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From carrying the burdens of life on one’s shoulders, putting forth a cold shoulder or offering a shoulder to cry on, to looking over your shoulder, taking a weight off your shoulders or carrying a chip on one, the shoulders need to be strong. They bear a lot of responsibilities – figuratively and literally.
Our shoulders are the most mobile joints in the human body due to their wide range of motion. Such extensive flexibility, however, can contribute to myriad injuries and issues, the most common being sprains, strains, rotator cuff tears, dislocation and frozen shoulder. Surgery, the last resort for remedy, is most often done for arthritis, severe rotator cuff tears and fractures.
Protecting your shoulders as a lifestyle measure helps avoid problems later. Nolan Stewart, president, clinic director and physical therapist at Professional Rehab Associates in Radford states: “It is recommended to work, play, rest and sleep with optimal posture. A more forward head position and rounded shoulders can increase improper movement and position of the shoulder blade. This may contribute to pinching the rotator cuff and biceps tendons.”
History and Fashion
The shoulder pad for protection was invented in 1877 by a Princeton University football player. It was fairly thin, crafted from wool and leather.
On the fashion front, shoulder pads might have first been worn at courts in the 17th century. They came into style in the 1930s in the U.S., after Joan Crawford wore a white silk gown with large shoulder pads in the movie Letty Lynton. The shoulders naturally slope, and men’s suits and jackets project a more refined appearance with shoulder pads. They were everywhere for a couple decades, then disappeared in the 1950s and ‘60s, except for men’s suit or sport coats. They have returned on the fashion runway.
On the Football Field
A wide variety of shoulder pads are found in football locker rooms. They can absorb impact, offer protection, minimize fatigue and increase ventilation. Some help regulate body temperature to avoid heat-related incidents.
“The primary function of our equipment staff at Virginia Tech is to help ensure the health, safety and well-being of student-athletes,” explains equipment manager Stewart Carter. “A key component of that mission is shoulder pads, which have seen significant changes over the last couple of decades.”
“Shoulder pads from the mid ‘80s to the early teens offered great protection through the use of air management foam, but tended to be bulky and restrictive. Players in the professional ranks looked for lighter shoulder pads that would enhance their performance, sometimes sacrificing the protective qualities. That trickled down to collegiate ranks,” Carter continues. Kevlar® and PORON® have become prevalent in the last several years to accomplish this by making them sleeker and lighter.
Lighter-weight shoulder pads are ideal for wide receivers and defensive backs who rely on speed and agility. It’s a strategic balance of having adequate protection for the shoulder and clavicle region while not inhibiting range of motion to run, catch, turn and maneuver one’s way down the field.
“We strive to find the balance between protection and performance,” Carter relates. “Each football player is fit with custom shoulder pads from a variety of companies. Quarterback Kyron Drones, for example, looks to achieve more mobility for his throwing arm to ensure accurate passes and beefed-up protection on his opposite side to safeguard blindside hits.” [QB photo here?]
In the Surgical Suite
Teresa Hall of Radford went through a lot of therapies to address shoulder pain. “My left arm began throbbing, and I experienced shooting pain when swinging the pickleball racket,” she recalls. Her first step was to visit Ortho Virginia. She received a steroid injection, then tried physical therapy, exercises, anti-inflammatory medicine and Celebrex®.
When a radiologist found nothing noteworthy in her MRI, Hall, 68, got second and third opinions. “Dr. Jonathan Mayer at Carilion New River Valley Medical Center explained everything, and one year after the pain began, I had surgery.” Though the first six weeks post-surgery are very awkward, she has enjoyed a complete recovery.
A retired hairdresser who moved to the New River Valley almost four years ago shares a similar experience. Mary True, 61, played pickleball four days in a row in December of 2022. “All was fine until I went up to hit a ball and fire shot through my arm. The pain was excruciating,” she relates. She also jumped through the hoops of steroid shots, physical therapy, massage and dry needling. Her x-rays showed arthritis.
“The last straw was exhaustion. I simply could not function or sleep for the pain.” True’s surgery at LewisGale Hospital Montgomery was also a success, following the uncomfortable sling holding your arm away from your body and doing nothing for six weeks. Pickleball? Both ladies love it, but are quick to say pickleball doesn’t love them.
At the Physical Therapist
Physical therapists throughout the New River Valley see patients frequently for shoulder discomfort. “Most often we treat patients suffering from subacromial impingement syndrome, which is a pinching of the soft tissues under the tip of the shoulder and upper arm, which limits function in overhead activities,” Nolan Stewart relates. “For strains and partial tears, we focus on manual therapy to provide stretching and mobility. Therapeutic exercises can restore strength. Neuromuscular education promotes optimal posture of the shoulder blade and proper movement of the upper arm.”
Physical therapy and conservative care is a good place to start reducing pain and regaining strength and range of motion. Stewart succinctly declares: “Surgery restores the anatomy. Physical therapy restores functional use.”
Stewart is spot-on about being cognizant of posture. According to mayoclinichealthsystem.org: “Looking down at electronic devices causes neck muscles to strain and shoulders to slump forward. Musculoskeletal fatigue and pressure on the nerve supply in the neck can cause pain in the neck, which may initiate referred pain in the arms and hands. Staying in this position increases the force and effort on your shoulders, neck and upper back muscles and puts uneven pressure on your spine.”
Our figurative shoulders can carry a lot of emotion for ourselves and for others, but our real shoulders need to be cared for as much as our eyes, skin, feet and everything else.
Text by Joanne M. Anderson
