Fix a shoulder fault in 20 mins !!! Ok guys listen up its been months and months with shoulder pain,its affecting your Job and your lifestyle. So you hit the GP he puts you through a few internal external rotations, adduct ion abduction and flexion extension, he/she throws some fancy words your way gives you pain killers and sets an appointment for you woth a physio!! youve seen the physio and after a few sessions of unstructured manual treatments and a paper hand out for you to do as homework your worse then you were when you started. Never fear ......... all muscular injury is neuromuscular regardless of the symptom but we will come back to that later in another blog, first lets recognise the pain. Sharp - acute inflammation Pain when rested - acute inflammation Aching - chronic soft tissue Dull,deep or boring - bone issue Crawling or burning - autonomic nerve issue Diffused or lancing - neural Radiating - neural (entrapment) Throbbing - vascular Stinging - dermal As well as indicating what tissue is damaged we can use the above information later to monitor progress. Ok so the shoulder pain usually at the anterior portion of the deltoid, for the likes of my patient here, will never be the actual anterior delt. It will be the whole structure of the girdle holding a difect. using my patient as an example I shall explain how we can reduce that pain in less the twenty minutes in 3 steps. Step 1. The pec minor - running from the coracoid process down to the third forth and fifth rib it moves the shoulder girdle by pulling the scapula anteriorly and posteriorly. If the muscle becomes chronically short then this can internally rotate the gleno humeral head causing protracted shoulders, this in turn can impinge the brachial plexus nerve and pull the head closer to the anterior portion of the capsule giving restricted movement.......step one stretch the pec minor!! Step 2- the infraspinatous, this usually shows up dark on an ultrasound because its hypertonic due to our patient her being short through the chest, the infraspinatous stabilize the joint by contracting horizontally across it from the scapula out to the humorous, this holds the head of the humerus correctly in the glenoid cavity. The gleno humeral joint is not bound together by strong ligaments but instead relies on the function of this muscle to keep the humeral head stable. If we are hypertonic due to the infraspinatous fighting to keep the head of the humerus stable then micro trauma will occur particularly around its insertion point .....The point we feel pain. As its tight the infraspinatous will pull the shoulder back and out allowing for very poor stability in pressing movements this can be fixed by pulling the elbows forward twisting the humeral head inward tightning the structural muscles pulling the head nice and snug into the gleno humeral socket. step 3 ........ RE-EDUCATE the movement applying an internal rotation of the shoulders pulling the head snug into the socket, As you can see below Barry Rowlands has a hypertonic infraspinatous we can see this due to the humeral head dragging back through the rear barbell press, after applying our internal rotation and fixing the dynamics ........perfect execution Easy. You can see clearly how a few tweaks puts the shoukder back in to a optimum position for reducating the structure. #re-energise #jedi #master #rehab #jediclinic
Posted on: Sun, 21 Dec 2014 17:41:40 +0000