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Working with Shoulders        

 The shoulder joint is quite brilliant; in my mind, a work of engineering genius. You have an enormously flexible joint which manages to be powerful and protect the underlying arteries at the same time. But boy is it a troublemaker.  

It is so much trouble, most practitioners could have a full practice just working on shoulders. (If they were good at it) I see shoulder and its close cousin, neck pain, in my treatment room every day; sometime two or three times.  But if this joint is such a spectacular work of design, why is it so hard to heal?  I have new patients with shoulders they hurt 15 years ago.      

  In my experience there are many reasons for this but here are a few.  First, the shoulder is very complex; it is a joint which has more range of motion than any other. (Ie. it lacks stability but has the ability to arrange itself in many angle.)  Secondly, the price we pay for standing upright is that the shoulder has to provide much more leverage to our neck and torso. With our long arms, great torque is put upon it to protect us from trauma like whiplash.   Far more fulcrum energy than it would exert upon an animal on all fours.    And thirdly, shoulders are very difficult to work on because the bones are thick and heavily muscled. But most of all, shoulder work fails because it is approached as if it were a soft tissue problem. Admittedly, if there is a tear in the rotator cuff or labrum it is a soft tissue problem; one which needs surgery.   And if the injury is not too deep, then working the muscles and ligaments will help.  But with most heavy trauma, from car accident to falls, shoulder trouble is always bone trouble.

To understand this, we need to decide what the shoulder is.  In a sense, it does not exist. What we really have, is a boney girdle and an arm fitting into it.  What we call the shoulder is a series of joints and muscular connections.   The head of the arm fits into a semi-lunar joint in the scapula. The scapula fits into the acromion, the back part onto the ribs and spine.  

 To support the leverage of this structure, the only direct boney foundation is the scapula at the acromion process (where the clavicle comes into acromion bones.) Otherwise, the scapula does not connect to the rest of the structure but rather is torqued down by heavy muscles.  In fact these muscles of the upper arm and shoulder are so powerful   the most common type of break in the arm is produced by these muscles breaking the bones between them.

This lack of boney support is necessary for us to have such an impressive range of motion with our arm.  But because the arm is such a long lever, when the force or the angle is too extreme for the supporting  muscles (the deltoid, the triceps, the biceps et al) to handle, the bones take the load.  In a very real sense, the bones of the shoulder girdle get bent. It is a systemic bend within the connective tissue of the bone. (The connective tissue is 40% of the bones mass). Often with this kind of deep injury, the connective tissue nearest to the bone, the ligaments, also absorb heavy doses.  They actually get driven into the bend of the bone in a pattern which coincides with the angle of blow.

This bend in the bones is not limited to one joint. It can jump across numerous joints.  (For instance, the head of the humerus to the elbow) But it almost always involves the acromion process. This seems to be the foundation joint which other bones and ligaments leverage against.

But if you have a shoulder problem, what does this mean to you?  If the trauma you received was over a certain level of intensity, then the injury is in these bones.  To work the soft tissue will improve it only so far.  Again and again, and by this I don’t mean 5 times, but 100‘s of  times, I have treated people with shoulder problems going back years and found it buried in bent bones within the acromion process.  This is very much like a separation of the shoulder, but usually it does not actively separatate the shoulder but bends it so much it cannot function properly; particularly under stress.

So how does vascular bone therapy treat this?  We use percussors to work these patterns of bone bends and release the stored up energy embedding from one leverage point to another.  At the same time, we engage, mostly with intention, the artery within this pattern to allow a change to take place.  The artery is king in the body, and the body will not change if it thinks the vascular is threatened. 

So what is the patient’s experience of this? The first impression is one of improved  flexibility; which allows  the bones to fall into place with gentle stretching or non thrusting pressure. Usually, this is accompanied almost immediately by a sense of relief from discomfort.  If not, then there is more to do. Often, even difficult shoulders will improve greatly in several sessions.  Sometimes, the worst injuries take 4 or 5 sessions but the success rate is extremely high.   This technique will not work, of course, if there is a torn rotator cuff or a badly damaged labrum.  These problems require surgery.  But post surgery, Vascular Bone therapy can provide tremendous help is restoring the joint back to strength and mobility.