One of the most common problems I see as people get older is the inability to raise their arms over their heads. Many struggle to lift their arms straight out in front of their bodies, others cannot lift their arms out to the side, and finally, hardly any of them would even think of lifting their arms over their heads!
Most of my clients in this state have been told they have arthritic shoulders or impingement. For some they do have enough damage that a shoulder replacement is needed. However, for the majority of these same clients they do not have either arthritis or an impingement. What they do have is weakness or muscle stiffness due to lack of use.
What is interesting in most cases is, someone will come to my office and state they cannot lift their arm, even straight out in front of them. When I asked them to relax the arm and let me move it around, there is little to no restriction in movement. I can lift their arm through the full range of motion above their head with no pain or restriction. When I ask them to lift their own arm, they cannot and sometimes trying to lift their arm is too painful. If the joint has no restrictions, how can that be?
1- How the Shoulder Works
Let’s begin by understanding how your shoulder works. In doing so, I will show the 3 reasons why you cannot lift your arm. Lifting your arm requires using many muscles in and around the shoulder and upper back. These muscles attach to the spine in the upper back and neck, then run down the arm to the elbow. If just one muscle goes into a spasm or becomes weak, it can stop all the others from working and this prevents you from lifting your arm.
Reason #1- The Outside Chest Muscle
The muscle on the outside of the chest, the Pectoralis minor, is a small muscle and can be felt by grasping the outer chest, just under the arm pit as you raise your arm. This muscle runs from under the breast to the outer edge of the collarbone. When lifting your arm, the Pectoralis minor must release for the arm to be raised. If it goes into a spasm, not only can you not raise your arm, but you may also feel pain shooting down the arm. The pain shooting down your arm is due to the muscles running from the shoulder to the neck overworking as they try to lift the weight of the arm.
You can do self-massage daily on the pectoralis minor by grasping the outside edge of your chest and slowly press one spot at a time, breathe out as you press, then allow the muscle to soften. If your arm movement is limited, each day try to lift your arm a little higher as you massage the chest. You can do this by using an armrest, then graduate to a table, and finally against a door frame. Over time you can improve the flexibility of the chest muscle. I have added the pec minor stretch video below.
Reason #2- The Shoulder Blade
The shoulder blade has many muscles on top, underneath, and attaching between the shoulder blade and spine. The shoulder blade contains the socket that the arm rests in. When you raise your arm, the shoulder must be able to rotate before you can raise your arm. This requires cooperation from the Pectoralis minor, as mentioned before, the Rhomboid muscles, between the shoulder blade and spine, then the muscles between the outer edge of the shoulder to the neck. If any of these muscles are in a spasm, again you cannot raise your arm without pain. The muscle will spasm when it is a prolong state of contraction when it fights against the opposing muscle. For example, when you flex your elbow by contracting your bicep, the triceps will extend allowing the bicep to contract. However, if the triceps is tight, then when you try to contract the bicep for too long the bicep will go into a cramp or spasm.
The easiest thing to do is use your tennis ball against the wall. First, place the ball between the shoulder blade and the spine, press gently and move one spot at a time. Do not roll on the ball or lie on the floor on top of the ball. Rolling on the ball prevents the brain from releasing the tight spots and lying on the ball prevents you from releasing as the pressure is all of nothing since you cannot levitate. As you soften the rhomboids, the movement of the shoulder blade will improve.
Next, place the ball on the shoulder blade. There are 3 muscles here and they can become very painful so go in slowly. Work one spot at a time, breathe out, and allow the muscle to relax. Once you soften these areas and the front of the chest, lifting your arm may become easier. I will add the stretch video for this area below.
Reason #3- Muscle Weakness
This one may seem obvious, but few people, as they age, practice lifting their arms above their heads. It is the “Use it or Lose it” theory about muscles. Too many times we never lift our arms up as we do not have to anymore. The same is true for looking up, but that is another article. Begin by practicing every day lifting one arm at a time, several times a day. Begin with just the weight of your arm 10 times. Then progress to 3 sets of 10 reps. As you get stronger, add some more weight, nothing crazy, just 2-3 pounds. Continue adding weight as your get stronger. As you get stronger, then try both arms at the same time.
You could work with large rubber bands to improve your strength in rotation, lifting out to the side, and lifting in front of you. The important thing here is to be consistent. By working a little each day, your strength will improve.
If your joint can move freely when someone else lifts your arm, you do not have a joint problem. Nerves can be pinched by tight muscles, but if you soften and stretch them, even that can be solved. If you feel afraid, get an MRI or X-ray to be sure there is no joint damage. If you are told it is arthritis, the stretching can provide some spacing to ease up the pain, and the strength training will allow you to do more than you are doing now. The key is to just do it consistently. If it feels better keep doing the exercises. Do not stop once the pain stops as it will come back.
What is Going on with My Book?
I will be announcing the winner of the Title Search contest tomorrow, February 1. We are in the home stretch in finishing the book and should be finished with this phase by March 1, then onto finding a national publisher. I will keep you posted on the journey.