Nagging shoulder pain

[Drjmilus]

Got a great question the other day: I hope it helps someone else besides this guy...

Hey, Doctor Jen,
I have this nagging shoulder pain. I can't get rid of it. My doc says nothing appears on the xray or MRI, and the orthopedic tests he has done on me are negative. Why then, is it so bothersome? It seems like it lights up every time I do something.... What do you think? I hav even tried icing... which is a real pain, as keeping an ice bag on my shoulder really gets in the way of moving around. Any suggestions?

First- I found a really cool icing tool. Click here. (http://www.amazon.com/dp/B000TIBME6/ref=nosim/?tag=nextag-hpc-20&creative=380333&creativeASIN=B000TIBME6&linkCode=asn) It's cheap, and very effective. Icing should be done 20 on, 20 off as much as possible.


Also, here's an article (http://www.fireagility.com/articles.php)I wrote on rotator cuff strengthening. Scroll down until you see the rotator cuff article. I use this protocal all the time... on myself, and other people. It's great, as long as a tear or other pathology has been ruled out by your doctor.

Best of luck to you all!

Dr. Jen
www.fireagility.com

[Drjmilus]

As O Gomez points out, in regards to shoudler issues:

My philosophy is to first look at posture to find out muscular balance issues, then do a functional assessment to find out mechanisms/movements that cause pain. Then work to re-educate postural muscles to re-align joints then begin endurance/ROM exercises and strengthen in the new positions....

Until all joints are re aligned his anterior shoulder pain isn't going to be addressed. I came from a traditional PT background where my treatment focused on the joint in pain with modalities and ROM and isolated unilateral strengthening. I have since learned a new approach where the entire body is considered as a whole: a shoulder issue could well stem from hip issues or visa versa. Here is the first routine I did with this client as well a picture of his posture.

I completely agree with your thought process. ...

YOu are absolutely on track here.
I once did an advanced certification in muscle balance and function with a PT named Geoff Gluckman. We addressed things like this in terms of unilateral and sometime uneven stretches and exercises to correct postural distortions.

I think many shoulder problems stem from the inequities you are speaking up- particularly over training pecs and biceps- which results in a forward flexion posture, and internal rotation (or pronation of the humari, arms and hands... causeing impingement. If this is the case, that stuff needs to be addressed, and the rotator cuff rrehab type stuff will not work until that causative factore ir removed!

Thank you for you thoughts!