Overhead Work and Shoulders

Working with your hands above your head is one of the hardest things you can ask a body to do, and it does its damage slowly enough that nobody connects the two.

What happens up there

• Blood supply drops. Raise your arm above shoulder height and the tendons in the rotator cuff get pinched between bone and squeezed by the position. Circulation falls sharply, and the tissue fatigues fast and repairs slowly.
• The neck takes it too. Looking up compresses the joints at the back of the neck, and the load is being held there for as long as you are working.
• Grip fails first. A tool held overhead gets heavier every minute, and the hand starts doing work the shoulder should be doing.
• It is cumulative. Rotator cuff damage from overhead trades shows up as a decade of work, not as one bad day — and it is a common reason people leave the trade early.

Getting the work down, or getting up to it

The best control is not to work overhead at all, and it is more often available than it looks.

• Raise yourself, not the tool. A scaffold, a lift, a platform or a taller step brings the work to chest height. The five minutes to reposition beats an hour with your arms up.
• Lower the work. Assemble on the ground, fit on the ground, and lift the finished piece into place.
• Extension tools. Pole tools for drilling, driving, cutting and painting take the arms out of it entirely.
• Tool balancers and supports. A spring balancer or a support arm carries the weight of a heavy tool so your shoulder does not.
• Lighter tools. Ounces matter enormously when they are held above your head — this is where a lighter cordless earns its money.

If you have to do it

• Rotate. Swap the overhead work around the crew, or alternate it with something at waist height. Fifteen minutes up, then something else.
• Both hands where you can, and get in as close as possible — an arm out in front is far worse than an arm straight up.
• Micro-breaks. Drop the arms and shake them out for a few seconds every couple of minutes. It is not lost time; it is what lets you keep going.
• Watch the ladder trap. Overhead work off a ladder puts you at full reach with nothing to brace against, and that is where the shoulder and the fall risk meet.
• Eye protection, always. Everything you are working on is directly above your face.

Say it early

A shoulder that aches at night, that wakes you when you roll onto it, or that cannot reach behind your back is telling you something. Caught early it is usually manageable. Left two years, it is often surgery.