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Tid Bits of Info

  • It is reported that children under the age of 18 yr spend an average of 7+ hours in front of a screen every day.
  • Recent studies have shown results indicating that nearly 40% of all swimmers age 10-18 suffer from shoulder pain at sometime.
  • The ability to serve a tennis ball with great velocity is greatly dependent upon lower extremity and core strength.
  • The entire body working together is referred to as the kinetic chain.
  • Seek the advice of a Physical Therapist if your adolescent athlete complains of shoulder pain.

Young athletes competing in sports that require hand and arm movements above the shoulder commonly experience shoulder pain. Healthcare professionals treat adolescents with complaint on a daily basis. After assessing the problem, the two most common causes are poor posture and muscle weakness. These can lead to temporary pain but also long term damage if not corrected. Physical Therapists focus on treating injury while also training the athletes to strengthen muscles in the shoulder and core and improve posture.

The shoulder joint is comprised of three bones: scapula, clavicle and humerus.  The head of the humerus rests on the Glenoid fossa of the scapula where it articulates when the muscles of the shoulder contract to move the arm. The space above the humeral head is the Sub Acromial (SA) space.  The Acromion of the scapulae forms a “ceiling” over the joint.  The space “houses” the top muscles of the RTC and the Subacromial bursa. The SA space is only 9-11 mm in the healthy shoulder. This space is sufficient for complete movement of the shoulder, but if one or more of the structures in this small space is damaged and becomes inflamed the space will be impinged and shoulder movement will be adversely affected.

If someone’s posture is “hunched” or “rounded” shoulder, the SA space is reduced in size.  Movement of the arm out to the side or upwards towards shoulder level makes the space smaller and the structures are compressed which can lead to more extensive damage to the soft tissues in the SA space.

The scapula needs to be in the correct anatomical position and remain stable when the arm moves.  The musculature that moves the arm attaches to the scapula and “pulls” on it when the arm is moved.  If the scapula is not stable, there is a lot of accessory motion and the musculature is over-worked which leads to over-use injuries.  If this scenario persists, more extensive damage can occur to the soft tissues of the shoulder joint.

The “hunched” or “rounded shoulder” posture often times occurs due to weak stabilizing musculature.  When an athlete, of any age, performs activities that require arm motions and movements above shoulder level they can jeopardize the structures in the SA space.  if they have “hunched” shoulder posture the structures are more at risk.  Weak core muscles are associated with this posture in most instances.  In order for the stabilizing muscles of the scapula to work properly, the core muscles must hold the rib cage and spine stable.  For muscles to function properly, the muscles must have a stable anchoring point which enables the opposite end to move a particular body part.

Adolescent athletes that complain of shoulder pain often times have rounded shoulder posture and weak core musculature. Their posture must be corrected and they must strengthen the musculature in their shoulders and core.  The core musculature is responsible for providing the dynamic stability for the spine and ribs.  The muscles that stabilize the scapulae attach to the ribs and spine.  If the core musculature is unable to stabilize the shoulder motions might be compromised and an injury can occur.

Treating the symptoms of injured adolescent athletes is the primary aspect of rehabilitation, but if their posture is not corrected and the core and shoulder muscle strength is not improved they will not fully recover. They will experience a reoccurrence of their symptoms if they continue to participate in the sport that leads to the injury in the first place.

Physical Therapists that specialize in treating orthopaedic injuries are the healthcare professionals that are able to help the adolescent athlete resolve their symptoms and educate them on proper posture and exercises.  The Physical Therapist will evaluate the athlete’s shoulder and develop a treatment protocol that will resolve the symptoms and correct the weakness in the involved musculature.

These young athletes are not alone when it comes to poor posture and core weakness.  There a large portion of the population of all ages that have developed poor posture and weak core musculature.  If these people correct their shoulder posture and begin to strengthen their shoulder and core musculature they can avoid many shoulder injuries that can be very debilitating and reduce the quality of the life.

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