Shoulder

Best Ways To Safely And Effectively Improve Shoulder Mobility

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Medically reviewed by Dr Ong Kee Leong, MBBS (Singapore), MMed (Ortho), FRCSEd (Ortho), Senior Consultant
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Best Ways To Safely And Effectively Improve Shoulder Mobility

The shoulder is one of the most important joints in our body, thanks to its unique and complex anatomy structure. With its extensive range of motion, the shoulder joint is also the most mobile joint in the entire body. 

However, despite possessing the amazing gift of mobility, the stability of the shoulder is often compromised. As such, the shoulder is also the most vulnerable to injuries. Fortunately, shoulder mobility can be improved with the correct methods, which can significantly reduce shoulder damages such as dislocations.

Read on further to find out more!

Here’s What You Need To Know…

You may often hear the words flexibility and mobility being tossed around interchangeably. True enough, even the dictionary thinks that these two words are synonymous with each other. However, flexibility and mobility are actually two different things, albeit being slightly related.

Flexibility is the ability of a muscle to lengthen passively, whereas mobility is the ability of a joint to move actively through a controlled range of motion. Still confused? To put it simply, flexibility is a ‘component’ of mobility; mobility requires flexibility. However, just being flexible is not enough. You will also need muscular strength, coordination and stability to actively manipulate your joints.

Without proper control of your muscles and joints, you may still be able to pull off specific movements successfully. However, you may sustain injuries due to the lack of proper control of your muscles and joints.

Furthermore, it is common for our shoulder mobility and flexibility to decrease as we age. You will likely realise this decline around the middle age mark, which will become more and more apparent as you grow even older. In fact, according to a 2013 study from the Journal of Aging Research, adults between the ages of 55 to 86 will likely experience a decrease in flexibility of the shoulder by an estimated 6 degrees every 10 years. This is primarily due to your bones solidifying and muscles tightening with age. 

Prolonged and poor sitting postures can also lead to shoulder damage such as shoulder impingement. When you slouch or hunch your shoulders, the space at the top of your shoulder bone (subacromial area) narrows, leading to less space for the muscle tendons. This may result in the muscle tendons becoming pinched.

Shoulder mobility issues also commonly occur amongst athletes and weightlifters, who often undergo repeated overhead, swinging and pressing movements. These movements place significant strain on a shoulder joint called the acromioclavicular (AC) joint, resulting in significant shoulder injuries.

Introducing The Shoulder Joint

To deal with shoulder mobility issues, you must first understand how these problems develop. As the shoulder has a complex anatomy structure, it helps to recognise the different components and functions of the shoulder.

Anatomy Of The Shoulder

The shoulder consists primarily of three bones—the upper arm bone (humerus), shoulder blade (scapula) and the collarbone (clavicle). These bones provide the fundamental support and structure for the various joints and ligaments that form the shoulder.

The shoulder is also made up of four main joints: the glenohumeral, sternoclavicular, scapulothoracic, and acromioclavicular joints. Out of these four joints, the glenohumeral joint, more commonly known as the shoulder joint, is the most vital part of the shoulder.

The shoulder joint is a ball-and-socket joint that attaches the head of the humerus to the rounded shallow socket (glenoid) of the scapula. It is the most mobile joint in the shoulder.

Apart from the various shoulder joints, the shoulder is also surrounded by many muscles and tendons, mainly the deltoids, biceps and rotator cuff. These muscles are in charge of supporting and controlling regular shoulder movements by allowing your arms to extend and rotate in multiple directions and angles. Additionally, the rotator cuff, which is a group of muscles and tendons surrounding the shoulder joint, helps secure the humerus to the socket of the scapula. This complex anatomy structure of the shoulder provides both mobility and stability.

However, even though the shoulder joint is highly flexible, it can also develop poor mobility due to various circumstances.

What Causes Our Limited Mobility

There are many causes of limited shoulder mobility, including the following:

  • Inactivity. A sedentary lifestyle is one of the most common causes of limited shoulder mobility. This is because a lack of activity will cause the shoulder muscles to tighten, reduce the stability of the joints and significantly restrict movement.
  • Poor posture. Poor standing or sitting postures can lead to internal rotation of the shoulders. As a result, the humerus bone will shift slightly and will be in a displaced position in the shoulder socket. This can contribute to shoulder damage such as impingement, resulting in potential swelling and inflammation.
  • Instability. Instability of the shoulder is often a result of muscle imbalances due to unequal forces acting on both sides of the shoulder. This is common in athletes involved in sports that require more movement on one side of the body, such as baseball or cricket.

Alternatively, improper techniques performed during strenuous exercises can also promote internal rotation of the shoulders and hence create muscle imbalances. This may place significant strain on muscles such as the rotator cuff, resulting in shoulder mobility issues and injuries.

Why You Should Be Concerned About Poor Shoulder Mobility

Now you know what leads to poor shoulder mobility, the question is, why should you be concerned about it?

The reason is simple. Poor shoulder mobility can result in:

Higher Risks Of Injury

When your shoulders lack mobility, they will also lack muscular strength, coordination and stability. As such, you may not appropriately activate the intended muscle groups or attain the optimal range of motion when performing certain exercises. This leads to dysfunctional movement patterns as other assistance and stabiliser muscles have to overcompensate, forcing them to be activated more. 

