The Problem
My client here was complaining about the limited range of motion in her shoulders which seemed to be causing her pain when she moved her arm over head. More specifically when she was training arms, but it was starting to affect her daily life.
The Assessment
What I call the table test is my standard test to understand the shoulder joint’s passive range of motion against gravity. In the test in the pictures, her arm initially is angled up indicating her shoulder is stuck in internal rotation. In a perfect world, her arm should be parallel to the table. Her active range of motion was not any better as it confirmed her shoulder was internally rotated.
The Solution
The muscles that keep your shoulders in internal rotation need to be re-lengthened as they are stuck in a shortened position. Her pec minor tightness was the one that really stood out. ART (active release techniques) and PNF (proprioceptive neuromuscular facilitation) were primarily used to re-lengthen her pec minor. We also addressed the bigger muscles like her upper pec major, front delt and subscap. All these muscles insert at the shoulder joint and can cause internal rotation when short and tight.
Conclusion
Pec minor specifically is an overlooked muscle when addressing shoulder tightness and impingements. It does insert at the shoulder and when released can have a big impact on improving shoulder range of motion. When addressing any shoulder impingement proper tests and understanding of habitual patterns needs to be taken into consideration. After the session, I did go over how to optimize sitting posture as my client here does sit at a desk all day. I did advise on easy-to-do pec and shoulder stretches to be done at her desk and home through the day to offset all the internal rotation she does at work.
Build Your Own Today!