The tendency in our modern life is to use our arms with the shoulder joint internally rotated.

You can assess where the shoulder is rotated relative to neutral by where the elbows are pointing. In a neutral shoulder position, the elbow points (on the tricep side of the arm) are pointing straight back and the elbow "pits" (on the bicep side of the arm where the upper and lower arm hinge), should be pointed straight forward. When the shoulder is internally rotated, the elbow pits are pointed inward, toward each other and the elbow points are pointed out to the side. An internally rotated shoulder joint allows for the muscles on both the top of the shoulder (trapezius) and the neck to activate more readily. When externally rotated, the elbow pits are pointed out to the sides with the point of the elbows coming toward each other. An externally rotated shoulder allows for the muscles of the mid back (latisiumus dorsi) to activate more readily. Both of these movements are normal and useful.

The problem arises when we develop a habit of internally rotating the shoulder for most of our daily activities. You might notice next time you are reading, eating, using a phone, and driving that chances are your elbow points are out to the side (elbow pits toward each other). When we spend a majority of our time that way, it's easy to develop an excessive amount of tension in the upper shoulders and neck area. Slouching or hunching forward may also be tied in with this shoulder position.

The remedy is to spend more time practicing external rotation of the shoulder and to bring your elbow pits to a neutral straight forward position whenever you can.

Watch where your elbows are pointing while holding onto the steering wheel. See if you can rotate and "squeeze" your elbow points toward each other and get your elbow pits to point toward the ceiling and/or straight forward.

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