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SHOULDER PAIN UNVEILED: THE SECRETS TO PAIN-FREE SHOULDERS

1. THE PAIN PATHWAY – WHY DO WE EXPERIENCE PAIN?

If you're not careful and accidentally cut your fingertip when slicing a tomato, acute pain
will force you to draw your hand back immediately to prevent you from cutting deeper.

WHEN WE TALK Our body responds primarily to three types of

external stimuli: thermal, mechanical, and
ABOUT PAIN
chemical. Mechanical pressure activates
mechanical nociceptors which converts the
stimuli into electrical energy in a process called
nociceptive transduction. When the magnitude
of the electrical energy exceeds a threshold, an
electric signal is transmitted to the brain, where
the signal will be perceived as pain.

In general, pain serves as an important warning

signal to the body that something is wrong, and
it prompts us to take action to protect ourselves
from further harm. It is a protective mechanism
that helps us avoid potential danger and injury.

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2. PAIN FROM BODY MISALIGNMENT

Arthritis is a condition that refers to the

inflammation of one or more joints in the
body. Lateral epicondylitis, medial
epicondylitis, and adhesive capsulitis
are the medical terms for tennis elbow,
golfer‘s elbow, and frozen shoulder,
respectively. They all end with ‘-itis’,
which is the suffix for inflammatory
diseases. There are five cardinal signs of
inflammation: heat, redness, swelling, and loss of function. If you have no
heat, no redness, and no swelling, then inflammation may not be the cause
of your pain.

Inflammation is a vital part of your body’s ability to fight infections by

activating the immune system. Pain is one sign of inflammation, but pain
is not always caused by inflammation. If you experience pain only
when you move outside of a certain range of motion, then it may not be
inflammation and should not be treated as arthritis.

“There are five cardinal signs of inflammation: heat, redness, swelling, and loss of function.”

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SO, WHAT When your muscles are stretched to their

limit, the shape of the muscles change which
HAPPENS TO
causes them to send a signal to your brain to
THOSE MUSCLES? stop moving in a way that could cause injury.

But how are we stretching our muscles

during training or by doing simple life tasks-
we’re not doing yoga or any particular
stretching exercises!?

The answer has to do with the consequences

of muscle overuse.

From the left to the right:

healthy/normal muscle, overused muscle, scar tissue on muscle

Repeated overuse of particular muscle

groups lead to muscle cohesion. The
muscles become compressed and contorted,
which results in muscles losing the ability to
properly function over their full range of
motion.

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While parts of the body are overused and compressed, the antagonist parts
of the body will be underutilized and stretched. These compensations create
new movement patterns that replace the ones the human body was born
with and designed for. Consequently, you may be experiencing pain from the
contorted muscles and misaligned body structure exacerbated over time by
poor posture during training and daily activities.

Take a look at this tensegrity structure. If I rotate it, some of the

cord becomes loose while the rest become over-stretched.

This is what we will be discussing in-

depth today with your shoulders.

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3. SHOULDER PAIN FROM BODY MISALIGNMENT

When you are performing a bicep curl, you may focus too much on the
contraction of your biceps. When you are performing a front raise, you may
focus too much on your front delt. And when are performing a snatch, you
may focus too much on the stability on the top of the shoulders while in the
catching position.

It's not intuitively obvious that the power for all of these movements are
strongly linked to your scapulothoracic joint, which connect the shoulder
blades to your rib cage.

When it comes to shoulder pain, it is the mazy glenohumeral joint that always gets the most attention.
Source: https://en.wikipedia.org/wiki/Subacromial_bursitis#/media/File:Shoulder_joint.svg

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SHOULDER PAIN UNVEILED: UNLOCKING THE SECRETS TO PAIN-FREE SHOULDERS

“When the ocean is calm without big waves then the ships can move smoothly.”

If you can imagine our ribs as the

ocean, then our shoulder blades are two
ships floating on the ocean. When the
ocean is calm without big waves then
the ships can move smoothly.

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SHOULDER PAIN UNVEILED: UNLOCKING THE SECRETS TO PAIN-FREE SHOULDERS

“just like ships traversing in a hurricane…”

However, if the shape of your ribs have

changed, then the movement of the
scapula will be quite bumpy, just like
ships traversing in a hurricane.

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 SHOULDER PAIN UNVEILED: UNLOCKING THE SECRETS TO PAIN-FREE SHOULDERS

AND GUESS WHAT'S It’s your entire arm- the humerus

(upper arm bone), elbows, wrists,
ATTACHED TO YOUR
and hands. Any type of pain in your
SCAPULAE? arms can be linked back to the
status of the relationship between
your shoulder blades and ribs.

The arms are connected to the torso through the scapula and the rib cage..
Image from Thomas Myers Anatomy Train
FIG. 7.3 ‘The Arm Lines are named for their relative positions at the level of the shoulder.’

