Starting position and instructions
Stand side on to a wall and place your right hand on the wall at shoulder height with your fingers horizontal and pointing back. Keeping your right arm straight (elbow locked), turn your feet to the left and rotate your body to the left, you’ll feel the stretch across the front of your right shoulder. Hold the stretch for 30-40sec and then release slowly.
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Changing the height of your hand on the wall will vary the site of the stretch, whilst rotating the trunk more or less will increase or reduce the stretch intensity respectively. Additionally, altering the angle of your head will vary the stretch emphasis on the nerves travelling into the arm (of which more later).
Points to note
You should always control the stretch – your trunk is a major and heavy segment of your body, rotating it quickly can place considerable stress on the smaller and lighter shoulder segment.
This stretch can be felt over the front (anterior) aspect of the shoulder and chest and along the inside (flexor aspect) of the arm. It targets three distinct tissue types – muscle, fascia, and nerve. The chest (pectorals), front shoulder muscles (anterior deltoid) and inner arm muscles (biceps and forearm flexors) are all stretched. These anterior muscles are often tight due to daily activities which tend to round the shoulders and restrict the chest. As this happens the biceps can also tighten, as it has attachments over the shoulder (long head of biceps).
Combining shoulder and elbow motions is this way is an excellent way to work the biceps, which is usually only worked using restricted arm bending actions. With the development of a round-shouldered posture, the shoulder blade often elevates due to theoverwork of the upper portion of the trapezius muscle.
If this stretch is performed with the arm below shoulder height and the action is to lift the chest, the lower trapezius is worked which rehearses a beneficial shoulder bracing action. Muscles are wrapped in a tissue sheath, which is continuous with that of others. The sheath, known as ‘fascia’ allows some of the muscle power to be transmitted further from a muscle’s attachments to a joint.
In addition the sheath structure means that stretching should target muscles in lines (series) or tracks. The anterior chest and shoulder stretch lengthens the fascia covering the inner aspect of the arm and the chest, a fascial track that is responsible for rotary throwing or striking actions.
Fascia may become tight and its function impaired if swelling from injury spreads beyond the muscle boundary, or if the fascia is cut. The fascia of the chest and arm can be cut during mastectomy, a common operation which removes breast and chest muscle tissue. Following mastectomy, women often notice their chest and shoulders getting very tight.
“As nerves are considerably more delicate than muscles, the stretch should be applied more gently and held for only 10-15sec”
This can cause upper back pain due to increasingly rounded shoulders. This condition requires physiotherapy and massage therapy to address the fascial tightness and as the treatment progresses supervised stretching. The combination of trunk rotation and arm position also stretches the nerves travelling from the neck and upper back into the arm (brachial plexus structures).
This is again important as these nerves are often tight following injuries such as whiplash. Subjects may notice tingling sensations travelling down the arm and into the fingers if the nerves are tight (neural tension). As nerves are considerably more delicate than muscles, the stretch should be applied more gently and held for only 10-15sec.
The neural stretch can also be released slightly and then built up progressively. You may experience tingling in the area at first. So, begin by allowing the elbow to bend slightly and when the exercise can be performed without tingling, lock the elbow. Over time, the tingling should reduce. If it remains see a physiotherapist who can use manual therapy techniques to help release the nerve.
A word of caution: as the arm is taken backwards when performing this stretch, the ball of the shoulder joint (humeral head) is pressed forwards, stretching the front aspect of the joint capsule. This may be dangerous if you have a history of recurrent shoulder dislocation – as such the stretch should only be performed under the close supervision of a physiotherapist, who will assess the position and movement of the humeral head as the stretch is performed.