to possible damage.

What are the most common injuries?

The four main muscles of the shoulder are collectively known as the ‘rotator cuff’, and this is often referenced when discussing shoulder injuries. Any movement that lifts the arm above shoulder height while loaded risks rotator cuff damage. This is especially true if the movement is not performed correctly, or repeated too often under strain. Rotator cuff injuries can take a long time to heal, and are extremely frustrating for those who enjoy being active. A damaged shoulder disturbs sleep and makes everyday tasks very difficult.

Another all-too-common problem is a shoulder dislocation. A fall on an outstretched hand, or a fall when the arm is caught in something and is wrenched suddenly, can displace the rounded end of the humerus from its normal position in the shoulder socket. As well as the pain of the injury, a dislocation can stretch and tear muscles and tendons. Once dislocated, the weakened muscles mean that the arm is more likely to dislocate again. The injury may require surgery and will certainly mean a period of immobilisation.

The other frequent problem in this area is a fracture of the collarbone or clavicle. This is the bone that connects the ribcage to the scapula (shoulder blade). This is again usually caused by a fall, and is a common result of a cycling accident. Collarbone fractures cannot be set in a cast, and so will probably not heal in a straight line. In some cases the bone does not heal naturally and surgical pinning is required.

How can shoulders be strengthened?

Searching online for ‘shoulder exercises’ tends to produce routines for heavy duty body building. For those not wishing to burst out of their shirts like the Incredible Hulk, what can be done to strengthen and shape shoulders?

Pull-ups and exercises with free weights are the key to strong and shapely shoulders. Like all gym work, these exercises need to be supervised by a qualified trainer until you are sure what you are doing. Like all parts of the body, the chance of injury is reduced if the shoulder is kept flexible and is supported by good body core strength and tone.

As well as normal good practice, upper-body workouts need to balance the muscles at the front and rear of the shoulder. If one set is much stronger than the other, the unbalanced forces risk injuring tendons as well as the weaker muscles. Correct positioning during exercise is also essential to avoid compressing muscles and tendons in unyielding bone.

Finally, look after your shoulders in your everyday life. Stretching to retrieve objects from the back seat of cars or sitting incorrectly at your computer are two classic causes of avoidable arm and shoulder injuries. Take a few moments to set up your workstation correctly or to get out of the car – your rotator cuff will love you for it.