When this occurs, it may place unnecessary stress on other muscles and joints, drastically increasing your susceptibility to injuries.

Potentially A Sign Of Muscular Imbalance

Poor shoulder mobility is also usually symptomatic of other hidden problems such as muscular imbalances or poor postural alignment. These issues may not be apparent from the start, but they are causes of concern.

Muscular imbalance arises when a group of muscles are stronger than the other due to improper techniques or repetitive movements when performing specific exercises. For example, your form may be incorrect when exercising, resulting in you training unintended muscle groups instead of the primarily targeted group. Alternatively, when you hold a specific posture for prolonged periods, you may also cause a muscle group to work harder than the rest. All these may result in limited mobility and range of motion.

How To Improve Shoulder Mobility

After knowing the causes and effects of poor shoulder mobility, the next step is to understand how to improve shoulder mobility. 

Here are some ways:

Perform Diagnostic Tests

To improve shoulder mobility, you will first need to understand your shoulder limitations to determine which areas you should work on.

A diagnostic test is the most common and direct method to identify mobility issues. Most of these tests are performed in conjunction with imaging tests such as an x-ray or ultrasound to detect and clarify the results of a physical examination.

Some of these tests may include:

  • Neer Test. For this test, a physical therapist will stand behind you and press down on the top of your shoulder. They will then rotate your arm towards your chest and raise your arm as high as possible.
  • Hawkins-Kennedy Test. Your physical therapist will position your elbow to a 90-degree angle and raise it to your shoulder level while you are seated down. They will then place their arm below your elbow before pressing down on your wrist to rotate your shoulder.
  • Yocum Test. You will be instructed to place one hand on your opposite shoulder and attempt to raise your elbow without moving your shoulder.

These tests are designed to detect any signs of pain and determine the exact location of the pain. A painful reaction when carrying out the exercises is usually a positive indication of a shoulder mobility issue.

Self Myofascial Release Techniques

Self-myofascial release techniques involve applying pressure to target tight muscles and fascia (a protective membrane that protects your muscles and other organs in your body) to reduce pain. These techniques, when applied correctly, can effectively resolve shoulder mobility issues. However, the reverse is also true. If done improperly, it can also aggravate the problem, causing greater pain.

Some of these techniques may include:

  • Deltoid rolls. This involves placing a foam roller between your shoulder and a wall. Position your hips to align with the wall and slowly move until you feel tightness. Proceed to move up and down using your body weight until the pain dissipates slightly. Repeat with your other shoulder.
  • Neck rolls. Lie down on your back with the foam roller under your neck. Next, tilt your chin to one side and gently move up and down. Repeat this process with the other side of your neck.
  • Lats roll. Lie on the floor with the foam roller placed under the back of your armpit. Gently rotate your body until your chest faces the floor and then slowly rotate back up. Repeat this process several times before changing sides.

Stick To A Shoulder Mobility Routine

A structured shoulder mobility routine can also considerably improve your shoulder mobility by fixing tight shoulders and correcting improper body posture. The routine should also be comprehensive and involve all related components of the shoulder, including the area from your mid-back to neck (thoracic spine) and lower back.

As everyone may experience issues in different areas, there isn’t a one-size-fits-all training programme. 

However, there are various effective exercises you can include in your routine, including the following:

  • Quadrupled shoulder overhead reach. This exercise will enable you to control your lower back (lumbar spine). Start with both hands and knees on the floor, with the hands beneath your shoulders and knees beneath your hips. Push into the ground to spread your shoulder blades (scapula). Next, put your lower back into a neutral position by arching and tucking. With this neutral position and scapula still extended, stretch one arm outwards and slowly reach overhead, rotating your thumb towards the ceiling. Perform a few repetitions before changing sides. Ensure that your scapula does not sag throughout the exercise, and you do not rotate your body (remain in a neutral position)
  • L-arm stretch. This exercise stretches your rotator cuffs and the back of your shoulder. Begin by lying on your stomach and place one arm by your side. Extend your other arm across your chest with your palms facing upwards. Ensure that you do not shrug your shoulders towards your ear as much as possible. Using your shoulder muscles, pull your chest towards the floor to stretch the shoulder capsule and hold for several seconds. Perform a few repetitions before changing sides.
  • Open book. Your thoracic spine will be actively stretched with this exercise. To start, lie on a side and extend both arms in front of you. Next, bring your top hand towards the ceiling and stretch it all the way to the floor on your other side. Your head should follow the motion of the hand. Perform a few repetitions before switching to the other side. Ensure that your hips remain still throughout this motion.

However, to improve shoulder mobility, it is insufficient to do these exercises only once. You have to perform them consistently to see progress.

Best Practices For Staying Injury Free

Improving your shoulder health and staying injury-free will help with shoulder mobility and vice versa. If you sustain an injury due to poor shoulder mobility, you may become sidelined for months at best. This may also result in inactivity and a possible further reduction in mobility.

