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Your shoulder pain started 3 years ago when you joined the gym and reached upwards in the zumba dance class. There were no weights involved, the class started with a good warm-up, yet suddenly, as you reached up, you felt the pain deep inside the shoulder. At first the pain was not too bad, you could finish the class, but an hour later you suddenly found that you could hardly lift your arm, it was so sore.

After a few treatments by your therapist, the pain started to subside, yet it took a good few months before the pain was completely gone. One year later, you slipped and hurt the same arm when you reached out to prevent yourself from falling. After a few treatments the worst pain subsided, but ever since then to prevent another injury, you have had to be careful not to use the arm above a certain level, .

WHY DOES THIS INJURY KEEP COMING BACK?

The diagnosis of this particular shoulder injury, which hurts when you lift the arm above a certain level, will most probably be Rotator Cuff Syndrome or Supraspinatus Tendinitis. Both these diagnoses involves inflammation and maybe even partial tears or calcification of the Supraspinatus Tendon. When looking at the mechanics of this condition, it becomes clear that when the painful shoulder reaches above a certain level, the arm rotates medially, causing impingement of the Supraspinatus tendon in between the clavicle and the scapula. Chronic impingement will cause chronic inflammation or injury and you will avoid lifting your shoulder.

Your therapist or trainer will insist on rehabilitation in order to re-program the shoulder to move correctly again and strengthen the muscles around the shoulder. But what if you have been through the whole rehabilitation process and were declared healed, yet, without warning, the injury returned when you least expected it?

YOU ARE MOST PROBABLY STILL LOCKED IN AN INJURY PATTERN

When we walk or run, our left shoulder moves forward (and rotates laterally) together with our right hip, while at the same time our right shoulder moves backward (and medially rotate) together with the left hip. This is the normal combined spiral pattern of the body.

If, however, we sustain an injury in any part of the body for example, badly sprain or a fracture an ankle which causes a limp; or we are in the habit of rotating towards one side of the body more than the other, as in throwing sports, carrying a baby on one hip; or you have had direct trauma or surgery, it may affect the normal spiral movement of the whole body. suddenly the one spiral pattern is favoured, causing the connective tissue (fascia) to become locked.

All muscles are imbedded in connective tissue and as soon as the connective tissue surrounding a muscle densifies and become locked, the muscle loses its ability to move or function and you have to find an alternative way, a compensation in your movement to get around the locked area.

DO THE FOLLOWING TESTS

Test 1 – (part of posterior/back upper spiral line)

IMG_4421Position
Place your hand on your shoulder. Move your elbow upwards until you can feel the end of range, but
stop as soon as your hand starts to rotate away from your shoulder. Make sure you do not stretch!
Measure
The horizontal distance between the shoulder and the elbow (between the vertical lines)
Normal
The hip, shoulder and elbow should be in line.

Test 2 – (part of anterior/front upper spiral line)


img_1093Position

Place your hand behind your back. Make sure your hand and forearm are in line and the hand is not pointing upwards.
Measure
The distance between the index finger and the bottom of the scapula
Normal
The index finger (and the whole hand) should be above the bottom of the scapula.

RESULTS AND ANALYSIS

PostersFor normal function of both upper spiral lines, there should not be a big discrepancy between the scores on the left and the right. As soon as there is a big discrepancy, it means that the one spiral line is dominant which will lead to compensation and eventually injury patterns.

So if the upper body has a lock in the posterior upper spiral line, the corresponding arm will become locked towards medial rotation. If you then elevate or abduct the arm beyond 90º, it will lead to impingement of the Supraspinatus Tendon (due to the medial rotation), resulting in chronic or recurring injury.

In some cases a locked upper spiral line, as discussed above, could be the result of a related locked lower spiral line, which means that the original cause of the chronic shoulder injury could be found somewhere in the leg. So an old knee injury that was never properly mobilized (fascia), will lead to a compensation pattern resulting in locked rotation, which works it way through to the arm spiral lines and eventually feeding an arm injury.

FIND SOMEONE WHO WILL DO A FULL BODY ASSESSMENT OF FASCIA MOBILITY

A full assessment of fascia mobility will clearly show up in which pattern your body is locked. The mechanism of your recurring injury will become obvious and you can follow the pattern to the original source. Only once you have unlocked the injury pattern, will your arm be able to move in neutral and the tendon be freed from pressure. And then the added benefit is that the wear and tear on the rest of your joints is diminished.

For a full body assessment of fascia mobility, find a Lyno Practitioner on www.thelynomethod.com/find a practitioner/