Pectoral (Chest) Stretch - The Most Common Mistake in the Best Shoulder Stretch

Mike Benson has sent several Fitness Fixer inspiring stories. In response to reader requests, he made us this photo set showing, "The most common mistake in the best stretch - How to not get any stretch from the pectoral stretch." I asked him to demonstrate this, because I see this mistake so often. People often "do" a stretch without "getting" a stretch.

Why is this stretch so good? Round-shouldered posture is a main contributor to neck and upper body pain and rotator cuff injury. Round-shouldered posture feels comfortable and natural when the front chest muscles are tight. A common mistake is to stretch the shoulder joint, which does not address this problem.

The purpose of the pectoral stretch is to lengthen chest muscles so that healthier positioning feels natural and comfortable. If you merely hold your elbow to the side, little lengthening can occur - shown in first photo:




Second photo below - changing the position to get the purpose - lengthening anterior (front) muscles that go across the chest. One way is to use a wall to help you press your elbow back.

• Turn your body and feet away from the wall.
• Your elbow is behind you, no longer out to the side.
• Raising the elbow higher or lower changes the stretch.
• Experiment until you only feel a stretch in the front chest and no pain or pinching anywhere in the shoulder:

• Keep shoulder down and relaxed
• Do not make any pain anywhere. The idea is to make things healthier, not to strain, push, force, tighten, grunt, and call that a health promotion activity.
• Understand the purpose first. The purpose of this stretch is to lengthen front chest muscles so that tightness does not pull you into feeling that round-shouldered position is the norm or that it is uncomfortable to straighten. Feel the stretch in the intended area.
  
• Use a mirror to help you connect what the position looks like with what it feels like.
• Use your brain.

Related:

Fix One Pain, Don't Cause Another
What Does Stretching Do?
The Stretch You Need The Least

More to Stretch the Anterior Chest:

Stretching With a Friend - Partner Pectoral Stretch
Pectoral Stretch was first introduced in Fixing Upper Back and Neck Pain
Quick, Feel-Good Upper Back and Chest Stretch

Mike Benson's Success Stories:

A Whole Big Fix
Fast Fitness - Core Hip & Body, Posture Strength & Balance
Flasher Exercises Not Best for Shoulder Pain
Healthy Youth Parties - Fun Exercise, No Junk Food

Labels: arm, chest, fix pain, posture, readers inspiring story, rotator cuff, shoulder, stretch

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Flasher Exercises Not Best for Shoulder Pain

In A Whole Big Fix Mike fixed several injuries and made the interesting statement, "I stopped cycling to improve my health."

Back in December, I asked Mike if he wanted to get back to cycling and about his shoulder. While we were working on his story, reader requests piled in by the hundreds. Stay with us and questions will be answered. If I only answer them in order, it will be hundreds more posts before I get to questions arriving today, so make your questions fun and helpful.

Mike wrote his update:

"The cycling didn't cause pain at the time, but created bad posture habits and muscle tightness (shoulder rounded forward after separating collarbone in a crash, tight psoas muscles and hamstrings) which led to pain later. I'm walking more human-like now. Also, the air and traffic around here has gotten worse because of the housing and population boom, so I was having horrible coughing fits. Now I don't, without the aid of any medicine and, I believe, by following your diet recommendations.


"Shoulder: The physical therapist had me doing the trench coat type exercises you've described in your books as not as effective or needed, in many different ways (pictured at right), especially the "closing of the trench coat" which didn't make sense to me because they said I was overly tight in the front and too flexible and weak in the back. The visits there didn't work.

"Instead, I used the two stretches shown by your husband - right angle elbow with hand in air in Fixing Upper Back and Neck Pain, and the hand in the opposite pocket behind the back while leaning sideways, in Nice Neck Stretch."

Standard physical therapy exercise for rotator cuff consists of keeping the elbow close to the waist and rotating the forearm inward and outward, like a flasher opening and closing a trench coat (photo). There are almost no daily activities that need this specific motion, not even opening a door. No one uses their muscles this way (unless you are a flasher I guess). People do these exercises then go back to daily bad overhead reaching and re-injure their shoulder, or wonder why it never heals.

The rationale for doing the trench coat exercise is that strengthening the rotator cuff will heal the injury. Strengthening is not the main issue in most shoulder injuries that I see. Misuse of the shoulder is the root cause. A common counterproductive scene is people "doing shoulder exercises" with their head and neck slouching forward, upper body rounded, which injures the shoulder with each arm lift.

Slouching the upper body forward when raising arms for any daily activity, stretch, yoga, or weightlifting will continue to injure the shoulder. What improvement are you making to your shoulder to do exercises in a way that will injure?

