The Rhythmic Physician: Unburden Your Shoulder
Recently I have noticed a significant rise in drummers with shoulder injuries. The cause of shoulder pain in drummers can vary and is dependent on several factors including arm dominance, age, playing ability, extracurricular activities such as sports, and how ergonomically we play.
The most common causes, however, are due to repetitive overhead activity such as reaching for a high crash cymbal or reaching behind the shoulder to hit a drum or cymbal. These maneuvers, although quite common in drumming, can predispose a player to shoulder injury. Older rockers that have played for decades reaching for crash cymbals day in and day out are frequent visitors to my office. Our arm dominance and posture can also be a significant etiological (or causal) factor. Poor upper trunk and thoracic and lumbar spine posture or a forward-rolled shoulder posture place the shoulder musculature at a biomechanical disadvantage leading to rotator cuff injury. Arm dominance resulting in muscle imbalances can also predispose to rotator cuff injury.
With repetitive elvation of the arm from our side, such as sustained ride cymbal play or repetitvely reaching for a crash, the soft tissues supporting the shoulder, the rotator cuff muscles are required to contract. If the these muscles are not prepared to maintain that sustained repetitive contraction or are placed in a biomechanically dangerous position due to poor postural position, injury to the rotator cuff tendons can occur leading to eventual tendon degeneration and or tearing.
The shoulder is made up of two bones that form four articulations: glenohumeral, acromioclavicular, sternoclavicular, and scapulothoracic joints. The shoulder in the most mobile of all joints permitting almost complete range of motion. The shoulder is supported by four muscles, the rotator cuff, and a number of ligaments and muscle tendons. Maintaining a balalced strength within the musculature supporting the shoulder is imperative for normal sustained function and to minimize the risk of overuse-type injuries.
Pain in the shoulder, biceps region, or upper arm with elevation of the arm and shoulder are common symptoms and warning signs that should not be ignored. Pain may also be experienced down the arm to the elbow and hand. It is also very common to experience pain sleeping on the shoulder or being awakened at night by shoulder pain. If pain persists for longer that a week, seek advice by an orthopedic physician.
Maintaining core and shoulder/upper extremity muscular strength and flexibility while maintaining optimal posture is extremely important to protect the shoulder and arm from injury. A shoulder exercise program emphasizing scapular stabilizer muscle and rotator muscle strengthening as well as a comprehensive core stabilization exercise program should be practiced by every drummer to help prevent injury.
Properly warming up prior to playing and cooling down after practice and performances can prevent shoulder injuries. Maintaining optimal playing posture, shoulders back, head and neck in a neutral position while sitting upright and not bending forward on the drum thrown will also help prevent injuries and keep us rockin’.