Shoulder Pain

Shoulder Compression and Rotator Cuff Problems

Sub Scap Fac - Infra Inh.png

Tis that time of the year where contact sports come back into competition. 

A rugby league athlete had recently come in with a panful R shoulder. This pain started after a heavy contact session at training. 

With repeated tackling in this session we had found that his R shoulder was compressed. This compression was exacerbated by a neurologically over active Subscapularis and a down regulated Infraspinatus. 

We decompressed their R shoulder whilst releasing the Subscapularis. We then activated the inhibited Infraspinatus.

After retesting all dysfunction structures became strong and were no longer affected by compression or decompression. 

This athlete has some easy preventative maintenance to do if these symptoms arise agin after another big session of contact. 

Right ACL Scar Creating Left Shoulder Pain + Left Jaw Dysfunction Creating Left Hip Pain

A client came into the clinic with left shoulder and left hip pain. This pain had been bugging them for a while and they had enough. After some palpation and discussion, we continued with a neuromuscular assessment.

This client had both their knee reconstructed after injuries from sports. As soon as I see surgical scars I will always start there and see what dysfunction is present.

This client had done a lot of massages and scar care on their left knee so this scar was all good, however, the scars on their right knee seem a bit suspicious.

With a scar on the right leg I was interested to see if the right glute was dysfunctional, and if so what was the left lat doing as its connected to the right glute max via the posterior oblique sling.

When testing the scar against the glute max we found a dysfunctional relationship. I then proceeded to test the scar against the left lat, and sure enough, this was also creating weakness. I released the scar and activated the glute max as it was the weakest test. This posterior sling now was functional and firing well.

This proves the point the scars can and do create global dysfunction. A scar on the right knee was creating left shoulder pain, how cool!!!!

We now had to find out what was happing with the left hip. I tested the QL’s and I found a weak left QL. I tested this agains the left medial Pterygoid in the jaw as I see this pattern very often. There was a relationship here. It was clear that we had a lateral sub system dysfunction at play. The left Pterygoid was facilitated, the left QL was inhibited, the right QL was compensating for the left QL and the left TFL was inhibited because of the right QL. Sound confusing but it really isn’t when you see it in person.

Anyway, we released the left Pterygoid, right QL and activated the L QL and TFL. The hip pain dropped significantly. . This client has some correctives to do but they should be able to finally reduce the aching in the hip and shoulder.

And remember just because the pain in on the same side on the body doesn’t mean that they are directly connected to each other. Sometimes one dysfunctional relationship with create or affect another. Clear the highest level dysfunction first and you can possibly have trickle down effects into lower level issues.

Stomach Scars and Shoulder Pain

A strongman athlete came in complaining about left shoulder pain. They were worried as they had about 10 days until their next comp. After discussion and some ROM assessment, we decided to use some NKT testing to assess the shoulder. This client had mentioned that their shoulder started to hurt after doing bench press last session. One of the first muscles I test when I am working with shoulder pain is the Latissimus Dorsi as its quite often dysfunctional. I tested the left lat, it was weak. I will usually immediately test the other side to check if its a unilateral or bilateral weakness. I tested the R lat and it was also weak. Having bilateral (both sides) weakness or pain generally means we are looking for a central interrelated cause that mightn’t necessarily be close to the source of pain.

I decided to continue to assess the shoulder before going too deep into looking for the REAL cause of pain.

After further testing, I found the that the Left pec minor and triceps for facilitated for an inhibited Lat. Basically, this was a compensation pattern that had developed for this athlete to continue to train. If the lat wasn’t weak the likelihood of this dysfunction occurring would be minimal.

I still had some work to do as I needed to find out WHY the lats were weak.

After further discussion, we found a scar on the client's stomach. I tested the lats against the scar on the stomach and sure enough, there was a relationship. The scar was facilitated for bilateral Lat weakness.

We released the scar, released the left pec minor and tricep and then activated both lats.

We retested the shoulder. Full Rom was restored and the pain was gone!.

This client had some specific scar work to do but they should be fine to compete in 10 days time as long as their diligent with their dysfunction management.