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.
The word “stress” tends to carry a negative stigma. In fact, many of our clients’ have mentioned that their stress levels elevate just at the mention of the word.
Over the last couple of decades, our society has become pretty well educated on the long term effects of stress.
It’s been linked to negative health outcomes like:
Just to name a few.
Such education over the last decade has led to the aforementioned negative “stigma” around stress.
But what if that negative stigma is actually increasing your likelihood of poor health outcomes?
A study in 2012 challenged this point by asking the question “Does the perception that stress affects health matter?”
The study concluded:
“Individuals who perceived that stress affects their health and reported a large amount of stress had an increased risk of premature death.”
It goes on to estimate that, over the 8 years of the survey, 182,000, people died prematurely in the US due to their negative perception of stress.
So what can we do with this information?
The first thing we need to do is understand why the stress response exists in the body.
The stress response evolved as a way for humans to “rise to the occasion” for big moments.
In other words, stress exists to HELP us, NOT hurt us.
When we understand this, we can start to identify stress as a POSITIVE thing in our life.
When we identify stress as a positive thing, we can harness it’s power and use it to tackle the challenges in front of us. And when we tackle the challenges in front of us, we feel good about what we’ve accomplished. And when we feel good about what we’ve accomplished, the stress response is short lived.
The problem with stress exists when we perceive it as a negative. When we perceive stress as a negative, we do one of three things that encourage the stress response to become ongoing.
If you’re dealing with stress in any of these 3 ways, you need to find a way to view stress as a POSITIVE in your life, or it will have a negative affect on your health.
A few of the tools from previous posts (here and here) will help you to control your stress, tackle the challenges in front of you, and take the time to recognize your accomplishments.
I can’t tell you how many people say these words to our therapists “I wish I knew you existed before surgery.”
When I hear this, I’m moved in a couple of different ways.
On one hand, I’m happy to hear clients are feeling improvement after working with us.
On the other hand, I’m motivated to help educate people on the alternatives to surgery before they find out “the hard way” that surgery doesn’t always deliver the results they were hoping for.
This week, I’ve compiled a few stats specifically related to shoulder surgery, hoping to do my part in educating others about the process.
.1) The number of total shoulder replacements performed in the US increased from 18,000 in 2000 to more than 45,000 in 2013.
On one side, this could be looked at as good news, because it’s an indication that the surgery might be a more viable option than in the past. However, it’s also scary in some regards, as it shows how often people are neglecting proper shoulder care BEFORE it gets to the point of surgery.
When you consider that a total shoulder replacement requires the arm to be in a sling for 4-6 weeks before starting 6 months of intensive rehabilitation, it might sound like a little better idea to take care of your shoulder before it gets to the point of replacement.
2) Surgery for shoulder impingement is no more effective than a supervised exercise program.
One study took a look at patients who had undergone surgery for shoulder impingement 8-11 years after surgery. The study found that 50% of patients still had pain during activity and 32% still had pain at rest.
In another study, it was found that patients who underwent surgery for should impingement experienced the same results as those who went through a structured exercise program. Of course, the cost and effort involved with surgery (and the rehab process) far exceeds the costs of a structured exercise program.
3) Even with minor rotator cuff repairs, unsuccessful surgery occurs 1 out of 4 times.
And the numbers get worse, depending on the severity of the tear. For moderate tears, the rate of unsuccessful surgery increases to 50%. For severe tears, the rate of unsuccessful surgery increases to 60%.
Moral of the story here:
Surgery should be an absolute last resort. If you haven’t already seen a physical therapist (or tried Neuro Therapy), surgery shouldn’t even be on your radar. The success rates are just too low and recovery processes too long.
If you're new to Neuro Therapy, our staff specializes in helping people who suffer from chronic pain (i.e. pain that has lasted longer than you expected), delayed recovery from surgery, and repetitive injuries.
In many cases, people suffering with shoulder pain want to do everything possible before trying surgery. If that sounds like you, click here to apply for a FREE Neuro Therapy session (we call it a "Discovery" Session).
After applying for the session, our staff will review your application to make sure you are a quality candidate for our program.
If selected, we will reach out to schedule the session.
You will get the chance to meet our staff, ask any questions you have about Neuro Therapy, and go through a Neuro Therapy session from beginning to end.
The discovery session is set up to give you all the information you need to see if Neuro Therapy can be a solution for your shoulder pain.
Click here to apply:
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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