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prolonged

Heat Or Ice For My Shoulder?

Try Standing Upright

In the gym, at the golf course, and during a visit to the hardware store, I am asked my advice on abolishing shoulder pain.  What everyone wants is the magical exercise, miracle ointment, or newest thermal treatment.  What they need–and what they do not want to hear–is that they have to fix their horrible posture.

Sustained poor posture can alter the function of your shoulder complex.  The shoulder girdle has only one, very small, bone to body connection.  The entire system is an interconnected series of muscles and ligaments.  Sustained slouched over postures create a faulty length-tension relationship in these structures that places adverse stress and strain on the four joints of the shoulder and the nerves in the neck and upper back.

OMG I sit lmGm (like my GrandMa).  

Shoulder posture pain problems are happening earlier.  I do not know if it is more tech toys, less physical education in schools, or a change in youth activity levels, but in the physical therapy clinic we are seeing younger people with older people postural shoulder pain.  They sit on the treatment table in extremely slouched over positions and are unable to pull themselves up into a correct position.  Most are unconvinced that how they sit and stand could be the generator of their pain problem.

What exercises can I do?

Stronger muscles will help restore posture.  The shoulder evolved to pull, lift, and carry.  The muscles that keep the shoulder strong and happy are in the back of the shoulder.  They hold the shoulder in a healthy position on the body.  Most of us never perform any pulling or lifting activities other than hoisting our laptop or toting our smart phone.   Making your shoulder girdle muscles stronger will help, but being mindful of your posture during the day is the most important factor.  Physical Therapist and US Soccer Team Trainer Sue Falsone says “You can’t out rep poor posture.”

Start with how you work and live.

Eight hours a day for five days a week equals 2080 hours of computer / desk time a year for the average office worker.  Add in a daily one hour car commute and another two hours of television a day and we push the Monday through Friday slump numbers to 2860 hours a year (120 days).  We have spent millions on state of the art chairs, elevated monitors, slanting keyboards, wrist rests, and lumbar supports.  Office modifications, while well intentioned and generally a good idea, cannot compete with 2860 hours (this number is probably low) of sitting in a year.  In order to fight against the postural stress that creates pain, we need to get up and move.

Recent research on prolonged sitting has demonstrated that the amount of movement we need to stay healthy is greater than we once thought.  To combat the adaptive changes of prolonged sitting, it is suggested you get up and move every twenty minutes.  Set a timer, enlist the help of your coworkers, and work at this every workday for a month.  I believe you will be surprised by the results.

Michael S. O’Hara, PT, OCS, CSCS

standing-desk-pro-plus-36_main-1I have known Tracy for at least seven years.  She is an active mother of three children and works full time as an accountant.  Over a four-year span, Tracy was a patient in our physical therapy clinic three times for the same problem of leg and lower back pain.  Tracy always recovered and was able to return to work but her last bout of pain lasted three months.  I ran into Tracy at a restaurant recently.  She stated that she was ashamed to admit it, but after four years of listening to me preach about the benefits of a standing work station, she finally got out of the chair and started working at a stand up desk.  This is her standing desk story.

Her legs “felt tired” for the initial eight weeks and she went back and forth between standing and an office chair.  Tracy kept performing her hip mobility exercises and lumbar stability drills and gradually became more accustom to her new workstation.  She has been using the standing desk for three years, and in that time, she has not been bothered by any back or leg pain.  An additional benefit has been an eight-pound weight loss and “surprisingly” her “sinus headaches” have resolved.  Tracy told me she sits for at most three hours of a workday and could not imagine going back to a seated workstation. Tracy stated that three of her coworkers have made the standing desk transition and all report similar results.

Prolonged sitting creates multiple postural pain problems.  Postural Stress Disorder (PSD) is the new term given to the pain created by seated office work.  In our physical therapy clinics, we are seeing more and more patients with face, head, neck, shoulder, back, and hip pain associated with prolonged sitting.

We are de-evolving into a nation of sitters.  Between internet, television, driving, and computer work, it is not uncommon for many of my physical therapy patients and fitness clients to sit for ten hours a day.  Unfortunately, you cannot train away the bad effects of prolonged sitting with a 45 minute session of exercise.

While it takes some effort, and a little office remodeling, the benefits of using a standing workstation cannot be ignored.  I was happy to hear Tracy’s story and recognize her as one of my reluctant, but now pain-free converts.  If you have an occupation that places you in front of a computer, you should invest in a stand up style workstation that allows you to be upright for most of the day.  Many large corporations have recognized the benefit and have made the switch to standing workstations.  Standing desks are now more affordable and several of my converts have one at work and one at home.
-Michael O’Hara, P.T., OCS, CSCS

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