Mike wrote:

"I'm also concentrating on keeping my thumbs facing forward when arms are down in order to help prevent my shoulders from rolling forward. I'm feeling more upright and balanced when doing everyday activities."

I told Mike that the idea is not to hold thumbs forward. The idea is to get the purpose of the stretch so that the chest muscles lengthen enough so that the arm bone is not pulled into inward rotation. The post on this topic is listed at the end.

Mike was also "doing" one of the key stretches but not getting the stretch needed, so no benefit was occurring. He was going through a set of motions to achieve the set of motions instead of to achieve the purpose, which was to restore resting length to the chest muscles. Mike made us some photos of how he was originally doing the pectoral stretch and how he fixed the motion to get the purpose. I will post them soon so everyone can see the difference.

• It is common to stretch in ways that does not achieve the purpose, or in injurious ways. Then news stories report on studies that stretching doesn't improve physical performance or help prevent injuries, and no one knows why. It is not difficult to see why: What Does Stretching Do?

• What do thumbs have to do with shoulder and neck pain? - Thumbs Can Show Tightness That Leads to Upper Back Pain

• Notice upper body positioning when exercising: Are You Making Your Exercise Unhealthy?

• Avoid rotator cuff and shoulder impingement and injury when raising arms: Overhead Lifting, Reaching, and Throwing - More Part I, and Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury.

• Avoid neck and shoulder pain when looking upward: Gaze Perseid Meteors Without Neck Pain

• How to avoid injurious movement habits and have healthier daily life and exercise: Health & Fitness in Plain English new THIRD edition - How to be Healthy Happy and Fit for the Rest of Your Life.

Labels: biking, fix pain, impingement, injury, posture, practice of medicine, readers inspiring story, rotator cuff, shoulder

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Overhead Lifting, Reaching, and Throwing - More Part I

Nice e-mails and requests came in after Part I last Monday about the overlooked training habit which slowly impinges and tears the rotator cuff. Here is one that covers the points from all received so far.

Reader Hanson writes:

"Thank you Dr. Bookspan for exactly the missing link. I had been attending months of expensive private yoga lessons at [well known studio name deleted] for my shoulder woes without much relief, and maybe have worsened my circumstances. I thought becoming worse with yoga was preferable to surgery that my orthopedic surgeon at [top California facility name deleted] said was required. The yoga directress said more months were necessary (for her wallet?) and I must learn to cool my mind (before I questioned why I wasn't getting better?). I sure didn't question when she wore that little outfit. She showed me yoga poses to "awaken" the area and other fuzzy yoga talk. Poses were raising arms overhead, leaning over with arms overhead, sitting with arms up, and so on. My shoulders burned, she said it was "awakenening." Now I discovered from you it was "impinging." No one said anything about a forward head when I raised arms. I did the same as the directress did. She had this bad posture too. She said do it slowly if it burns. So I burned up my shoulders slowly. Instead of paying the yoga directress for another private session of self-injury raising my arms with head forward I printed your blog and held it overhead to read it. I didn't lean myself back and didn't tilt my head forward. The shoulder is already better. I found all those yoga lessons never prepared me to stand up straight. They told me yoga gives you posture, but it didn't give me anything except a worse shoulder. The "awakening" came from your blog saying use this for life not just exercise. I can lift arms without pain now. I keep my head straight, not forward. Can you put more pictures up of what to look for and can you tell people about your blog?"

Fix Your Fitness to be Healthy and Stronger. Be able to do more, not give up lifting:

• How to avoid neck and shoulder injury when raising arms: Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury
  
• Avoid neck and shoulder pain and herniated neck discs from the forward head in activities without arms raised: Gaze Perseid Meteors Without Neck Pain
• Stretch triceps without forward head: Friday Fast Fitness - Better Shoulder and Triceps Stretch.
• Checking straight standing - How Doctors Use The Wall Stand
  
• Click labels under this post for all Fitness Fixer on each topic.
  
  

Labels: impingement, injury, neck, readers inspiring story, repetitive strain, rotator cuff, yoga

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Overhead Lifting, Reaching, and Throwing Part I - Shoulder and Rotator Cuff Injury

The photo at right shows one main contributor to shoulder and rotator cuff pain, and one for lower back pain. Can you see them? Can you see why the person in red is not getting as much stretch in the shoulder as they think?

