Or is it the complex shoulder?!

I say that because shoulders are complex, and as a physio, shoulder pain comes a close 2nd to groin pain in my least favourite part of the body to treat. There are so many component parts to the area that forms the shoulder – often called the shoulder girdle as well – that often trying to work out the root of the problem is very tricky. The parts all interact in chains and layers, and pain can be referred from the nerves in the neck as well as trigger points in the muscles.

But this complexity is one of the features that makes the shoulder such an amazing structure. It gives us huge degrees of movement that enable us to have the dexterity and function that is unique to our line of mammals.

So what am I doing talking about this in a blog about riding horses? Well, think about what sits at the other end of the arm to the shoulder…the hand. Contact and seat are the 2 critical areas that we all work on to be better, more effective yet more sympathetic riders. We spend hours working on strength, fitness, leg position. We spend lots of money on a saddle that puts us in the best position, with rolls to keep our legs still. We get shouted at about our hands, and even have dress code rules to make sure we wear light coloured gloves in competition to make sure our hands are clearly visible ( which I think is a good thing). Yet rarely are we actually taught how to correctly control those hands.

In this entry I a going to give you a brief anatomy lesson, and then hopefully link this through to the functional importance of the shoulder for riders.

Here you can see the position of the shoulder blades (scapulae) over the back of the ribs, and where these attach to the shoulder. This joint – the acromio-clavicular joint –  is the only place where the scapulae actually attach to the rest of the skeleton. The scapulae can slide over the rib cage, which allows us to reach right forwards and upwards with our arms.

In this view you can see the front view where the scapula comes round and joins to the collar bone – the clavicle – to form that acromio-clavicular joint. For ease, we usually refer to this as the a/c joint. This is a joint you may well be familiar with, because it can easily be dislocated – sometimes this can be called ‘sprung’. The clavicle is also an oft-injured site in the body in riding falls.

The acromion then forms the top of the shoulder – gleno-humeral – joint itself. You may be aware that the shoulder, like the hip, is a ‘ball and socket’ joint. If you look at the picture above though, you might think that the joint doesn’t really look like a ball and socket, and you’d be correct; it is probably more helpful to think of it as a ‘cup and saucer’. This is fantastic for giving us the enormous range of movement in our arms, but utterly hopeless when it comes stability. That is one reason why this it is common to hear of dislocated shoulders in riding falls.

There is one other joint to consider in the shoulder complex, and this is the sterno-clavicular joint, which lies at the opposite end of the clavicle to the a/c joint. It is where the clavicle attaches to the sternum – or breastbone. It is more stable thankfully!

A problem that is linked to the poor stability – or you could say excellent mobility – is that the stability that is present around the shoulder comes from soft tissues. This is predominantly ligaments and tendons. You may have heard before that it is often better to injure a bone than soft tissue; this is because once a bone has healed, it is basically as strong as it was before it was broken. Unfortunately, the same is not true with soft tissue due to the formation of scar tissue. As I’ve discussed before, scar tissue is not as elastic or as strong as ‘normal’ tissue, so if there is a stabilising role on its function, then this is going to be reduced.

Some people are unlucky enough to naturally have rather lax ligaments around the shoulder (me for one, although fortunately not severely), and in the extreme can suffer from dislocations without any trauma involved.

The tendons around the shoulder are immensely important to both stability and strength. The scapula has 4 muscles that run from it to the humerus, which is the upper arm bone (visible in the picture above). These muscles are called the Rotator Cuff (Supraspinatus, Infraspinatus, Teres Minor and Subscapularis), and are HUGELY important for stability of the whole area. But, remember I said before that the scapula itself is only attached to the skeleton at the shoulder? That has major implications for the rotator cuff in their endeavours to stabilise the shoulder, as the scapula is only itself stabilised by other muscles that hold it on to the trunk; trapezius, rhomboids and latissimus dorsi (lats).

You can see the trapezius and lats clearly in this picture in the right hand image (sorry I can’t actually indicate them, but I will endeavour to find a picture which has them labelled).

There are also a lot of nerves that pass around the shoulder joint; they come from the neck and down the arm. Shoulder and arm pain can often originate from these nerves, but I won’t go into any further detail today because that would be another whole essay!

So, back to the beginning, and why is this complex mechanism so important for riders and their contact, especially if you have never had an injury? Well, we use our hands to hold the reins, and for this we use muscles in our arms that are predominantly responsible for fine control. But in order to hold our arms in a steady position, or move them forwards and backwards – such as over a fence – we need stabilising muscles. These are the Rotator Cuff that I outlined above, and then in turn the trapezius, rhomboids and lats. It’s like a chain of control, from gross stabilising control at the scapula, right down to fine motor control at the hand.

If you have weakness around the shoulder, whether it’s a joint instability or specific muscle weakness, that will reduce your ability to have the fine control you need over your hands. You will also fatigue more quickly.

If you have poor posture, this means the scapula muscles are long and weak (as I have discussed in a previous post), and unable to carry out their stabilising function properly. This is exacerbated by the opposing muscles – the pectorals – becoming tight in an attempt to create stability. However, the position the shoulder girdle is pulled into is actually more restrictive than stable, and therefore this reduces the functional mobility that is available to the rest of the arm.

If you are very dominant in 1 arm (like me), then you are probably not balanced around your shoulder girdle. The side that is more stable at the start of the chain, will have a lighter and more consistent contact in the hand, simply because it can. (With me, that is my Right side. My Left hand I fix with because not only is my fine control poorer on that side, but my Left shoulder stability is pretty terrible. ) The result is an asymmetric contact which is not great for the aids and confusing for the horse.

If you don’t fully appreciate and utilise the way the scapulae slide around the rib cage to allow arm movement, you may not fully understand how to naturally allow your arms and hands to move with the horse’s head. This is particularly important with jumping or if your horse has large movement at walk. It is why you don’t want to have a rigid, soldier-like posture which locks the scapulae, but rather a tall but soft posture which allows the scapulae to subtly move as needed. You need strength through movement, which is what the scapulae and their muscles provide.

 

 

This picture is a good example of what happens when the scapulae slide forwards and get ‘stuck’; the hands are low and close, and the body weight tipped forwards

 

 

 

If you are weak around the shoulder girdle, when it comes to giving the contact over a fence, you are more likely to fall forwards rather than move in control. Fatigue is also much more likely, which in turn means your contact will become more inconsistent.

I once had a wonderful lady come to Pilates. She had ridden for years, had lessons on and off in that time, but never understood how she should properly move her arms with the horse. It was only in coming to Pilates and having the anatomy and mechanics of the movement explained that she truly ‘found’ the technique. It might seem so obvious, and to some people it comes naturally, but I challenge you to look at your own technique and just check that you are using your shoulders correctly.

So, having strong and stable muscles around the scapulae not only helps to stabilise the very mobile shoulder joint, but it helps you to have still hands and an even contact. The shoulder complex is indeed complex, but it has a crucial role for you as a rider. I focus a lot on this area in my Pilates work, and will include some key work on this area on my YouTube sessions.

Go and get familiar with those shoulders!

Louise