The Top Shelf

Many adults begin to develop shoulder pain, even though they may not have sustained a specific injury. It's important to pay attention to such shoulder issues, as a healthy shoulder joint is the key to full function of the upper extremities. We all know at least one person whose ability to perform normal activities of daily living has been significantly compromised by chronic shoulder pain. Conservative treatment may be of benefit, but the key, as always, is to prevent these problems before they occur. The primary prophylactic intervention, as is the case for most musculoskeletal conditions, is exercise.

We all agree that the human body's design is magnificent. Every component has a purpose, down to the smallest cell. Every system is deeply interconnected with every other. Miraculously, the whole is much greater than the sum of the parts. And yet, there are a few "gotchas" built-in to this ingenious design. With respect to the shoulder, the "gotcha" relates to the shoulder joint's extraordinary mobility. The shoulder joint has the greatest range of motion of all the joints in your body. But this extreme mobility comes at a price, that is, the shoulder joint is not a particularly stable joint. For example, shoulder dislocations comprise approximately 50% of all such injuries.

Shoulder pain in the absence of a specific injury often represents damage to the rotator cuff. Again, the design of the shoulder joint and surrounding soft tissues is implicated in these rotator cuff problems. The blood supply to the bones, muscles, ligaments, and tendons of the shoulder is consistently compromised during normal motion of the shoulder above 90º, as in placing an object on or taking an object down from the top shelf in a kitchen cabinet. If much of your day is spent with your arm elevated above 90º to the front or to the side, over time you may develop nagging shoulder pain. Worse, with persistent repetitive motion above 90º, nagging shoulder pain may become chronic pain that restricts activities.

The best approach to shoulder problems is to become aware of the rotator cuff's well-known tendency to develop degenerative changes. We can be proactive by doing strength-training exercises for the shoulder and incorporating these exercises in our weekly exercise program as soon as possible.1,2 Beginning such exercises in the teenage years would be ideal. For those of us who are older, the right time to begin shoulder strength training is now. Shoulder exercises stimulate growth of new muscle fibers, increase the size of muscle fibers already in existence, and stimulate growth of nerve fibers bringing information to and from all shoulder girdle structures.

Shoulder exercises should be done once or twice a week as part of your overall fitness program. As with all exercise that's new to you, start slowly and gradually increase the level of difficulty over time.3 The result of all this activity is a dramatically improved blood supply to the shoulder region and a dramatically reduced tendency for rotator cuff degeneration and injury.

1Choi SH, Lee BH: Clinical Usefulness of Shoulder Stability Exercises for Middle-aged Women. J Phys Ther Sci 25(10):1243-1246, 2013
2Saltychev M, et al: Conservative treatment or surgery for shoulder impingement: systematic review and meta-analysis. Disabil Rehabil 37(1):1-8, 2015
Another example of a common issues
3Daenen L, et al: Exercise, not to exercise, or how to exercise in patients with chronic pain? Applying science to practice. Clin J Pain 31(2):108-114, 2015

Multicare Health Clinic

3930 STADIUM DR
SIOUX CITY, IA 51106
Phone Number: (712) 276-4325

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8:30 am-2:00 pm

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Testimonials

  • "Being able to present my back pain to three different professions in one place and knowing that they are working together to make me better is very comforting."
    Charlie P.
  • "I'm so glad my sister referred me to Multicare! My elbow hasn't felt this good in a long time. Thanks to the great physical therapy team there."
    Ellen E.
  • "I'm a runner. When I wasn't able to run due to leg problems, I was devastated. But a consultation at Multicare Health Clinic identified the problem and after some adjustments, stimulation treatments and therapy, I'm running again!"
    Lisa L.
  • "After my consultatin with the doctors at Multicare Health Clinic, I understand how to address my balance issues."
    Anna A.
  • "At night my right hand would go painfully numb at least 2-3 times where I could not sleep. Now, I don't have that pain and can get a full night sleep."
    Janet D.
  • "My shoulder and neck feel so much better. I now have the knowledge, motivation, desire and tools to keep up the exercises."
    Barb B.
  • "There couldn't be a better physical therapy team in Siouxland! Not only did my knee feel so much better after six weeks, but I feel like I made new friends."
    Karla K.
  • "I wasn't able to use my hand the way I should. After working with Dr. Sneller and the physical therapy team, I can use my hand again."
    Henry H.
  • "After an accident at work I didn't think I'd ever get relief from my aching shoulder. But, the doctors at Multicare gave me adjustments and physical therapy and now I feel normal again."
    Cliff C.
  • "Dr. Sneller helped. I haven't been feeling dizzy anymore."
    Belinda B
  • "I leave here feeling confident that I have the resources to manage my pain and live normally, and that's priceless."
    Alycen V.
  • "After my knee surgery I was asked where I wanted to do my physical therapy, I chose Multicare Health Clinic and I'm so glad I did! Dr. Steve and the therapy assistants (Sara and Megan) are fabulous! They know what they're doing and they all really seemed to care about my recovery. I'm feeling fantastic! I'll definitely go back again whenever I need therapy or adjustments."
    Sheri J.
  • "I now can go a full week without pain and headaches."
    Luke W.
  • "My company encouraged all of us employees to get screened at Multicare. I didn't know what to expect. It was easy and I learned so much. The orthotics they prescribed really help me to feel more stable and confident at work."
    Jim J.
  • "Not only is my pain level down to zero, but what I'm really thrilled with, is that I have normal feeling in my hands."
    Jill L.
  • "I'm now a believer now! I didn't think chiropractic could help my foot problems. But after meeting with Dr. Pistello and Dr. Dave for a few weeks, I'm feeling so much better!"
    Gino G.
  • "I wasn't able to use my hand the way I should. After working with Dr. Sneller and the physical therapy team, I can use my hand again."
    Ivy I.