The Importance of a good posture

As a result of the recent Covid-19 condition, many people are experiencing neck and shoulder pains due to an incorrect posture. They are bored because they have stopped their routine activities and as a result try to do exercises at home without paying attention to how to do it right.

Background – Start of pain

3 weeks ago a female patient came to our clinic with complaints of pain in her right shoulder. A few days before, she performed a kettlebell rack reverse lunge lifting with a weight of 6 kg, and the next day she felt pain in her right shoulder, especially when lifting.

Analysis

There are several things that must be considered in examining the condition of the shoulder injury.

Firstly, the Posture, in this case clearly shows that the patient’s right shoulder is deeper than the left shoulder. Then the movement of the shoulder in terms of limitations and pain is observed when the patient is asked to do a movement. A comparison to the healthier shoulder helps gives a better picture. This patient found limitations and pain when she is asked to move the arm to the side up with resistance, besides which also seen a “winged scapula” in both shoulder joints.

This shows that there is weakness in the muscles around the shoulder blades (scapula), among others: the rhomboid muscles and lattisimus dorsi. Next we continue the examination by palpating to confirm the area that is experiencing pain; palpation is done to feel any abnormalities in both the muscles and joints in the injured area. For this case, the palpation examination found a tension in the muscles around the right shoulder such as Upper trapezius, Scalene and also the Levator scapula. This occurs due to too much load on the muscles due to poor functioning of the stability muscles of the scapula.

Hypothesis

From the above examinations it can be concluded that the pain experienced by the patient was caused by wrong position during weightlifting, which resulted from malfunctioning of the scapula stabilization muscles so that there were some muscles that were overworked and muscle tension around the shoulder. This is what makes the patient feel discomfort and pain when the patient makes certain movements.

Treatment Plan

Scapular Squeeze

Scapular Squeeze

Resisted Row Tandem

Resisted Row Tandem

For this condition, the most effective way is to reactivate the function of the stabilizing muscles in the shoulder blades (scapula). However, in order for this to be achieved, it is better if the muscles around the tense shoulder should be relaxed using the trigger point method combined with the MWM (mobilization with movement) technique. Then we teach the patient the exercises to activate the stabilization muscles of the scapula. Because if the tense muscles have not been relaxed, the patient will find it difficult to feel the activation of the rhomboid and lattisimus dorsi muscles. The exercises that are given to activate these muscles are by using a stretch band aid that is tied to something at the level of the chest and then the patient holds the stretch band with both hands and pulls it towards the body, things that must be considered in doing this exercise among others: an upright body position with the shoulders lowered first, the grip is not too strong, and try to keep the arms close to the body and the core activation during the exercise. Activation of the stabilization muscles is needed so that all the muscles around the shoulder can work according to their respective functions. Besides, the posture can be corrected properly. What cannot be forgotten is the education of the patient’s posture so that they can do the exercises in the right way and position so that they will not cause injury in the future.

Closing

Being active is very good because by moving we mean life. However, there are some things that must be considered if we want to try something new. Namely, do it right and do it gradually.

CategoryNeck Pain, Shoulder

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