The exercises your physical therapist recommended can be a great help to shoulder pain. However, if the nervous system isn’t functioning correctly, there’s a possibility they might not be providing the benefit you were hoping for.
There’s 3 different reasons your nervous system could be interfering with your physical therapy exercises:
1. The muscles in the shoulder and arm are stuck in a shortened, protective state.
When an injury occurs or pain starts to develop, the nervous system immediately begins to place muscles around the shoulder in what we call a protective state.
In the protected state, the muscles are limited to a much smaller range of motion, making them feel tight (and sometimes sore).
You may notice as you go through your physical therapy exercises that your range of motion feels very limited, or that you’re unable to hold your shoulder in the position that’s recommended for the exercise.
These are both indications that the muscles around the shoulder are stuck in a shortened, protective state, preventing your physical therapy exercises from giving you the most benefit.
2. You’ve learned compensation patterns that keep the correct muscles from working during the exercises.
Think back to when you first injured your shoulder or started to experience pain. Did you immediately start using the affected arm a little differently?
Maybe you started rotating your body a little more when reaching for objects, or pulling your neck down to your shoulder when reaching overhead.
These adjustments to your normal movement patterns are what we call compensation patterns.
Because your body believes a certain movement may be painful, it learns different ways to accomplish the same tasks.
Let’s take one of the most classic physical therapy exercises: external rotation with a resistance band and see how compensations might affect the exercise (Video below).
This exercise is often prescribed to help strengthen the rotator cuff – however, it’s rarely performed properly.
The rotator cuff muscles are so weak that the body learns more efficient ways to perform the movement.
If the wrist bends, elbow comes away from the body, or shoulder sits forward during the exercise (all compensation patterns), you will not get the intended benefit of the exercise.
3. Your nervous system is sympathetic dominant.
The nervous system constantly shifts on a spectrum between the sympathetic and parasympathetic state.
The sympathetic state is more commonly known as our “fight or flight” response, which can be extremely beneficial in overcoming challenging situations.
The parasympathetic state is commonly known as our “rest and digest” state, which is where our body does its most efficient repair and healing.
When your nervous system fails to properly process stressors (whether they are related to work, relationships, exercise, nutrition, sleep, or a number of other factors), it can become what we call “sympathetic dominant.”
When the nervous system is sympathetic dominant, it spends less time in the parasympathetic state, meaning it will not heal optimally (no matter how often you do your physical therapy exercises).
So what does all this mean?
If you want your physical therapy exercises to be effective, I highly recommend qualified supervision while performing the movements. Your physical therapist should be able to instruct you on how to perform the movements properly AND common ways they are done improperly.
If you feel your forearm fatiguing during an exercise that’s supposed to be strengthening your shoulder, you’re probably doing it incorrectly, and need to communicate that with your therapist.
If you believe you might have trouble processing stressors, ask your physical therapist for techniques on how to do so or if they can connect you with another professional with expertise in this area.
At Premier, we use a number of techniques to overcome all 3 of these obstacle and optimize the recovery proceess.. Neuro Therapy helps to identify muscles that are in the protected state, fix compensation patterns, and re-train the nervous system to repair the shoulder efficiently.
Click the link below to apply for a chance to experience Neuro Therapy for free:
A member of our team will review your application and determine if you qualify for a free Neuro Therapy Discovery Session. If additional information is required, we will reach out within 1 buiness day after receving the application.
About the Author
Evan Lewis is a nationwide leader in Neuro Therapy and founded the Baltimore area's only specialist Neuro Therapy facility.
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