I am a physical therapist and I get shoulder pain too.
I want to share my story because I understand first hand how irritating and frustrating it can be to experience re-occurring shoulder pain. (Not to mention, it is quite embarrassing walking around with Rock tape on and explaining to my CrossFit friends that, yes, I’m hurt again.)
My shoulder pain started in spring of 2016 when my family and I were on a vacation in Florida. My husband and I were doing our best to work out and decided to race one another doing plank hip drops. This particular exercise requires a great deal of shoulder stability and control. While moving fast, I was certainly not controlling it very well and felt a sudden sharp pain in my right shoulder. I knew this wasn’t a good thing as this pain persisted and it became difficult to move my arm without compensation over the remainder of our vacation.
Fast forward a few weeks, I found myself in the orthopedic clinic above the rehab facility in which I worked. MRI indicated a partial tear of my supraspinatus muscle (one of the rotator cuff muscles) and I was offered an injection.
I denied the injection (for fear of weakening the tendon only to get temporary relief) and knew that I wasn’t going to consider surgery. I was going to go to physical therapy.
Getting PT as a PT
I loved the experience of getting PT myself as I had someone else’s viewpoint to evaluate my shoulder and help me take care of it. My treatment consisted of dry needling and cupping to the back of my shoulder followed by joint mobilization, taping and an exercise program. The exercise program was primarily focused on isometrics at first and I was diligent with it. My pain resolved and I was able to move on using my arm completely normal.
Over the next 3 years to present, my shoulder has “acted up” several times. This typically happens whenever I overdo an activity such as raking or leaf blowing and push ups. I’ve learned to pace myself during yard work and modify my push ups at CrossFit.
I have been self treating my flareups with ice and rock tape as well as some self massage to the back of my shoulder. This helps but I was starting to get irritated that it kept re-occurring and that I couldn’t get all the necessary yard work done in a timely manner.
The Missing Link
I then went to a new continuing education course entitled Neurokinetic Therapy (aka NKT). My hope was renewed for lasting relief to my acute shoulder flare ups. I learned all about how to test our bodies learned patterns or programs. In other words, how to figure out which muscles our body prefers to use or rely on more heavily.
After an injury we often compensate for pain and our brain develops a new program so we can continue to use our body. Despite being rehabbed for my shoulder pain, I wondered if I never fully recovered because there was a missing link that was not addressed. Perhaps I’m still using the compensated program my brain developed after my injury? This program lets me get the job done, but it is not quality movement and leads to eventual muscle strain and pain.
So…I decided to have a PT colleague and friend of mine (who also attended the NKT course) evaluate my shoulder with this newly gained knowledge. Ironically, a few days after taking the course, I did several hours of yard work and had a return of my usual symptoms so it was perfect timing to truly test out this newly acquired evaluation tool.
Diagnosis vs PT Diagnosis…a bit of a soap box
“Diagnosis” is a powerful word in our society. It has become an expectation that our aches and pains are defined in a way that labels our condition. This can be convenient as it puts us on an often well researched treatment plan and it does allow us to find information on our condition in a more precise manner. However, it has also created self limitations and has caused many to define themselves from this diagnosis.
I could have defined my shoulder pain as the common diagnosis of “Tendonitis” or even “Impingement”. My symptoms certainly do fall under both of those categories. However, treatment for these conditions are often limited to anti-inflammatory interventions such as injections, NSAIDS (medication) and basic PT. The problem with this is that it is often considered to be healed when the pain is gone. But then, the pain returns, time and time again. Why? What is this diagnosis? Recurring tendonitis or better yet, “chronic shoulder pain”?
This is why I love PT. We dive in further. We don’t accept these labels. We want to understand the underlying cause of this inflammatory process. It is, after all, our responsibility to actually get you better and enable your body to truly function as it should. We don’t believe in quick fixes as they often lead to seeing clients back in our office again. Our “diagnosis” looks and sounds a little different. It is usually not just one word that is easy to google. It is often an explanation of sorts that we refer to as a “PT diagnosis”.
My PT Diagnosis and Treatment Plan
My PT diagnosis is an overactive or facilitated latissimus dorsi (lats) and an inhibited anterior deltoid. In other words, my body has been electing to depend more on my lats and less on my anterior deltoid leaving me with a strained and weakened deltoid muscle. My pain has been consistently along the length of the deltoid and the tissue here always feels more tight and tender. I had focused here with my treatment in the past and I never paid attention to the fact that my lats were also very tender and tight. My lats may be the missing link and the underlying culprit to my shoulder dysfunction!
Treatment consisted of soft tissue massage to my lats followed by activation of my anterior deltoid. I also underwent dry needling with electrical stimulation to my deltoid to reduce the overall tightness in the tissue. My home program was to continue to release the tight and tender lats (through self massage with a mobility ball) followed by activation of my anterior deltoid. This routine is to be done 2x/day in order to try to change the faulty motor program in my brain.
It has been only a few days since this initial treatment and so far, my shoulder feels great. I have a renewed hope that my re-occurring symptoms are a thing of the past. I just have to keep up with my very basic 2-step home program to ensure that I can truly change my brain’s program for this shoulder. I’ll keep you posted AND I’ll capture a video of my treatment…
If you would like a PT diagnosis for your recurring issues…Just click the button below. It will lead you to a quick form that will get you in for a FREE Discovery Visit with me!