Shoulder Pain in Chaturanga?


Chaturanga is a posture that can often cause shoulder issues when not performed correctly. 

In the Ashtanga Vinyasa system, because this posture is practised so often, incorrect technique or imbalance in the body can start to irritate the shoulders. 

A common area to feel discomfort is at the front of the shoulder. The pain may run down the biceps muscle, and the more chaturanga's you do, the worse it gets. Sometimes the pain is vaguer and harder to pinpoint. Another common symptom is the loss of strength in the shoulder. You may feel unable to generate the same force that you used to.

If this sounds familiar, the first thing to do is to take a step back. You cannot try to push through the pain and hope things will sort themselves out. So consider avoiding, modifying and/or reducing the amount this posture is practised.

One simple modification you can try is to not allow the shoulder to go into extension. You can do this by making sure the elbows stay just in front of the trunk at the lowest point of the posture and only bend the elbow around 80°.  The video clip below is from my Shoulder Course and helps explain this further.

Image from Tara Mitra's Primary Series Chart

Avoiding shoulder extension may help reduce compression of the biceps tendon

(video taken from the Shoulder Course)
If this does help relieve the discomfort, you may have a long head of the biceps tendinopathy. What this modification does is prevent this tendon from compressing into the humerus bone and becoming irritated. 

Keep in mind, however, that there may be other issues you need to address. That's because this tendinopathy is often seen in conjunction with other shoulder disorders. For example, it may be seen alongside 80% of rotator cuff tears (1,2,3), impingement, labrum tears, bursitis, AC joint disorders, shoulder instability (4,5) and glenohumeral internal rotation deficit (GIRD) (6). In these cases, the tendon issue is really a side effect of another problem. So you must establish what that is. 

I highly recommend taking a video of yourself and seeing what your chaturanga looks like. Do at least 5 rounds and even more of not too painful. This is useful as it will show how your alignment is as the muscles fatigue. The first round may look fine, but by the 5th, you can start to see that your alignment has been lost, indicating poor endurance.

Look out for movment in the spine and pelvis, which can indicate poor core stability. The spine and pelvis should move as one connected unit. If not, this can put more pressure on the shoulders and lead to irritation.  Check out the video below for a visual explanation of what I mean.

Poor core stability in Chaturanga and push ups can be detrimental to the shoulder

(video taken from the Shoulder Course)
Another area to closely observe is the shoulder blade or scapula. It's not uncommon for one or both to be seen to peel off the rib cage, something called scapular winging. This, when seen, will very likely be linked to the pain you are experiencing and will need to be addressed.

There are many other things to look out for but try these first. 

If, after doing this, you are still struggling to understand what is happening, consider an online consultation with me.

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References

  1. Pouliquen L, Berhouet J, Istvan M, Thomazeau H, Ropars M, Collin P. Popeye sign: Frequency and functional impact. Orthop Traumatol Surg Res. 2018 Oct;104(6):817-822. doi: 10.1016/j.otsr.2018.02.016. Epub 2018 May 24. PMID: 29803774.
  2. Rees JD, Wilson AM, Wolman RL. Current concepts in the management of tendon disorders. Rheumatology (Oxford). 2006 May;45(5):508-21. doi: 10.1093/rheumatology/kel046. Epub 2006 Feb 20. PMID: 16490749.
  3. Neer CS 2nd. Impingement lesions. Clin Orthop Relat Res. 1983 Mar;(173):70-7. PMID: 6825348.
  4. Nho, Shane J. MD, MS; Strauss, Eric J. MD; Lenart, Brett A. MD; Provencher, Matthew T. MD, MC, USN; Mazzocca, Augustus D. MD, MS; Verma, Nikhil N. MD; Romeo, Anthony A. MD Long Head of the Biceps Tendinopathy: Diagnosis and Management, American Academy of Orthopaedic Surgeon: November 2010 - Volume 18 - Issue 11 - p 645-656
  5. Wilk KE, Hooks TR. The Painful Long Head of the Biceps Brachii: Nonoperative Treatment Approaches. Clin Sports Med. 2016 Jan;35(1):75-92. doi: 10.1016/j.csm.2015.08.012. Epub 2015 Oct 17. PMID: 26614470.
  6. Varacallo M, Seaman TJ, Mair SD. Biceps Tendon Dislocation and Instability. [Updated 2021 May 4]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK534102/