I got an excellent question from a Fixing Elbow Pain customer on, “How does the shoulder affect your elbow pain?”
The Elbow is Like the Knee
The elbow is very much like the knee. It ends up being at the mercy of the shoulder.
If you look at the knee, the knees ends up being at mercy to the hip. A lot of times when there are:
- hip issues
- hip weakness
- hip tightness
- hip injury
All of that ends up having a negative effect on the knees.
The same thing ends up happening in the elbow when there is:
- poor activation
- poor movement patterns
This all ends up affecting the elbow, putting greater strain on the elbow leading to pain, leading to injury, and slowing down recovery from injury.
3 Things in the Shoulder that Affect the Elbow
Now 3 things that I look at in the shoulder that have a big impact on the elbow are:
- Scapular Stabilizer Muscles
- Pushing Movements
- Pulling Movements
#1 – Look at the Scapular Stabilizers
When it comes to Scapular Stabilizers I want to end up looking and seeing how those shoulder blades are when people are exercising or moving.
Are those shoulder blades staying flat up against the thoracic spine (mid-back)? Or do they end up winging so the medial border of the scapula (shoulder blade) ends up lifting or even the bottom part of the scapula ends up tilting up?
If I end up getting winging of the scapula, let’s say with pushing movements, pressing movements, overhead, diagonal pattern movements, it’s my cue that I need work on the scapular muscles. And I need to look at working on the activation, endurance, and strength of those scapular muscles. I end up utilizing what I cover up in the Scapular Stabilization Exercise Program to help with this problem.
#2 – What Happens with Rowing Movements?
The second thing that I end up looking at is how the client is when it relates to rowing movements.
Looking at the rowing movements, the rowing movements should end up coming from the shoulders.
If they end up having a poor position in their shoulders, the wrists and the elbows end up playing more of a role when it comes to rowing or pulling movements. If they end up having good posture, the rowing movement ends up coming from the shoulders with the elbows and wrists assisting.
If I see collapsing in the shoulders and if I see the wrists and elbows being the primary things working, then I need to work on fixing this. Either there is a weakness or there is motor pattern issue that I need to address.
#3 – Looking at Pushing Movements
The third thing that I am going to end up looking at is I want to look and see how things look when it relates to pushing movements. I can end up looking at the push up, as an example. This exercise will highlight things when it comes to the scapular muscles and will also end up helping to see if there is excess stress and strain on the elbows.
I can just have them do the push up movement. What will end up happening is if the elbows gravitate out more there will be more stress on the elbows. If the elbows end up being closer to the body, there will be less stress on the elbow. If they end up activating and bringing in the latissimus dorsi (lats) into the pushing movement or a push up movement there will be less stress on the elbow.
Push Up Self Test
A little self-test that I will ask my clients to do is to relax their abdominal area, stay weak in the shoulders, and go through a wall push up or push up movement and asking how does that end up feeling in the elbows?
And then I will end up asking them to build tension in those lats and bring the elbows down.
Then I ask, which way was better on your elbows?
If it feels like their shoulder and back are doing more of the work, there is less stress on the elbows.
If you end up having a client with elbow pain or if you end up having elbow pain, take a look at those 3 things. Take a look at the scapular muscles to see if the shoulder blades are staying nice and flat during pushing and diagonal movements. Take a look and see how you are when it comes to the rowing (pulling) movements with you and your clients. And then take a look and see how you are when it comes to the pushing movements.
That is it. Take care and bye bye.
Rick Kaselj, MS