Shoulders Shoulders Shoulders (Part 1)



In this two-part blog on shoulder alignment, I’d like to clear up a common shoulder misconception I regularly see. I know a lot of us have heard instructions like ‘relax your shoulders away from your ears,’ ‘slide your shoulder blades down your back,’ or even ‘press your shoulders down.’ These are well-intended instructions that I think aim to combat tension in the upper traps a lot of get n the modern world. Yet they often backfire and create even more tightness in these pesky muscles. Let’s look at why.

First, the anatomy. The shoulder girdle is comprised of three bones: the upper arm bone (humerus), shoulder blade (scapula) and collarbone (clavicle) that articulate to move the arm. The inherently unstable shoulder joint is supported by the rotator cuff, a group of four muscles that each have a unique action on the shoulder. The acronym SITS is used for the muscles of the rotator cuff: subscapularis, infraspinatus, teres minor, and supraspinatus. The infraspinatus and teres minor are responsible for externally rotating the humerus, and are often weak. The subscapularis is a strong internal rotator, and the supraspinatus is the most commonly injured rotator cuff muscle. It is responsible for arm adduction as in Warrior II, and also stabilizing the humeral head, preventing subluxation.

Our modern, screen-oriented lifestyle tends to draw the humeri forward and down, rotating them internally. This tightens the chest and frontal shoulders muscles, flattens the neck curve, and creates tension in the muscles of the upper back and neck. When the humeri move forward and down, and rotate internally, the upper fibers of the trapezius muscles seize on either side of the base of the neck and shoulders. Those of us who work a desk job are often all too familiar with chronic tightness of the upper body, and may seek massage therapy to work out those knots, and yoga to increase flexibility.

However, unless we address the pattern of arm bones rotating in and dropping down and forward, we’re missing the structural cause and won’t get to the root of the problem.

Observe your shoulder position and rotation in tadasana, or mountain pose. Stand with your feet hip width, and relax your arms and shoulders completely, gently shaking them, and let them hang at your sides. Ideal shoulder alignment is observed with the humeral heads (tops of the upper arm bones) about square across with the base of the neck, and the arms should hang at rest with your elbow crease facing forward, and the palm of the hand facing your body.

Observe if one shoulder is more dropped and forward in placement, and notice if one palm spins more to face the back of your body, with its elbow crease turning in instead of forward. That dropped and internally rotated shoulder generally tends to be the tweaky one (or cranky elbow, or painful wrist, or tense neck, as that shoulder misalignment can often refer pain up or down the arm). The last thing you’ll want to do is press that shoulder ‘down your back.’ Instead, take a huge breath in, lifting your rib cage with the deep muscles of the torso, and keep that inner lift so your shoulders are more square across. Externally rotate your arm so the elbow crease points directly forward and your palm faces the side of your body.

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In this video, I show some of the simple observational techniques for the shoulder joint, and the low-stakes pose, setu bandha sarvangasana (bridge pose), in which I commonly observe students depressing the shoulder girdle. It can be a great pose for shoulder health when the alignment is clear.

Next month we’ll apply this to weight-bearing yoga poses, and look at plank pose, low plank, down dog and up dog, and how to transition among these for optimal shoulder health.