A Shoulder Ache StoryNov 13, 2020
Written by David Johnson, PT, MPT / Owner of Evergreen PT
My wife Tammy asked me to look at a light in our daughter’s closet that was loose and hanging. I am not "Mr. Fixit", but I went to take a look anyway. If it’s the human body that’s in need of repair then I do pretty well, if not, then I am out of luck and need an owner’s manual (that I don’t have patience to read it).
I began my inspection of the hanging light, in the dark, with a flashlight in my teeth, and my "essential" glasses on crooked. It wasn’t 60 seconds with my hands over my head that my shoulders began to ache. I had to drop them down. Repeat. I could sustain holding my arms up to the light fixture, less than 60 seconds at a time. It was almost like a marble was poking the top of my joint. It was annoying. Ugh. "This is never going to get fixed", I secretly thought.
While I was forced to give my shoulders a break every other minute, a conversation with my friend about his shoulder pain, leapt into my mind. This was my "light bulb moment". I know how to fix shoulders. So I stepped down the ladder and tried my “remedy”. When I went back up the ladder to work, my shoulders were fine. Better than fine, they lasted the next 25-30 minutes. Voila! Lights were back on. Success, which is rare for me in home repairs and it felt good.
So what was the DIY remedy? Well, I go back to my conversation with my friend, who I'll call Mike, just 24 hours before my lightbulb incident.
Most of the time, when shoulders ache after being held over head, or while sleeping, this happens because the rotator cuff is compressed.
I didn’t say it was torn, like many people might think. The rotator cuff tendon running over the top of the humerus has limited space height to move through. It can become inflamed and when it is compressed, it hurts like the Dickens. It usually starts as annoying and persistent aching, which can be disruptive to sustained over-head arm tasks and cause intense sleep disruptions. The good news is that you can ‘decompress: the tendon and distract the shoulder joint yourself. Success in this maneuver will be a welcome relief from pressure of the rotator cuff tendon.
So, back to my conversation with Mike. Mike texted Monday asking me if I had any suggestions for bad shoulder pain. He couldn’t sleep all night, for many nights. He was hoping to leave the next day for a trip so we arranged a virtual appointment by zoom. He gave me a 30- 60 second description of his pain. It was his wife who filled in the details. Ha! She was a great historian. She gave a chronology of recent travel, carrying suitcases and boxes from the car to a cabin, putting stuff up high, and even fishing with repetitive shoulder action. It was confirmed he needed to try to decompress the rotator cuff tendons, and after testing a few motions, like his hand behind back and over-head, across midline reach and self-strength assessments it was confirmed he had some rotator cuff related pain.
The subacromial space is a narrow space between the head of the humerus (shoulder bone) and the acromion ( outer edge bump on top of the shoulder). In a healthy shoulder joint, there should be some slight downward motion, some give, some pliability. I had his wife test it. She was amazing. She went right to the test and performed it perfect the first time – even picking up some subtleties of how my friend was twisting while he leaned away, which would interfere with a good test. We did three things to mobilize the joint space and relieve pressure on the rotator cuff tendon. We also discussed a better way to sleep on his sides.
Here are the three things we did:
Inferior glide of humerus
Posterior and lateral variations of glide of the humerus
Sleep recommendation / rib pillow
After the first two exercises, Mike had range of motion with significantly less pain, and could reach behind his back and lift it off without pain. I could tell he and his wife were hopeful. He asked “can I go to San Diego tomorrow?“
This is the text Mike sent me the next day, right before I had the closet light incident:
“ Well, here's a report. First and foremost thank you very much for taking your time last night. Second, I did sleep better and the video was very instructive. I put a pillow under my rib cage and head and my arm went between them and the pain was significantly diminished. Third, I did my exercises this morning and also I woke up with far less pain this morning. I can’t thank you enough.”
So, here’s the take home messages :
- Pain often has easy solutions that are at least worth a try.
- Not all remedies have to be a huge commitment of time or money.
- TV-PT ( online ) can work very nicely. I am having good success lately with shoulders.
- Wives are often better at the details ;) ha!
So, why do I tell this story ?
There are people out there, maybe it's you or someone you know, that might have pain or aches and are in need of a simplified shoulder remedy. They are hesitant to invest what they think will take large amounts of their money and, more importantly, their time to fix, so they decide to just endure the pain. However, as my and Mike's story shows, the remedy doesn't have to be expensive or time consuming.
Call us : 626 683 8536 , it’s that easy.
Oh, and my friend’s name really is Mike =). Thank you, Mike, for letting me share your story ! I think it could help others. It helped me too.
David Johnson is the Owner of Evergreen PT. He has been a physical therapist for over 25 years and recently completed the Movement Fellowship at Azusa Pacific University. He and his wife Tammy started Evergreen over 14 years ago and have made it their mission to provide exceptional physical therapy care to the Pasadena community and beyond.
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