Healthy Shoulders in Downward Dog and Inversions
Strong, Open and Healthy Shoulders in Yoga
My husband clutches his shoulder in pain after he reaches to get his coat on his way to the office. It’s a common injury and I see it so often, especially with clients that work predominately with arms, shoulders and often heads forward of their body. The injury is to the supraspinatus, a rotator cuff muscle that wraps around the front of the shoulder and attaches to the outer point on the head of the humerus (upper arm bone).
Before we dive into this injury, and how to nurture healthy shoulders in yoga, let’s take a look at this incredible joint and how it works.
A Little Anatomy and Biomechanics
We often don’t consider the body as we move but if we look closer we see that even the subtlest movements light up an array of muscles. Imagine if our body actually lit up in different colours in correspondence to the muscular contractions as we moved. As we circle our arms at their full range we would see a beautiful light show as muscles contract, relax, lengthen and contract again to create movement and stability. Our shoulder joint has the widest range of movement in the body and unlike the hip it doesn’t have a socket for which the head of the humerus sits snug, and instead sits on a shelf created by the end of the clavicle (collar bones) and the scapulae (shoulder blades).
The rotator cuff are the muscles that wrap in front, behind, and on top of the shoulder and stabilise the joint, performing delicate movements that move the humerus exclusively. The larger muscles such as the pectoralis major (chest muscles), latissimus dorsi (lats) and deltoids create powerful full range movements and work by moving the humerus and the scapula together.
Large, strong muscles and how they create injury
When you raise your arms overhead the main mover is the deltoid, but it can only lift the arm until it’s about level with the shoulder. Here the deltoid works to pull the humerus into the joint and it is the supraspinatus which is then employed to continue lifting the arm for the next 30 – 40 degrees, after which the deltoid jumps back in. It is during this time when the supraspinatus is active, that injury occurs. If your deltoid is super tight, or the supraspinatus weak, then the former will over engage, which jams the shoulder joint and can cause impingement, a kind pinching of the supraspinatus tendon. This can happen in Downward Facing Dog if you are not engaging the shoulders properly.
How posture creates injury
Our bodies are not built to be sedentary with our arms forward for long periods and it is this pattern of everyday living leads to postural misalignment, muscular imbalance and eventually injury.
As our shoulders work to support our forward head and shoulder posture, the muscles that run down the back of the neck to the top of the shoulder (levator scapulae and upper trapezius) become tight and short, pulling the shoulders to the ears, causing a perpetual shrug. The rhomboids (muscles between shoulder blades) are weakened while pectoralis minor (little muscle deep at the front of the shoulder) becomes short, causing you to hunch your shoulders forward. This position means the tendon of supraspinatus is immediately under extra strain causing it to be more vulnerable and it also means the deltoid is far less likely to relax when it is supposed to, pinching the supraspinatus tendon during movement.
How to Strengthen and Open the Shoulder in Yoga
In yoga we frequently bring our arms overhead in poses such as Utthita Hastasana or Cresent Lunge and we bring our arms straight out from our shoulders in poses such as Warrior 2. These standing poses are perfect for finding openness and freedom in the shoulders but can also create pain when done incorrectly as shoulders hunch and deltoids over engage.
First, let's do it incorrectly so that you can feel the difference. Bring your arms straight out from your shoulders as you would in Warrior 2. Now internally rotate your shoulders so that your thumbs roll down toward the ground. Notice here how your upper shoulders feel tense and the front shoulders feel as if they are closing and pinching. This is an exaggerated movement but if you think of positions you repetitively find yourself in during the day, such as breast feeding your baby or typing on your computer, we are often in this internally rotated position with shoulders forward. It is these habits of holding ourselves that cause movement patterns that lead to injury.
Now try this same position but open your palms to the ceiling. You can even reach the little fingers up to the sky to really feel this. Notice how your shoulders relax away from your ears and the sides and back of your neck releases. Feel how the weight of your arms is supported more by your shoulder blades, which are pressing into the back as opposed to winging or lifting away. You will also notice a firming of the outer edges of the shoulder blades as small the external rotators of your shoulders engage and lower trapezius begins to pull our shoulder girdle into lovely open stability.
If this feels good then try incorporating this movement into your yoga practice, whenever your arms are overhead, when in Utthita Hastasana or upward salute, spin your pinky fingers towards each other and glide shoulder blades down and into the back.
Connecting with the right muscles in Downward Facing Dog and Inversions
Downward Facing Dog, or Adho Mukha Svanasana, is a wonderful pose for both opening and strengthening the shoulders, however, they are also at their most vulnerable here, so knowing what you should be feeling and engaging is really important to keep your shoulders happy.
Something I often say in Downward Dog is “lengthen your spine from your armpits”, this may seem strange but there is a method to my madness.
This action fires up the lats, teres major and subscapularis, these muscles pull the head of the humerus back, creating more space at the front of the shoulder. Not only do they bring you into a safer alignment, but they help to hold your weight so that you again are not overusing your deltoids. I remember the ‘a ha!’ moment I got when I was doing my yoga teacher training in Bali, in inversions I struggled so much to hold my weight, my shoulders would burn and my arms give way. Until my teacher said to push into the floor by engaging the muscles around the outer and lower scapulae, all of a sudden my head lifted an extra inch away from the floor, my upper shoulders opened and softened and I felt as if I could stay forever. It wasn’t that I got stronger, I simply learnt to use my muscles more efficiently.
To feel this, try Downward Facing Dog on your forearms at the wall.
Place your forearms on the wall in a headstand position but with your fingers interlaced, palms separate and elbows shoulder width. Walk your feet back and allow your forearms to slide down the wall as you come to a 90 degree angle, nice straight spine, bend your knees if you need.
Draw your elbows toward each other, as if your fingers would release and hands slide away from each other, this engages our external rotators and broadens the upper shoulder blades, similar to the feeling that came from turning little fingers up in Warrior 2.
Now press your forearms into the wall to lengthen your torso away from the wall. Can you feel how your shoulder blades firm into your back and the muscles on the outer edges and below your shoulder blades engage? These are those big muscles I spoke of above, lats, subscapularis and teres major all working to create strength and space. To feel the difference, try pressing only through your wrists and notice how the fronts of the shoulders engage and upper shoulders tighten and hunch.
So to recap, in your right angle position with forearms on the wall and fingers interlaced, draw elbows gently towards each other (energetically, not actually), and press into the elbows as you lengthen the spine away from the wall. Let your spine relax through your shoulders towards the floor, you should feel a nice balance of stretch and strength.
Another thing I do notice, and that I am guilty of, is hammocking through the spine here, creating instability through the front of the body. If you are like me, then remember to pull your front ribs in toward the back body creating a nice neutral spine.
Downward Facing Dog
Now that we have felt the muscles working as they should in a safe, non-weight bearing position, let's try Downward Facing Dog.
From your Downward Dog, activate Hasta Bandha (please see my blog about wrist pain if you don’t know what this is), now as if you were opening two jars with your hands, energetically turn your hands outward, your hands won’t move but your external shoulder rotators will, feel your upper back broaden as you do this. Now push the floor away, from the inside of your hand and lengthen your torso away from the floor by using the muscles underneath your armpits and shoulder blades, as you do this feel the space that is created in the upper and front shoulders and enjoy the new found strength.
Yoga is an extremely therapeutic practice, for both the body, and the mind, and if done well can not only support your body in health but heal your body from injury. When you put in the time and energy to practice the poses correctly it soon becomes second nature, and gradually this overflows into our daily life. We begin to notice when our shoulders are tight and unhappy off the mat, and have the tools to invite openness and comfort instead of ignoring tension and pain.