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Shoulder pain affects our ability to workout, sleep, compete, and even do every day tasks around the house. It’s amazing what simple tasks can be affected when our ability to reach overhead or across the body is limited. It’s even more frustrating when it feels like nothing (rest, ice, heat, massage and even in-home exercises) is helping the shoulder pain start to feel better. If you have ever experienced Neuro Therapy for your shoulder pain, I’m sure you are well accustomed to a few of these exercises that we do at our clinic. If you have not, you might be wondering if there is anything you can do to relieve your shoulder pain short of working 1 on 1 with a qualified health professional - I'm sure there is someone out there in the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area willing to help ;-). Or, perhaps you are not looking for a 100% fix to the shoulder pain, but maybe something that will at least treat the shoulder pain (perhaps help sleep a little better) until you can actually make moves on a real shoulder therapy program. If you can relate to any of those things, you are in for a treat as the 2 exercises we will discuss are some of the most basic, yet useful movements you can perform at home to learn more about your shoulder pain as it relates to potential:
Ultimately, whether you find yourself really struggling with these exercises or cruising through the movement with minor difficulty, my recommendation would be to work these two exercises 3-5x per week in a range of motion that you feel most comfortable. As far as duration, aim for 5 minutes of extremely focused, active work for each exercise (total of 10 minutes). Exercise #1: Teeter Totter Stand with your feet 6-8 inches apart, toes pointing straight ahead, and upper body erect with your chest separated from the sternum. Your head should be kept in line with the body and your eyes looking straight ahead. Your hands are holding a broomstick, PVC pipe, or a wooden dowel (or something similar) horizontally with a straight elbow and wrist (knuckles aimed at ground). This is the ideal starting position. To start the movement, use your lats to pull the left shoulder down and lengthen the arm (no bend in elbow) at the same time. Doing so will cause the opposite shoulder to rise slightly creating a teeter-totter motion. Pause for 1 count and then reverse the movement by pulling your shoulder back to the starting position as described above. Once you have returned to the starting position, you will repeat the same movement with the right arm. Continue to alternate between the left and right until 5 repetitions of the teeter-totter movement have been completed with proper movement on each side. Sounds simple right? Well, let’s dive in a little while thinking about the educational part of this process from the list above. Questions to ask yourself:
There is definitely a lot to think about here but finding out these answers and doing something about them can provide so much information in regard to what’s contributing to your shoulder pain. Ultimately, these questions are exactly what we focus on when going through a session at Premier to help relieve your shoulder pain. The only difference is that we use technology to make the process more efficient :-) Let’s now take a look at our second very basic movement that you can perform at home to learn more about your shoulder pain. Remember, keep in mind the educational piece we just discussed and use that as your lens to navigate through the second movement, as well. Just incase, here they are again (from above):
Exercise #2: Front Delt Raise Stand with your feet 6-8 inches apart, toes pointing straight ahead, and upper body erect with your chest separated from the sternum. Your head should be kept in line with the body and your eyes looking straight ahead. Your arms are resting at your sides holding onto a broomstick, PVC pipe, or a wooden dowel (or something similar) with wrists directly below the shoulder. This is the ideal starting position. From this position, raise the arms with extended/straight elbows (no bend) until they are directly over your head. Pause for 1 count and then reverse the movement by using your lats to pull the arms (with elbows extended/straight) back down to the starting position. Easy, right? Not so fast…. Questions to ask yourself:
It’s definitely possible that by reading this list of questions, you are overwhelmed and even more frustrated than when you started. That is completely ok and completely expected. You have to start somewhere and if you are truly looking to relieve your shoulder pain or find the ultimate fix, it requires an attention to detail that was not previously there and a very deep understanding of how your movement patterns could help get rid of your shoulder pain. With that being said, everyone is different and will experience a different recovery rate and path to improving the shoulder pain so do your best to stay focused on you and your path to getting rid of your shoulder pain. If you run through this list, your form is perfect, but yet still experience shoulder pain, it’s possible it would just require a deeper dive into all of these questions by a qualified health professional. Sometimes (and I am even guilty of it!), we think everything looks good until someone else gets their eyes on us and within seconds, we are brought back down to reality ;-) But let’s keep it simple for now - start with the ideal starting position. Can you hit the cues for the ideal starting position? If you can, great. Move on to the next cue. If you can’t, that’s great too - start by perfecting the ideal starting position and DO NOT move on until your form is perfect. Lastly, don't forget the recommendation on frequency and duration: 3-5x a week for a total of 5 min on each exercise. Good luck! Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
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This week’s post highlights the success of one of our Premier Family clients, Steve. I met Steve at one of the best CrossFit gyms in the area, Outsiders Crossfit. At the time, Steve was dealing with persistent pain in both the shoulder and hip that were forcing him to scale back and modify his workouts. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE Discovery Session at Premier! While he was excited to be a member at Outsiders, he was discouraged that this persistent pain was keeping him from continuing to build on his level of fitness. Because the problem has been going on for 6 months, and he had tried many other conservative means (like resistance band exercises, stretching, and resting), Steve was convinced surgery would be needed to fix the problem.  If surgery was required, it wouldn’t only affect his ability to stay fit, but it would also inhibit his ability to stick to his busy travel schedule for work. He was concerned that surgery and/or physical therapy would take so long that his work would start to be affected. Working around Steve’s busy travel schedule, we were able to find 2 weeks to work on his shoulder together. By the end of the two weeks, all of Steve’s hard work at Premier allowed him to work out at Outsiders and feel much more confident in his shoulder. The need for surgery was off the table. After going on a trip for work, Steve returned several weeks later to work on his hip, with similar, successful results. He's back in the gym at 100%, continuing to improve his fitness levels each day. Before Steve and I met, he admits he had very limited knowledge about Neuro Therapy. Even now, he maintains it is just one of those things you have to experience to understand how it can work for you. Because many people have expressed this to us, we offer the ability to experience Neuro Therapy completely for free. You can learn more about the process and go through a full session at no cost to you: Just click here to sign up go.premierneurotherapy.com/apply Check out the video below to see Steve’s full story and find out what his favorite part of the Premier Neuro Therapy experience was. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier! This week’s post highlights a success story from one of our clients, Ned. Ned heard about Neuro Therapy through one of his friends who knew he had been dealing with an injured shoulder for years (26 to be exact). The injured shoulder was keeping him from working out, feeling strong, and wrestling around with his kids. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE Discovery Session at Premier! After hearing about Premier Neuro Therapy, Ned filled out an online form to schedule a time to talk to a member of our team (click here to do the same), Within a day, we got in contact with him via phone call to answer his questions about the Neuro Therapy process.