As such, following the best practices below can go a long way towards an injury-free body.

Prehab Exercises

Performing physical therapy exercises even if you are not injured may seem counterintuitive to many people. However, prehab or preventive rehabilitation exercises are vital even if your shoulder is in good health, as they can dramatically reduce the risks of injuries and pain.

As such, do not wait until you are injured before you have to do rehabilitation work, as the damage would have already been done.

However, keep in mind that prehab exercises are not warm-ups you do before an exercise. Prehab exercises are designed to be performed regularly and consistently about 2 to 3 times per week. These exercises need to be individualised and tailor to your specific weakness.

Perform Dynamic Warm-Ups Before Exercising

One of the best ways to reduce the risk of injury is to perform warm-ups before a workout. There are generally two types of warm-ups: Static stretching and dynamic stretching. 

For a long time, static stretching has been regarded as a vital pre-workout warm-up. However, warmups have since evolved as people are now more equipped with the knowledge of what our body requires to perform an action optimally and safely. As such, an even more appropriate warm-up now is the dynamic warm-up.

A good warm-up routine should include dynamic exercises (cardio) such as squats, burpees or push-ups as it increases your heart rate and loosens up your muscles. These warm-up exercises will allow your muscles and joints to become activated to tolerate the intensity required during the workout. Furthermore, dynamic warmups should also be tailored specifically to the type of exercise or sport you will be performing, as well as focus on engaging several muscle groups together. 

However, that does not mean that static stretching is not essential. It is still paramount to stretch, but only after the workout as it is the most effective. Stretching reduces muscle tension and loosens up your muscles after an exercise, which helps to prevent the risk of injuries.

Conclusion

Poor shoulder mobility may not be an urgent cause for concern initially, as the red flags may not be apparent (it may start as a simple case of difficulty raising the arms above your head). You may even ignore this signal and pass it off as a one-time or temporary occurrence.

However, poor shoulder mobility may result in more severe repercussions if not improved. It is thus vital to understand the cause of your shoulder mobility and learn how to improve it to reduce the risks of injuries.

"Moving your body the way nature intended is a freedom not well appreciated until it is lost. We are passionate about getting you back in the game, and staying in the game. Our team is fully committed to returning you to the life and activities you love."

Dr Ong Kee Leong

About Dr. Ong Kee Leong

Senior Consultant, MBBS (Singapore), MMed (Ortho), FRCSEd (Ortho)

Dr. Ong Kee Leong is a fellowship-trained orthopaedic surgeon. He subspecializes in shoulder and knee, foot and ankle, hand wrist and elbow surgeries, arthroscopic sports surgery, and the management of sports-related injuries.

He has been registered with the Singapore Medical Council as a specialist in Orthopaedic Surgery since 2011.

  • MBBS, National University of Singapore (NUS) Faculty of Medicine 2001
  • Member of the Royal College of Surgeons of Edinburgh 2007
  • Master of Medicine in Orthopaedic Surgery (NUS) 2007
  • Fellow of the Royal College of Surgeons of Edinburgh in Orthopaedic Surgery 2011
  • Health Manpower Development Plan (HMDP) Scholarship, Ministry of Health 2012-2013:
  • Sports Surgery and Arthroscopy in Germany (Hannover)
  • Adjunct Assistant Professor, Lee Kong Chian School Of Medicine, Nanyang Technological University
  • Senior Clinical Lecturer, Yong Loo Lin School of Medicine, NUS
Awards & Teaching
  • Dr. Ong had received numerous awards such as Best Service and Eastern Health Alliance Caring (Gold) Awards.
  • He also has an interest in clinical research and has written papers in multiple peer-review journals. As a Core Faculty of Singhealth Orthopaedic Surgery Residency Program, he oversees the training of junior orthopaedic surgeons.
  • Regularly invited to teach local and regional surgeons in Shoulder and Knee Surgery Courses.
  • He is a recipient of multiple teaching awards including the Singhealth Residency Outstanding Faculty Awards from 2014-2016 and Changi General Hospital Outstanding Educator Awards 2015-2016.

Why Do Patients Choose Dr Ong Kee Leong?

  • Dr. Ong Is Passionate In Sports, Giving Him A Deep Understanding Of Sports-Related Injuries And How They Can Be Treated
  • Fellowship Trained Surgeon With 15 Years Of Experience In Orthopaedic Conditions
  • Personalised And Professional Approach To Deliver High-Quality Orthopaedic Care Based On The Most Up-To-Date Literature
  • Detailed Aftercare Plan To Ensure Smooth, Long-Term Recovery
  • Problem-Oriented, Well-Organised and Individualized Treatment Plans Catered To Your Specific Needs
  • Specialist In The Management Of Sports Injuries And Degenerative Conditions Of The Shoulder And Knee Joints
  • Knowledgeable And Pleasant Clinical Staff To Assist You With Your Every Need Detailed Aftercare Plan To Ensure
  • Our Care Is Conveniently Accessible At Mount Elizabeth Novena and Farrer Park hospital
  • Minimal Waiting Time For Initial Consultation
  • Assistance With Medical Claims (e.g. Medisave & Integrated Shield Plans)

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