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Shrugging It Off

Shrugging It Off!

by Megan Piersol, PT, DPT

Stiff Neck & Shoulder

Some people are unaware that how you hold your shoulders can contribute to that nagging neck and/or shoulder pain.  This world places us in a lot of forward activity situations: staring at a computer, holding cell phones in front of the face, driving, reading, cooking, etc. All of these activities can easily cause the shoulders to start migrating towards the ear and not be in a relaxed position.  These same forward activities also contribute to a more forward posture that further closes down the shoulder and places strain on the neck (and back). We will save the neck and back talks for another blog and focus on the unconscious shoulder shrugging that probably occurs more often throughout the day than you think.  All of this adds up over time and can cause problems in various areas of the body starting at the neck and shoulder.

Anatomy of Shrugged Shoulders

The Upper Trapezius and Levator Scapula are two muscles that are involved with the shrugging of the shoulder motion.  Both of these muscles attach to the neck and shoulder blade region. When they are constantly firing, as such with shrugging your shoulder, they become irritated and unable to relax fully. This is when that burning pain starts to become present in your neck or in the upper part of the shoulder. As we train the Upper Tap (UT) and Levator Scapula (LS) to be constantly “on,” it can change the way we use our arms and create an imbalance between all of the muscles that help the arm glide smoothly in the shoulder socket.  The shoulder is an intricate system of pulleys that allows smooth pursuit of your arm. If any muscle is off, overpowering, or unable to turn on/off at the right time, this system becomes off kilter and you get that annoying pinch or sharp pain that immediately tells you to stop. The UT and LS are such muscles that can throw off the nice pulley system in our shoulder when they are overused or taught. What is even worse, is that these muscles also attach to the neck, so neck pain can also start to evolve.

Anatomy of Shrugged Shoulders

Everyday Life Brings Possibilities For Shrugging Those Shoulders

Poor Posture on PhoneBeing able to relax the shoulders and hold a good posture is a lot of work and takes a conscious effort for most, if not all of us.  The cold weather outside has a tendency to have us want to bunch up forward and bring our shoulders upward. Try to dress warm enough to allow your body to relax comfortably in the cold weather. Check in with your body and make sure that your shoulders aren’t starting to raise up towards your ears.
Carrying moderate to heavy purses or bags on our shoulders (and often times even in our hands) causes a counter reflex response of the shoulder to hike up to support the bag and prevent it from falling off (or to carry to weight). It also causes changes in your spine as you will tend to side bend towards one direction and become asymmetrical.  If you don’t believe me, place a bag on your shoulder and see what your first response is. I bet your shoulder raises up. Now try and relax and keep the bag on the shoulder. It becomes a bit harder, right?

Moral? Try not to carry things on your shoulders too often.  My motto for going out is that if it doesn’t fit in my pockets, then it doesn’t come with me.  I often find that when I bring a purse or bag, I end up not using anything I have inside of it anyway. If you are like my mother, your purse is about 5-10 pounds heavier than it should be and contains an entire pharmacy of products.  Start trying to go through your purse often and get rid of things, especially heavy items, that you aren’t using or don’t need. Granted, mothers have to carry a lot of stuff plus what their child pawns off on them. If this is the case and carrying a bag is unavoidable, then find bags that can rest on both shoulders and are comfortable enough to support on their own without the need of your shoulders having to hold it up.  Perhaps investing in a bag that rolls on the ground if there is too much stuff. Switching up the shoulder you carry a bag (whether directly or crossed on opposing shoulder) on also helps. It is good to not place everything in one bag and instead divide the weight into two bags carrying one in each hand. Think of your body as a see-saw. Wasn’t the best part of the see-saw trying to stop in the center where you and your friend could hold steady in the middle and not tilt one way or the other?  Try being more conscious of relaxing your shoulders and using more of your shoulder blade region if you have to carry something on your shoulders.

Shrugging While Driving

Poor Posture Driving
Driving is another area where prolonged shrugging of the shoulders may occur.  As we raise our arms up on the steering wheel, it is hard to relax that pesky UT muscle and up the shoulders go.  The shoulder blades should be helping with most of the work that your arms are doing with driving. Most of us don’t feel our shoulder blades while driving. We feel the neck and top of the shoulder screaming at us. Corrections that can be made to better driving postures are relaxing the shoulders down and making sure your head isn’t sticking out like a turtle. Adjust your seat if you can’t drive without poking your head outward and/or keeping your shoulders relaxed. Your chin should be pointing slightly downward and back and your head should elongate in the back of the neck as if a string was pulling the top of your head towards the sky.

Endurance Fatigue Can Lead To Shrugging

Another common area where the shoulders may be placed at a disadvantage is during cardio exercise. As we exert ourselves and get fatigued, we tend to use more neck and superficial shoulder muscles to obtain the space needed for taking in more air.  We can’t relax very well as we fatigue. We kick in compensatory muscles in our shoulder, neck, legs, and arms to try and finish what we started. This usually means that the core isn’t helping with good stabilization anymore. If you can’t relax your neck and shoulder muscles and breath better into the stomach, then it is probably a good time to stop the activity and try again next time until you start to build up your endurance (mostly lung/respiratory and core endurance).

Awareness Throughout The Day

When we are typing or writing, doing artwork, cooking, cleaning, etc. you may also notice that your shoulders want to sneak up on you.  Learning how to relax the UT and LS and support yourself more through your shoulder blades is important. It may take several “check-ins” to be more aware of this shoulder hike habit. The more often you can correct, the easier it will become and the more relief you will get from neck and shoulder pain. Again, your posture and head position also play a role in decreasing neck pain with activities. Even how you sit on your sofa or in chairs can affect what you are doing with your shoulders. Leaning on one arm more often can slowly contribute to one-sided neck, shoulder, and even back and hip pain. You may think you’re “relaxing,” but your UT and LS may be silently firing too much and your spine twisting.



Quick Corrective Tip to Avoid Shrugging

Here is a little trick to help you achieve a good shoulder position that allows the neck muscles to relax better: bring your shoulders up (yes, as if you are shrugging), then slightly back (you are NOT pinching your shoulder blades, just bringing the shoulder back slightly), and then let them drop down.  The shoulders should feel like they sit in place or “fit” where they are at. Almost like hanging a coat up. The coat falls slightly downward on the hanger in order for it to stay in a good place.

Correcting your shoulders are just a part of helping decrease risk of neck and shoulder problems or minimizing neck and shoulder pain if you already have some issues here.  A good balance of scapular (shoulder blade) muscle support, good spinal posture and head position, better body awareness, and better stabilization are important as well. A physical therapist will be able to help you with all of these. Stay tuned for future blogs as I will continue to dive into posture and the incredible role it plays in solving and/or preventing our body from breaking down.  It’s always good to shrug things off, but don’t shrug off your posture!

Check out Dr. Tamer Issa's book, Freedom From Neck & Back Pain- Learn to Live an Active Life Without Fear of Pain