Movement University Upper Extremity (Shoulder, Elbow, Wrist, Hand)
Upper Extremity Overview
The upper extremity includes the shoulder, elbow, wrist, and hand.
The sole function of the shoulder and elbow is to properly position the hand for grasping, reaching, lifting, and catching.
This means that the shoulder must have good motion and be strong to allow the hand to work fully.
One in three people over the age of 30 (and two out of three people over the age of 70) has abnormal MRI findings related to their shoulder, including complete rotator cuff tears. In many instances, these individuals had no pain!
Shoulder impingement and rotator cuff tears are two common shoulder diagnosis' that are commonly treated by strengthening the middle and lower trapezius, serratus anterior, and gradually improving shoulder range of motion.
Continue reading about the upper extremity and causes of pain in this region by scrolling down on this page!
About Upper Extremity Pain
To better understand shoulder mechanics, let’s do a quick test. First, slouch down and try to raise your arms overhead. Second, sit upright and raise your arms overhead again. Hopefully you had further range of motion while sitting up tall. Why? THE POSITION OF THE MIDDLE BACK DETERMINES HOW MUCH SHOULDER MOTION IS POSSIBLE! Since many people naturally rest in a rounded shoulder posture, the middle back is often slouched. Attempting to lift a weight from this position can place extra stress across the front of the shoulder.
The habits we develop while performing repetitive tasks transfer to our habits when we move. If you sit in a slouched position OR rarely raise your arms overhead, your brain forgets how to do these motions. Why do you forget these movements? In short, it is because your brain is similar to a detailed GPS system.
When an injury occurs, your internal GPS is often reprogrammed to make you move in different ways. With an injury, there can be different messages sent between the brain and the muscle, meaning your “muscle memory” has been disrupted. After some time, your internal GPS may no longer be able to accurately identify certain roads on your body’s map. While the injury is healing, the brain and body often coordinate alternative, compensatory strategies for certain movements like a limp, awkward bending mechanics, stiff movements, or limited range of motion. These protective phenomena are much like how a GPS detours to an alternative route because of a road closure.
In regards to the shoulder, you must build new and confident movement strategies, It is important to gradually continue movement as you are healing. Once the body’s recovered and the route’s obstructions are cleared, it’s important to return to the main road without fear.
When does it typically occur? Symptoms typically occur when raising the arm overhead, pushing or rotating arm out to side, reaching behind back, and/or sleeping on the involved side.
Why does it commonly occur? Stiffness in the middle back Weakness of the back shoulder blade muscles- middle and lower trapezius Weakness of the serratus anterior Limited shoulder mobility and range of motion during each day