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Shoulder pain - the complete picture

Sub-acromial pain syndrome is a very painful and debilitating condition which affects a large percentage of the caseload who come to see me. Shoulders can be notoriously difficult to manage due to the amount of pain they can give. More often than not there is some rotator cuff weakness (stabilising muscles of the shoulder) which is usually simple to address, but sometimes this is only scratching the surface. You'll hear clinicians such as Ben Ashworth (Arsenal 1st team Physio) often say don't pay too much attention to posture at rest. However, it can give clues as to how the shoulders will move dynamically. Protracted (rounded) shoulders, weak posterior chain (muscles of the shoulder blades) and dominant muscles in the anterior (front) shoulders can all contribute to shoulder pain. I'll discuss my favourite exercises to strengthen the posterior chain in future posts but this exercise is a nice way to increase the length of pec major and minor. Eccentricly loading (slowly lengthening muscles under load) muscles and taking them into their outer range is incredibly effective way of improving range if movement. Purely stretching in the classical sense tends to have a very temporary benefit. Try Pec flat/incline flys and ensure you're performing the exercise slowly, allowing the weight to ease right to the outer ranges.

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