Thursday, September 6, 2012

Got the World on Your Shoulders? Does it just feel like it?

   Shoulder pain from impingement (meaning the pressing on the soft tissue of tendon, muscle, or nerve by bone), sometimes called “frozen shoulder” is a common problem. It occurs frequently in the first quarter of the year. Why? Because of New Year’s resolutions for being fitter, stronger, etc. Starting too hard or too fast in upper body workouts can bring on shoulder problems very quickly.

Why does this happen and what can we do about it?

   Shoulder impingement can happen with great frequency in modern society because of a combination of factors, some anatomical, others arising from posture, exercise, and overuse. The pain involved in shoulder issues can range from mildly uncomfortable to completely debilitating. Complications can include pain, numbness and tingling in the elbow, wrist and hand and affect the thoracic outlet for the nerve trunk and artery for the entire arm.

   There are several anatomical reasons for shoulder impingements. In order to have its range-of-motion the shoulder joint has it uses muscles and bones to provide stability. It has to be stable throughout wide ranges of motion in different directions so it cannot use a ball-in-socket joint like the hip.  Fifteen muscles cross the shoulder and provide for its movement capacity. They work in concert like a small orchestra, supporting and giving way to each other in a finely tuned manner. If imbalanced, the entire assembly will be affected. Even a small imbalance can eventually have a profound effect. 

    Another anatomical issue is the small amount of clearance between the bones of the collarbone and ribcage. The nerve trunk, artery for the arm and a tendon pass through a space less an inch across. The space can shrink from poor form in exercise, bad ergonomics (a forward leaning posture or too much extension of the arms at the keyboard) or overusing a set of muscles in comparison with their balancing set in the “orchestra”.  Decreasing the space inch can result in pain, blockage of blood and nerve impulse flow. Like a car’s valves, operating without sufficient clearance produces overheating (inflammation) and potential damage. Once pain and loss of function begins, further muscle contraction and “guarding” of the painful arm progresses to more and more pain.

    Classic “frozen shoulder” or adhesive capsulitis comes from tissues within the joint capsule of the shoulder that “glue” together, resulting in complete immobilization of the joint. This is not the case in most painful shoulders, especially if addressed early. If inflammation and tissue damage is kept at a minimum, functional recovery can proceed quickly.

    Restoring the balance of range-of-motion to the muscles that provide stability and motion for the shoulder can relieve impingement very quickly and easily, when Bowenwork restores the perfect pattern memory for the area the body has stored. Often in less than 3 Bowenwork sessions pain relief is followed by movement recovery, then exercise and postural correction for long-term stability. 

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