Shoulder Pain: The Truth Behind the Hurt

This week's blog piggy-backs off of one of the exercises we talked about last week in The 10 Minute Self Check To Help Relieve Shoulder Pain - the front delt raise.  The directions to that exercise are shown below not only as a reminder on how we would like to see the exercise performed, but also as a segue into our topic of this week, the truth behind the hurt.

Directions: 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?

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Well, the picture below depicts a client with shoulder pain (AC joint injury) going through this exact exercise and this is the end product – definitely not part of the directions.

I know what you are thinking - that can’t possibly be helpful to relieving her shoulder pain.  Oh, but it is :-)
 
So why is she standing in that position?  Faulty movement patterns.
 
Faulty movement patterns are at the core of shoulder injuries and pain (and really any type of injury and pain).  Naturally, the body learns ways to compensate as a means to guard and protect the shoulder, making it extremely difficult to execute even the simplest movements.  These faulty movement patterns can start as early as our adolescent years without even knowing it.  Before you know it, you’re going on 50 years old, dealing with a nagging shoulder injury that’s been around for years, you can’t find relief, you feel like there is no fix, and you look like that picture when being asked to do a simple overhead movement.  Not good!
 
So let’s rewind that picture a little bit, break it down a little just as we would at Premier, and try to provide a little more substance as to why faulty movement patterns are such an important piece to helping you get rid of your shoulder pain once and for all.

Picture 1: Not bad.  But upon a deeper glance, that PVC pipe is definitely not parallel to the ground.  Her left hand naturally sits a little farther away from the body.  Immediately, we know there is an imbalance somewhere and it needs to be addressed.  Crazy right?  Even before actually moving, a faulty movement pattern exists in her resting position.  If anything, it’s possible it could start with pulling the left shoulder down and back as it appears her left trap is sitting just a tad higher than the right.  If we were to take a look at her from the side, we would probably see the left shoulder incorrectly rolled forward actually.  Furthermore, you can even tell the musculature of the traps are not even.

Picture 2: Without being cued through the movement, she made an adjustment to align both arms (nice!), elbows are extended (perfect!), head is kept in line with the body (yes!), and even the wrists and hand grip look great (let’s go!).  When searching for absolute symmetry, you could get a little picky with the right shoulder sitting a little higher than the left, but I was trying to keep it more positive with this picture so we won’t go there ;-)

Picture 3: The shot is taken at the point of what I would say is extreme compensation.  We see that when her arms hit this particular point in the exercise, there’s a slight shift to the left (easily detected by the spacing between each ear and biceps).  We also see that the left biceps INCORRECTLY shortens, causing elbow flexion (it’s not straight). There is also a slight bend in the right elbow, as well. 

Picture 4: As she pulls overhead, she is still unable to straighten both elbows fully and now there is a significant shift to the right.  Although her body is dead center, we start to lose sight of her forearm in the picture.  Interesting….

Picture 5: At full range of motion, things begin to center a little more but it appears the biceps begin to take over a little more as a means to help her pull into full range and back to more of a centered-looking position.  However, it’s more of a false centering as the right forearm is still really far away from where it should be.

Picture 6: Seconds later, as she attempted to counter the right shift to a symmetrical position as well as lengthen the biceps so as to extend the elbows (straighten arms), her body doubles down on the guarding/protecting and we are now in faulty movement pattern city.
 
To quickly recap what I’m pulling from this…even at resting position (picture 1), her body is in a guarding/protective state.  Her faulty movement patterns pick up just a bit when moving towards a position overhead, and stay decently consistently in the wrong position throughout the movement until things go absolutely crazy at the end range of motion when she is really trying to achieve a perfect position.  Ultimately, her body just does not like to move correctly.
 
If you have experienced Neuro before, you know how much our technology can easily elicit your compensations and faulty movement patterns.
 
For those of you who have not yet experienced Neuro, I know what you are thinking – “Why in the world did her arms move that way?  That is not normal.  Maybe the patterns she is showing in pictures 1, 2, 3, and 4, and 5 are normal, but definitely not 6”.
 
Well, you are right!
 
Sometimes it is very difficult to use the naked eye when looking for faulty movement patterns causing shoulder pain or injury, so our technology does a tremendous job in aiding that process.  Essentially, as she is moving, our technology is being applied to her simultaneously, helping to really draw out her faulty movement patterns.  Once we are able to successfully elicit these patterns, the re-education process can really start to take place, resulting in an adaptation for change.
 
In her case, that change was specific to not being able to do a dip exercise prior to the session because of pain levels reported at an 8 out of 10, to immediately afterwards being able to execute multiple dips in succession without pain.
 
And how is that possible?  We were able to eventually work through those faulty movement patterns to a point where she was able to lift the PVC pipe overhead head WITHOUT any compensation.
 
This is precisely the reason as to why she didn’t have any discomfort afterwards – her patterns were changed and it carried over into executing her dips.
 
Exploiting and changing faulty movement patterns is such an important piece to recovering from shoulder pain and injury and I hope that I’ve been able to provide a little window into the how’s and why’s behind that concept.
 
At the end of the day, you don’t need the fancy technology to elicit some of the faulty movement patterns that are causing your shoulder pain and injury (although it certainly makes it extremely easy and efficient).  However, if you, a friend, or family member are struggling with identifying your faulty movement patterns, how to properly re-educate your body to move correctly, and not seeing pain relief or a change in recovery, let us know by clicking the link below.  We would be more than happy to help!

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