I see patients for shoulder pain all the time. Their chart says, "normal range of motion at the shoulder," or the chart reads with a number of angle degrees corresponding to directly overhead reach. I ask the person, "Reach up for me please." They lean their upper body backward, increase the inward curve of the lower back, and their hand points directly overhead. Often they do this while tilting their neck and head forward, which puts the shoulder at a position of compression when the arm is raised. I show them how to straighten the upper body upright, reduce the lower back over-arch, and return to neutral spine. I ask them to reach up again. They can't. They shoulder is too tight to reach directly overhead. They were never stretching their shoulder when they thought they were. They were getting the motion from their lower back, not shoulder. They were only leaning backward, adding compressive load to their lower spine joints, called facets. This will be covered next in Part II.

In the photo, note that the head is forward, a major contributor to rotator cuff injury during overhead arm motion. Lifting your arm with the neck and head tilted forward mashes the upper arm bone against the shoulder bones. This compresses the soft tissue between them, including the rotator cuff and nerves that go down the arm. Each small pinch can eventually saw at the area until a rotator cuff tear begins.

Rotator cuff injury is common, even in people who do no overhead athletics, like pitching, martial arts, or kayaking. Reaching upward is common around the house and for exercise. Starting in the morning, you wash or comb hair (or polish a bald head). You pull clothing on and off overhead. You reach in cabinets, wave goodbye, shield your eyes from the sun, open car trunks and hatches, put things up on racks, shop for groceries and put them away in cabinets, lift children, clean curtains and tub walls, put work in overhead shelves - many reaches, all day, every day. At the gym there are overhead lifts, stretches, and arm motions.

Compressing the nerves that pass through the area and go down the arm sets is called impingement. Impingement is not a disease. Someone with a diagnosis of impingement does not have a real diagnosis. Impingement is not a cause of pain, it is a result. If you stop the mechanical cause, then you can stop the resulting impingement. No drugs or surgery or repeated therapies are needed:

• Notice your neck and head position when lifting overhead and don't let your head and neck sag or jut or tilt forward. To see if you have the health and flexibility just to stand straight, try seeing of you can stand comfortably with your back and back of your head against a wall. If not, try some posts on upper body flexibility, such as Fixing Upper Back and Neck Pain. Don't force. Breathe. Smile. Relax. It's all for health.

• When you lift arms upward, check if you lean your upper body backward (photo above) or tilt your pelvis out of upright neutral position. To see how to prevent the resulting overarched lower spine, and restore neutral spine, click Kettlebells Without Spine Injury, and to see short movies, see Fast Fitness - Fixing Yoga Warrior and Lunge Exercise to Neutral Spine and Friday Fast Fitness - Neutral Spine in 5 Seconds.
  

• More on the forward head and how to fix it - Breasts Causing Upper Back Pain is a Myth and associated links.

• More on back and shoulder during reaching - Change Daily Reaching to Get Ab Exercise and Stop Back and Shoulder Pain.

• Overhead weight lifting - Safer Overhead Military Press.

• More photos and situations for safer daily and exercise overhead movement, click Overhead Lifting, Reaching, and Throwing - More Part I.
  

Labels: fix pain, impingement, injury, repetitive strain, rotator cuff, shoulder

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Is Your Drinking Hurting Your Neck?

A reader sent me this Hauku:


The photo above shows an injurious positioning called "a forward head." A forward head position presses cervical (neck) discs outward, causes upper back and neck pain often called "upper crossed" syndrome, and can press the nerve going down the arm, leading to arm pain and hand/finger numbness. Jutting the chin upward with the neck forward can, over time, create a spondylolisthesis (vertebral shifting). Raising the arm with the shoulder rounded and the neck forward adds to shoulder and rotator cuff injury.

Check yourself for a forward head position when eating and drinking (and on the phone):

• Corner of the jaw is far forward of the shoulder
• Neck tilts forward
• Jaw juts forward
• Neck pinches backward, with high compressive force
• Shoulder rounded

Don't round your back or jut your chin forward. Instead, keep chin in when you eat and drink and talk on the phone. To look upward, get the upward motion more from straightening your upper back, and not from one joint in your neck. The neck is not a hinge joint.

Don't rely on, "Keep ear over shoulder" thinking that is straight posture. You can see in the photo that the ear is over the shoulder, but the neck is craned badly.

Use healthful positioning for built-in upper body muscle exercise and easy pain prevention. Check yourself sideways in a mirror. Watch other people eating and drinking for an easy reminder. Happy Holidays.

For More Healthy Neck Motion:

• For looking upward, click Gaze Perseid Meteors Without Neck Pain.
• For neck and upper back health looking downward over desk, click Tax Preparation Health.
• For drinking and biking, with drawings of fixing neck and upper back while looking up, click Fast Fitness - Stop Neck Pain From Biking

Labels: fix pain, impingement, injury, neck, rotator cuff, shoulder, upper back, yoga

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