We also let him know that the best way to understand how Neuro Therapy can help is experiencing it, and that we offer the first session (we call it a Discovery Session) for free. He decided to schedule a Discovery Session within the next few days. Before starting at Premier Neuro Therapy, Ned had spent the previous few years only being able to bench around 185 lbs. It wasn't necessarily that he couldn't go higher, but if he pushed the shoulder too much, he would really pay for it in the days to follow. During his Discovery Session, we identified Neuro Communication issues with Ned's anterior deltoid and medial biceps that were keeping the shoulder from healing properly and feeling strong. After just a few weeks of work getting these problems corrected, Ned was benching 255 lbs for 10 reps - a huge jump from what he had been able to do prior to Neuro Therapy. Not only did Neuro Therapy help him to feel better, but it also helped him to become stronger. As Ned puts it, he hasn't been this strong since he was in his 20s. If you're wondering if Neuro Therapy can help solve your biggest pain problem, be like Ned and schedule a time to talk to a member of our team by clicking this link: go.premierneurotherapy.com/talk 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: trial.premierneurotherapy.com A member of our team will review your application and determine if you qualify for a free Neuro Therapy trial. If additional information is required, we will reach out within 1 business day after receiving the application. 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. Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE Discovery Session at Premier! 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). https://go.premierneurotherapy.com/apply  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: https://go.premierneurotherapy.com/apply Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
Discovery Session at Premier! Whether it is wrapping pads, assessing a client, or analyzing movement patterns, our staff works with a careful eye to ensure no stone goes unturned in helping clients recover from persistent pain. Out of all of the joints in the body, the shoulder is where this level of detail matters most. If the little things are ignored, you’ll drastically decrease your chances of successfully relieving shoulder pain Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE Discovery Session at Premier! In other words, the little things matter when addressing the shoulder. Here’s why. 1) The Shoulder Is a Complex Joint The shoulder is what’s called a “ball and socket” joint. This means that there is a ball at the top of your arm that rests inside a socket close to the end of your collar bone. The ball and socket set-up gives it a lot of freedom in movement that other joints do not have. With increased freedom, comes increased complexity. All of the muscles (deltoid, pectoral, lat, rotator cuff muscles, biceps, etc.) must work in unison to properly support the socket in the joint. If not, movement can become painful.  2) The Shoulder Builds Physical Protective Mechanisms Ideally, movement of the shoulder should be smooth. However, when things are just a little bit off, you may feel roughness, catching, grinding, or snapping, which can start to be painful. When the shoulder isn’t moving smoothly, it starts to develop physical protective mechanisms, like bone spurs and scar tissue. With additional tissue in the socket of the joint, the space for the ball to move becomes more limited, and problems can compound. In other words, when things like bone spurs and scar tissue develop, the little things matter even more.  3) The Rotator Cuff Muscles Often Get Overworked The shoulder uses several large, powerful muscles to generate force like the pec, deltoid, lat, and biceps. However, if any of these large muscles are not doing their jobs correctly (due to previous injury or improper movement patterns), the rotator cuff muscles must pick up the slack. The rotator cuff muscles are smaller muscles meant to stabilize the shoulder. If they’re required to do the work of large muscle groups, they will become overworked and potentially tear. Like I mentioned above, the shoulder is a complex joint. If you’ve been dealing with shoulder pain and aren’t getting better, it’s likely that the little things aren’t getting addressed. Click the link below to schedule a FREE, 90 minute, initial evaluation (we call it a Discovery Session) with my detail oriented team, and you’ll learn what “little things” are keeping your shoulder from feeling normal again. Click here>> go.premierneurotherapy.com/apply Local to the Towson, Lutherville-Timonium, Cockeysville, or Hunt Valley area? Friends & Family receive a FREE
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About the AuthorEvan Lewis is a nationwide leader in Neuro Therapy and founded the Baltimore area's only specialist Neuro Therapy facility. 
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Premier Neuro Therapy specializes in helping people overcome nagging pains and injuries, avoid surgery and injections, and transform the body to a state of peak performance.
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