Yogi Shoulder

You can feel the heat building in the room, and the steady flow of breath around you. You look down at your fingers spread wide on the yoga mat, part way through your sun salutation, hesitating before you lower to the ground. You’re dreading that ‘pinchy’ feeling in your shoulder that’s been nagging you for weeks.

Welcome to ‘Yogi Shoulder’.
Usually known as ‘Swimmers Shoulder’, or technically ‘Impingement Syndrome,’ shoulder impingement is a common occurrence in yoga practitioners, particularly those who have a vinyasa type asana practice with lots of chaturangas and sun salutations.

Off the Cuff

The structures that are actually being impinged or pinched are the muscles of the rotator cuff. The rotator cuff is made up of four very important muscles that control the position of the arm bone in the socket: supraspinatus, infraspinatus, subscapularis, and teres minor. These muscles move the arm from inward rotation to outward rotation or lift the arm overhead. The rotator cuff muscles wrap from the shoulder blade onto the arm bone. It is the portion of the muscles that wrap onto the top of the arm bone that often get irritated or impinged under the tip of the shoulder blade known as the acromium. You can feel this part of your anatomy yourself by walking your fingers firmly along your clavicle or collarbone starting at your sternum. When you come to a divot, just as you reach the round portion of you shoulder, you have reached the joint made between your acromium and the clavicle known as the AC joint. Often yogis will feel a deep ache or pinching near this area, sometimes radiating into the arm. If you drop your fingers just below the joint and press outwards, you should feel the ball portion of your arm bone. Move your arm forward and back, inward and outward and you can feel the way the arm bone moves in its socket.

Balance Please

Like all areas of the body, and all areas of our life for that matter, problems in the shoulder start when there is a lack of balance. Often the stabilizing muscles of the shoulder blade become weak, allowing the shoulder blade to wing out, disrupting the natural movements of the rotator cuff muscles. One key muscle to shoulder stabilization is the serratus anterior muscle, which attaches from our side ribs to the shoulder blade. To increase the strength and activation of this muscle you can add a “plank plus” exercise to your asanas. From plank, or all fours, without bending your elbows, allow your heart to move towards the floor, sending your arm bones into their sockets. Keeping your elbows straight, your mid back motionless, press into the palms so that your arm bones move towards the floor and your body moves away from the floor. This pushing action activates the serratus anterior as the shoulder blade slides around the ribs. Repeat this subtle motion up to ten times.

Another common imbalance that can contribute to impingement in the shoulder is the shortening and tightening of the pectoralis muscles of the chest. Many of us spend our days working on computers, or at the very least doing some sort of activity in front of us. This can often close down the space at the front of the shoulders, resulting in rounded shoulders. Ensuring that chest openers are a regular part of your asana practice can help increase the space at the front of your shoulders. Try taking a chest opener attitude into all of your asanas: shoulder blades moving towards each other, open through the collar bone, and send your throat straight back.

These two imbalances are the most common contributors to ‘yogi shoulder’ but it is important to seek attention from a health professional if you do not seem to be getting any relief.

Our shoulders are a complex part of our anatomy and an integral part of our yoga practice. Honoring any strange or painful sensations we feel, and seeking out the cause, is an important part of staying on the mat for years to come.

Asana Anatomy - Chaturanga Part 2

The following continues my recent article from myyogaonline.com.

Anatomy in Motion
Building on what we've learned in Part 1, let's begin in plank. Starting from this place of stability and alignment, we can now safely flow into chaturanga.

Upper Body
The most complex movements in Chaturanga come from our upper body. In order for us to lower, a number of actions must occur. Firstly, we must balance the action of inward and outward rotation at the shoulder joint. The outward rotation of teres major and infraspinatus muscles of the rotator cuff counteract the inward pull of the pectoralis muscles, and lattisimus dorsi on the back. By nature of the fact that our palms are on the mat, the pronator muscles of the forearm are activating an inward rotation at the wrist. To maintain neutral rotation at our shoulder joint, our elbows must hug to our sides to engage the triceps, whose natural action is pure flexion and extension at the elbows. It is important that we keep the engagement of the scapular support muscles that we started with in plank pose. This means that we keep an open heart moving forward, broad across the collarbones, and our shoulder tips never drop below our elbows. The subscapularis muscle of the rotator cuff (on the underside of the shoulder blade) is working over time to prevent the arm bone from moving forward out of the shoulder joint.

Core
We maintain the contraction of the transversus abdominus throughout chaturanga, which keeps our body parallel to the floor and avoids any lower back discomfort. Imagine your side body growing long as your heart shines forward and your heels press firmly back.

Lower Body
The action of pressing back through the heels maintains length through the legs and deep hip flexor muscle, the psoas, which has attachments in the spine and the legs. The legs support our upper body so that chaturanga becomes a full body pose, not just an arm balance.

Benefits & Considerations
Chaturanga is an excellent pose to build awareness of the muscles that support and stabilize our shoulder blades. It is important to be mindful as we enter the pose, setting up the action of the shoulder blades pressing together. If we do allow the shoulders to tip forward, this can result in injury to our sensitive rotator cuff muscles.
Chaturanga is also an excellent core exercise. If you find that as your practice goes on it is difficult to maintain your body parallel to the floor, it is better to drop to your knees but stay aligned from your knees to the crown of your head. If you are finding wrist discomfort, ensure that you are distributing weight throughout the palm, not just on the inner portion which may be overcome by the pronation (inward rotation) in your forearms. Wrist pain can also be a sign that you have not accessed the power in your shoulder muscles. Of course sometimes aches and pains may signal a larger injury so it is important to consult with a health professional that understands yoga.

Now Flow
Chaturanga Dandasana gives us a feeling of power, accessing our inner strength as well as building our outer strength. It enables us to flow gracefully through our sun salutations and between poses, and when done with mindful alignment can be a satisfying and fulfilling asana.