Same Shoulder Pain – Two Different Reasons

Last week we talked about different strategies for dealing with a similar problem. Depending on if the origin of the problem is external or internal, our strategy to improve should reflect that. So, lets take a closer look at two different people with “the same” shoulder pain.

Ben shows up at my practice complaining of pain in his right shoulder. It bothers him at work (he works in an office) and during sports. He has taken some painkillers that helps a little bit, but not completely. He also wakes up in the night sometimes because the shoulder bothers him. He does a few quick stretches at the gym, but not always.

Upon further examination it’s clear that all the rotator cuff muscles of the shoulder are very tight. When I ask him further about his sports, it turns out that he has increased his workout routine lately, and in particular he is doing a lot more push-ups. I ask him to show me how he does a push-up, and it is clear that he is lacking the proper technique. He is not supporting his shoulders properly, and therefore putting an unnecessary burden on the rotator cuffs. For a while the rotator cuff muscles managed to compensate, but now they have reached a point of exhaustion – enter pain.

Ben’s homework included learning proper push-up technique. He was shocked to find out he had been doing it wrong for all these years. He also learned proper mobility work  for the shoulder, working with a foam roller and lacrosse ball for 10-15 minutes a day. Being strong without being flexible, is a road to injury. With a few complimentary deep tissue massage session he was “as good as new” within a few weeks.

Roy shows up at my practice complaining of pain in his right shoulder. It bothers him at work (he works in an office) and during sports. He has taken some painkillers but it doesn’t seem to help. He wakes up in the night, because the shoulder and neck bothers him, often around 3am. Sometimes he does a few quick stretches at the gym.

Roy’s rotator cuff muscles in the shoulder are very tight. He has not changed his work out routine in the past few months. He has dark, puffy circles under his eyes. The area around the lower end of his right rib-cage is a bit tender to the touch, and there is a slight metallic smell to his skin. These are all signs of an over burdened liver. I check his push-up technique, and it is fine.

He tells me that he drinks about 1-1,5 L of water a day, which he thinks is good. Further questioning reveals that he has had a lot of extra events at work  in the last few months, which includes “wining and dining”. As he feels very tired he drinks coffee throughout the day to keep himself going. Part from the “wining and dining” in the evening, he is quite rushed during the day and tends to eat quickly on the go, mostly carbs, like sandwiches and sweet stuff. All of these things have put a tremendous burden on his liver, which indirectly through shared nerve pathways sends pain into his shoulder.

Roy’s homework is to learn about proper hydration, diuretic beverages and basic liver function. He downloads the app to re-educate himself about how much and what he drinks, so that he can adjust accordingly. He was surprised to calculate that his baseline of drinking water is almost 3 Liter a day. He stops taking painkillers as they increase the burden on the liver. He reduces the intake of caffeine and alcohol, and notice that he starts sleeping a lot better.
He also learned proper mobility work  for the shoulder, working with a foam roller and lacrosse ball for 10-15 minutes a day, to speed up the recovery. With a few complimentary deep tissue massage session he was “as good as new” within a few months.

I hope these two examples has given you some ideas and food for thought in terms of problem solving. Making a change takes time and effort, but what could be more important in the long run, than investing in your own health?   😉

 


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