DOWN and BACK

“DOWN AND BACK” is horrible advice for your shoulders!

I have often heard trainers and coaches saying down and back to their clients. queuing them to depress their shoulders and pinch them back. I am going to take issue with this practice and here is why.

As a corrective exercise specialist it is my job to get people out of pain and discomfort. So I have to pay close attention to friction and inflammation that can affect the nerve path and pinch the arteries. So let's take a close look at the brachial plexus.

The nerves that reach out to the arms come from the cervical spine and between the disc through an opening called the intervertebral foramen. This space is not very large so you can see how the positioning of the neck could impinge the nerve with compression or excessive curvatures. Adding motion to a compromised position will build up friction that can and often does lead to inflammation further restricting the nerve root and likely stimulating pain or deferred pain. Let’s take compression into consideration for the moment. There is a large muscle that connects the base of the cranium to the top of the scapula along with connecting the spinous process of each cervical vertebrae with the nuchal ligament.

Yes, the Upper Trapezius.

Here we have a good look at the connections this part of the muscle has to the structure. Here is where I will ask “What holds a bone in position?” Ligaments, tendons and muscles. Because the body is an integrated system, when a muscle is held in an unbalanced position it will transfer that tension through any tissue that it is connected to, and there is a lot of tissue connecting the whole body. Que the “BACK AND DOWN”

WIth this new position we can see a lengthening of the upper Trap and a downward pull of the direct tissues. This tension will have a tendency to change the position of the head with the cervical spine bending back. However, the body wants to keep the horizon level so It will counter this tug up by pulling the chin down. Now we have tension in the front and tension in the back. This force will compress the cervical spine lessening the height of the cervical discs. The vertebral foramen just got smaller and the nerve roots are compromised.

Now, we will follow a bundle of nerves called the brachial plexus to the shoulder joint.

As the nerves travel through a joint they often come together with the artery and vein to form a fibrous bundle that is usually tucked away into a channel or fossa to help safeguard them from damage. Although if a body is out of alignment then those channels and fossa can become sub optimal.

With the brachial plexus the nerves travel under the clavicle and in front of the first rib in a space called the thoracic outlet.

There are only two joins attaching the shoulder to the rib cage and they are both on the clavicle bone. As we move the shoulders as commanded we also lower our clavicle making the thoracic outlet smaller. The brachial plexus has been slightly stretched, stressed and also confined. There are a lot more tissues in the space of the outlet than just the nerves. Like the arteries, bursa, muscles, fascia, lymphatics and fluids as we can see here

We can see that there is not room for much more and we just made that space smaller by pulling the clavicle down. Impingement, friction and swelling has just constricted a few systems that have certain symptoms like

Headaches
Neck pain or strain in the back of the neck
Chest pain and tightness
Pain in the upper back, especially the shoulders
Difficulty sitting, reading, watching television, or driving for long periods of time
Restricted range of motion in the neck or shoulders
Frozen shoulder
Numbness, tingling, and pain in the upper and lower arms

Now, let’s add some tight restricted muscles

DOWN AND BACK might not seem so promising.

In order to give the nerves room and put the shoulder in a better position to optimize your range of motion may be qued something like this. SHOULDERS BACK, PROTRACTED OUT AND SLIGHTLY ELEVATED BUT NOT SHRUGGED.