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Pain ManagementA hairstylist at a neighboring salon came to see me recently because of chronic right shoulder pain. It was just a little nagging sort of thing for the past few years, but lately, the pain grew to be too much. She couldn’t lift her arm higher than a few inches. Reaching back behind her, like reaching for a purse in the back seat, had not been able to occur in over a year. She had to go home early from work the day before because of the pain and had not slept through the night for many nights. This was serious because it involved her livelihood and if she could not lift her arms to cut hair, she was out of income and out of business. She had tried a few things like muscle rub and massage, but those only gave her temporary relief.

We sat on the floor, and she shared her history of injuries. She was working out recently and felt some pain in her shoulder, but it had been bothering her before that. She had broken her right wrist in high school, fractured the big toe of her left foot ten years ago, which required surgery and metal pins, and her left sacroiliac joint felt jammed. She had also gone through a hysterectomy a couple of years ago.

One or more of these previous experiences could very well have contributed to her shoulder pain. If her broken wrist did not have its proper range of motion restored it may ask other areas to work harder and over time could make another area irritated or inflamed. The hysterectomy left a small scar, and even though it was fully healed without any complications, it could still affect her structure. Her body could subtly be pulled toward the scar as a way of protection, and that would place her shoulder in a compromised position for repetitive motions of cutting hair (perhaps the next blog will explore how the body reacts to scars?…it’s pretty fascinating).

As it turned out the trouble seemed to be coming from the broken toe of her left foot. As we directed our attention to her foot, she remembered that after her foot surgery she had suffered a fall and dislodged the pins through the sole of her foot. That was pretty significant information. As a result, the pins were fully removed (in general, the fewer metal pins in the body, the better) but she was not willing to fully place weight on that forefoot. We then noticed that she couldn’t lift her big toe off the floor. That may not seem to be a big deal, but if she could not lift her big toe, then she would be unable to properly supinate (create an arch in the foot). Without proper supination, she would struggle to extend her left knee or rotate her hips left which would unlock the “jammed” sacroiliac joint. If the hips had difficulty rotating left then her ribs would have trouble rotating right. When the ribs rotate right, it allows the shoulder to retract, depress, externally rotate and open up.

We found that when a wedge was placed under her big toe on the left foot her right arm range of motion improved significantly! She was pretty blown away. This showed that the connection between the left foot and right shoulder function was worth exploring. We went through two exercises which explored integrative, full body motion. She was able to experience her ribs rotating opposite her hips, and that’s when things really began to happen. What is interesting is that we did not focus on her shoulder and left it relaxed through the exercises.

Diagnostic AssessmentAfter these movements, she walked around, and then we rechecked her shoulder pain and her arm’s range of motion. Her jaw dropped, and eyes went wide as she went through a full range of motion with no pain!!! She could reach back behind her for the first time in over a year without pain. It all took 20 minutes.

It does not always happen in so short a time. Normally the session is 90 minutes long, and I have to confess we do not always find the problem site the first time. The body is so complex that the problem could be hiding in the least likely place. I suppose that is why I love what I do. It is like being Sherlock Holmes and sorting through the clues. The more I learn about the body, the more clues get revealed. The really cool part is that the body is like Dr. Watson and the victim all rolled into one. The body will not only provide the clues, but it will also be the faithful assistant that helps solve the mystery.