It's All Connected
When I first sat down to write this blog I was going to focus on shoulder pain and what I can do to help you ease your pain. But it got a little more complex as many of the common shoulder diagnoses are part of a more global problem, as everything in the body is connected. Here's some of the common painful conditions relating to the shoulder:
Frozen Shoulder (adhesive capsulitis)
Tendonopathies e.g. supraspinatus tendonitis (or tendinopathy)
Referred pain from the neck e.g. C5 nerve root irritation
I will use the shoulder in this blog as an example of how we are connected from top to toe.
A Few Rules of the Body
(there's many more)
- If there has been no direct trauma to the shoulder (or any painful part you have) something must be happening to cause it. And the problem probably isn’t the shoulder
- If you put your bones in the right place at the right time muscles work. For this you need sound joint mechanics (a good level of controlled range of movement) and a singing nervous system.
- The body likes variety. Repetitive movements can cause tissue irritation over time.
A bit of Shoulder Anatomy
I think the scapula bone is one of the most beautiful in the body. Well actually, I think the sphenoid is my absolute favourite, but I’m here to talk about the shoulder; to try and simplify its complexities, which will be difficult. The scapula along with the humerus and clavicle and the huge array of beautiful soft tissues form what we term the shoulder girdle
There are 18 muscles that attach to the scapula. One in fact attaches from it to the hyoid bone, omohyoid, which is in the throat! If any one of these muscles is tight, weak, or inhibited then all of the others have to rearrange themselves around it to adapt. But why has the imbalance happened? If there had been no direct trauma to the area (and this goes for any pain in the body) then it must be that one or more of the rules have not been adhered to, and could be a global-body issue.
“The body is excellent at adapting. It’s the adaptability that makes it so complex. Everyone’s ability to adapt is different and the way one adapts is unique and for unique reasons. There are however patterns that one as a practitioner sees that are more common than others”
Muscles blend in with the scapula via tendons and ligaments (fascia) which then go off and connect it to the rest of the body. (Fascia is a fascinating tissue, one of which I will address in a future blog) Thomas Myers has done a lot of research and created maps of the fascial connections in his book Anatomy Trains.
This means that something else that may have happened years ago, like a direct trauma, may have influenced how your shoulder functions. The injury that happened years ago when you twisted your knee skiing, or the ankle that you sprained badly caused the body to adapt and compensate. Perhaps it’s the direct effects of the repetitive movements from work or your beloved sport that may be causing the soft tissues in the shoulder to become irritated and painful. All you know is that it hurts, it's frustrating and it's stopping you from doing what you love to do.
How an Old Achilles Injury can lead to Shoulder Pain
- The mechanics - An old Achilles Tendon rupture which wasn’t properly rehabilitated has affected your foot position (more turned out) causing the leg to laterally turn out, affecting the efficiency at which you can propel you forward when you walk. Oh, and you might have a bunion forming on that side too? The hip and shoulder (both on the same AND very much on the opposite side) work in tandem and if there is a disconnection due to your old injury, the shoulder joint could be moving differently to how it’s meant to, leading to eventually maybe 15 years later shoulder pain maybe years later.
- The nervous system - Pain makes us move differently. When you rupture an Achilles tendon for example you don’t want to stand on it - quite right too, it’s trying to heal! But we then need to re-learn how to accept weight onto that side once the tendon is ready for such loading. This is often missed during rehab. If you cannot accept weight effortlessly then something else will compensate.
Proprioception, the ability to feel (and see in your mind's eye) your body in fine detail without looking at it, becomes fuzzy with any injury. It’s thought to be a protective mechanism by the nervous system (read: your brain) to stop you from using the area until it heals. But then the proprioception needs to be re-trained and ‘re-mapped’ in your sensory cortex to not only prevent reinjury, but to have the muscles firing up and when necessary and switching off when not needed...leading to compensatory changes leading eventually to pain.
The body adapts and compensates
You can imagine the array of different ways the body will adapt and therefore cause pain in other areas. Areas that you have no idea why you are sore there! Everyone has their own unique way of moving and we will get from A to B no matter what. This is how amazing the body is - it adapts and it will get you there, but over time these adaptations can cause tissue irritation as the joint/muscle or whatever is doing a job it is just not designed to do.
By losing the ability to accept weight efficiently on one leg, can cause a sequence of events up or down or across the myofascial chains in the body due to the neuro-bio-mechanics adapting and compensating for something that has happened. Try it and see. Stand on one leg and see what happens to the rest of your body. Then compare it with the other side.
Things to look out for:
- Toes gripping - have you got sore feet?
- Knee bending - niggly knee?
- Very wobbly?
- Pelvis tipping - hip pain/back pain?
- Spine side bending
- Jaw tensing - neck pain? Headaches?
- Head tipping to one side - neck pain?
- Holding your breath
- Tongue sticking out? 🙂
- Gaze fixing?
So, if you have shoulder pain, or any pain for that matter, that has come on for no reason, with no direct trauma to the area, if you’re systemically well, you’ve tried loads of really fab practitioners who work their magic on the shoulder and yet you still get pain in your shoulder, then your pain is not coming from your shoulder. Your shoulder is just the bit that is taking the brunt of whatever else is going on in the rest of the body.
The Mind and the Body are One; Connected
But it’s not just about the body either…! Our mind is a huge influencing factor. The two are not separate. Stress, depression and anxiety play a huge part in the level of pain you feel.
Please Contact me to see how I can help you.