One sided shoulder pain (although it is possible to have both being affected) from exercises such as the Plank could be attributed to increased engagement of particular muscles of the shoulder. This is relative to the opposite unaffected side. In this writing, I will dissect the anatomy and biomechanics to give you an understanding of why this could be the case.
A complaint that we see frequently is shoulder pain rooted without trauma. In other words these cases are more from overuse or improper biomechanics versus a muscle or tendon tear.
With the increased popularity of modalities such as Pilates and Yoga, we have seen a growth in injuries related to these forms of exercise. For example, more cases of wrist pain and discomfort stemming from exercises such as the Downward Dog.
Also shoulder pain and discomfort due to improper upper body posture performing exercises such as the plank or push up.
These forms of exercise are terrific for overall core strength, flexibility and functional body strength when used appropriately. Having said this, there are instances where injuries may occur.
Some of the common reasons include:
Improper technique
Lack of supervision and lack of correction of technique (this can be the case especially when one is a novice and has decided to use videos and/or online instruction. I believe that with these forms of exercise, one on one and actual manual hands-on correction are needed)
Overuse and basically over doing it on exercise without appropriate rest
In this composition we will be specific as to the primary root of injury. In this case we will discuss improper form when performing the Plank. This will be targeted to the upper body portion of the exercise(s).
With many exercises “balance” is a key factor in helping to prevent injuries. For example when performing exercises such as the squat or lunge, it is important to make sure that your pelvis is balanced versus having one side dropping or tilted during the repetition.
This may help with issues of overuse injuries due to overcompensation of one group or one side of muscles versus another.
In the case of the Plank the issue is when performing the exercise, one shoulder is more “rolled” forward than the opposite side (pic). In this scenario what will occur is you will have increased engagement of certain muscles of that particular side.
For example three muscles perform the action of Scapular protraction: Pectoralis Minor and Major and Serratus Anterior.
Protraction is the action where these muscles draw the shoulder blade away from the spine (laterally) on the ribcage.
These muscles during the Plank would work in a static contracted fashion (isometric). The one side that is more rolled forward (protracted) would have those three muscles working harder than the opposite side.
Over time the individual who performs this exercise in this fashion could start noticing pain mostly around the front of the shoulder, the inside of the shoulder blade and the side of the ribcage.
A simple correction may help with alleviating the pain and discomfort. Speaking specifically about the upper body, when performing this exercise it is important to be sure that when you are propped on your elbows and forearms that both shoulders are balanced and your body weight is evenly distributed and NOT landing more on one side versus the other. Keep an eye on if your upper body is rotated. This rotation and uneven distribution of the weight potentially loads one shoulder more than the other and recruits the scapular protractors (Pectoralis Minor, Pectoralis Major and Serratus Anterior) in an uneven distribution from right versus the left.
Hopefully you have a professional that can watch and correct you manually or at the very least you understand what you need to correct and make the correction yourself.
Three other simple tips that may help to improve symptoms include:
Perform stretches for those muscles that perform protraction
Focus on strengthening the core. Strengthening the core may help with maintaining the proper balanced posture through the exercise. This might mean you may have to adjust the Plank so that you are on your knees as opposed to having fully extended legs and being on your toes
Rest. Very simple. Very basic but just resting a few days from the exercise may help with the pain and discomfort
Book and appointment for some manual treatment such as massage to help relax the tissues and decrease pain
One final note. What I have written in regards to the pathology and correction can also be applied to the pushup. Pay attention to your shoulders at the top of the motion. Observe if you are extending your arm more on that side along with rolling the shoulder more forward. Ask yourself the question, “Am I putting more weight on one shoulder versus the other?” If you answer, “Yes.” Make the correction.
The Plank visibly looks deceivingly simple. Contrarily, the Plank can be more complicated with the intricacies required of the body parts having to work together fluidly to perform the exercise. By understanding the anatomy and the biomechanics of this exercise, it may help with long term gains over pain and discomfort that may put you on the shelf for a few days to potentially a few months.
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