Vail Health Insights column: Do you carry your stress in your shoulders?
November 21, 2016
Even the untrained eye can spot this one: that shoulder that sits a few inches higher than the other. If you touch it, first it feels like a rock and then the person will likely jump. For many who suffer from this shoulder-near-the-ear, there is no history of trauma and they've had it forever. The logical explanation: "It's where I carry my stress."
We do what we can to ease the pain. We can massage the knots and dry needle the trigger points. With kinesio tape, we can pin the shoulder back down. Lastly, we train with the cue "squeeze your shoulder down your back." The symptoms often come back. Many are left to think this is simply their cross to bear.
What if there is an answer better than carrying stress? There are certain statements we hear often enough that we accept them as truths, like the five-second rule for food on the floor or that cold weather causes colds. They seem reasonable enough, so we learn to believe them. The truth is, they're not fact.
It turns out that hiked shoulder is not a stress-management problem but rather a mass-management problem. I regularly film patients for gait analysis. I want to see what the body is and is not doing while walking. I started noticing the shoulder hike was repeatedly showing up in non-shoulder cases. Paired with the history, there are two predominant categories for the hike:
1) the person struggles to get off that side, and
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2) the body has learned one side is not safe and does what it can to get off that side.
The shoulder hike is a compensation to shift his or her mass.
Consider a person who has suffered an ankle sprain, an anterior cruciate ligament repair and a hip scope on one side. His or her brain may consider loading that side risky. The body will favor loading the opposite side. Similarly, take into account the person with a flat foot, a bunion and rigid orthotics. That's an inefficient foot. The body will struggle to push off from that side. We can't take a step with all of our weight on one side. To make this shift happen, the clever body shrugs the shoulder.
Of course, it seems logical to treat the shoulder — it hurts. However, pain is often a low-lying fruit. If a person ejects from his or her skis and lands smack on the shoulder, that's a straight up shoulder problem. If there is no history, or logical explanation, consider other sources. Perhaps the shoulder is overactive because it has no other choice.
The goal is to restore options. Make the unsafe safe, and give the joints a job. I use neurokinetic therapy to clean up the "software." This ranges from treating active scars to waking dormant muscles. I also use Anatomy in Motion to restore 3-D motion. By using foam wedges and organic movements, one can restore joint function, repair sequencing and modify perception. The brain lights up when it relearns what it's meant to do.
TREAT THE PERSON
Of course, my initial goal is to get people out of pain. I'm a fixer at heart. My ultimate goal is to solve the puzzle. Rather than trying to shove your shoulder down, I'd like to give it a reason to go down on its own. It's in the story. The lasting fix comes from addressing the source. Treat the person, not the pain.
Julie Peterson, MPT, is the owner of Concierge Physical Therapy Colorado. She is a certified neurokinetic therapy specialist with a strong background in manual therapy. She can be reached at 970-306-3006 and firstname.lastname@example.org. For more information, visit http://www.conciergeptcolorado.com.
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