Shoulder Positioning Tricks

Shoulder injuries cause significant pain and affect most aspects of daily living. There are several different ways that shoulder injuries are treated and recovery can take several months. During the healing process, the shoulder can be positioned to decrease pain and prevent further injury. The recommended position depends on the specific injury.

Shoulder Anatomy

• The shoulder joint is a ball-and-socket joint that allows movement in multiple directions. The upper arm bone -- humerus -- moves forward, backward, behind the back, overhead, and away from, toward and across the body. Because it moves in multiple directions, it is also more vulnerable to injury. The shoulder joint is stabilized by ligaments that connect bone to bone, a capsule that surrounds the entire joint and multiple tendons that connect muscle to bone.

Shoulder Sling

• Shoulder injuries can require immobilization for a period of time to allow the arm to heal. A sling is the most commonly used shoulder immobilizer. It supports the arm during daily activities; however, sleeping with a sling can be uncomfortable. The most recommended sleeping position when wearing a sling is a recliner. This chair supports the person in a semi-reclined position and prevents him from accidentally rolling onto the arm. A pillow can be placed on the injured side of the body under the elbow to reduce pressure on the shoulder. To obtain this position in a bed, place several pillows at the head to prop the upper body into a semi-reclined position. Place pillows under the elbow for added support.

Shoulder Impingement

• Tendons that surround the joint can be impinged -- pinched -- causing pain and affecting function. Shoulder impingement is often caused by improper positioning while performing repetitive movements and sitting with poor posture for extended periods of time. The shoulders tend to round forward as a person slouches. This closes down the space between the ball and socket, and as the arm moves, structures have less room to move and are impinged. To properly position the shoulder, sit upright and squeeze your shoulder blades together. Bring your chin back and lengthen your neck as if a string attached to the top of your head is being pulled. Maintain this position when sitting and during activities -- particularly tasks that require reaching overhead.

Strengthening After Injury

• After immobilization, the shoulder muscles are weak and need to be strengthened. It is important to correctly position the shoulder during these exercises to avoid re-injury. Start by strengthening the shoulder in a neutral position -- with the arm next to the body. This will allow the muscles to contract with minimal pressure on the shoulder joint. Shoulder exercises can be performed using gravity for resistance then progressing to elastic bands or free weights. As the arm gets stronger, exercises can be performed with the arm away from the body.