THEN WHY DO YOUR It is because of the misalignment

RIBS GET BUMPY? of the scapula that comes from
the following two directions of
force - the vertical axis and the
horizontal axis.

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3.1 The relative position change of the shoulder

blades and rib cage comes from the misalignment
of the horizontal axis.

Throughout our daily life, there are many occasions when we unevenly use
our arms (the horizontal axis). Primarily, there are two types of imbalance.

“like we only play mouse or phone with one hand…”

THE FIRST KIND IS Most of us have a dominant arm with which

we use the computer mouse or single-
LEFT-RIGHT
handedly use our phones. In sports such as
UNEVEN USE OF golf, badminton, or tennis these imbalances
THE ARMS. are obvious. However, handedness can also
subconsciously influence how we carry heavy
bags or backpacks on one shoulder and not
the other, or which side of the body we prefer
to sleep on.

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THE OTHER KIND IS The extensor muscles of the arm are

located on the backside of the upper
EXTENSOR-FLEXOR
arm and forearm. Extensors are
IMBALANCE OF responsible for straightening the elbow
THE ARMS. and wrist. The flexor muscles of the arm
are located on the front of the arms.
Flexors are responsible for bending the
elbow and wrist. Perhaps you sit in front
of the screen all day long, or you
preferentially train your chest with
presses or push-ups. Regardless of the
intensity associated with the use of the
forearms, any prolonged imbalance will
alter the arms’ movement patterns.
Ultimately, these types of imbalances will
impact the horizontal axis and change
the relative position of the shoulder
blades and rib cage.

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3.2 The relative position change of the shoulder

blades and rib cage comes from the misalignment
of the vertical axis.

The two axis in the human body

Poorly controlled force generation coming up from the feet can cause the
pelvis to rotate and change shapes. This then can cause the spine and the
ribs attached to the spine to counteract the misaligned force by rotating and
changing their shape as well. At this point, your ribs have become
misaligned by the force transmitted through the vertical axis, thereby shifting
position of the scapula.

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4. REVERSING THE MISALIGNMENT & REGAINING

PAIN-FREE SHOULDERS

As mentioned earlier, there are a few key steps to follow in order to regain a
healthy shoulder joint.

FIRSTLY, IT‘S to prevent power from transmitting

in a rotated direction and changing
IMPORTANT TO the shape of your ribs.
MAINTAIN AN ALIGNED
For example, make sure to set up
VERTICAL AXIS,
symmetrical foot positioning in
training for squatting, deadlifting,
Olympic weightlifting, etc.

Gaby’s Body Alignment Training Exercise - Lower Body Flexion and Extension re-alignment

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SECONDLY, to prevent overuse of certain muscles that

can cause rotation.
MAINTAINING
AN ALIGNED If you only use your right hand to use the
computer mouse or phone, you may need to
HORIZONTAL stretch your right arm from time to time. You
AXIS IS CRUCIAL can also incorporate exercises or habits that
help to develop the functionality of your left
hand and create a more balanced left-right
structure.

Additionally, plan your training to maintain a

balanced extensor-flexor alignment. After a
push-focused training session (i.e., chest
presses) involving mainly the flexors of the
arms, make sure to still use the antagonist
muscles (i.e., shoulder external rotation) have
to do some shoulder external rotation &
extending training to maintain a balanced
structure.

LASTLY, IF YOU it's important to practice control over the full

range of motion to strengthen your joints and
PERFORM HEAVY connective tissues such as ligaments and
WEIGHTLIFTING tendons. Much like progressively overloading
TRAINING, muscles for hypertrophy, joints and
connective tissue must develop resilience to
bear the impact of heavier and heavier loads.

The famous LXJ raise is an excellent example

of reinforcing the shoulder’s control over the
full range of motion with heavy load.

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5. ABOUT TREATMENT
Regardless of the type of treatment you apply, such as a joint surgery, sports
massage or chiropractor, the focus has always been on stretching and/or
foam-rolling the tight region. These approaches are futile if the tightness or
the pain come from the misalignment of the whole structure. What you are
doing is isolating the problematic area and treating it as an independent unit.
While you may experience short-term, you are not affecting any long-term
change and the structure will merge back with the rest of the body after a
few days. When this happens, the same pain in the same area will reemerge
or even worse it may occur elsewhere if the structure has been changed,
often time after a surgery.

6. CONCLUSION
Treating chronic shoulder pain with narrow focused approaches or by
training the weak spot in isolation are never the right long-term solutions. To
achieve sustainable, pain-free mobile shoulder you must establish and
maintain a balanced structure along both the vertical and horizontal axes.
Otherwise, all of your efforts are futile and you are simply putting layers and
layers of patches that will slowly but surely peel back and fall off.

Don’t find yourself stuck in the train-injury-rest loop. Take a step back and
look at the bigger picture, the appearance of the pain is rarely the root of the
problem. We have to see through the appearance to reach the essence.

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