Shoulder impingement surgery is a popular procedure that has been done for years. According to a trial of more than 300 patients, published in The Lancet that the procedure is not effective at relieving shoulder pain. In the U.K., 21,000 of these procedures are done yearly as reported by The Telegraph News in the U.K.
The sub acromial decompression procedure was thought to relieve the pressure and rubbing on the supraspinatus tendon that may be compressed by bone and soft tissue as it inserts into the shoulder. According to David Beard, a physiotherapist in the U.K., and researcher in evidence-based medicine with the University of Oxford in Oxford, U.K.
According to NPR, “in an arthroscopic surgical procedure known as subacromial decompression, surgeons insert an instrument through a small hole in the shoulder to remove some of the bone and soft tissue. The idea, Beard says, is to reduce stress and open up the space — “theoretically relieving the pain.””
The problem is many shoulder problems are postural based. Unless you look at the body and understand why there is impingement you will never solve the problem. Impingement is a postural problem, often involving the feet, pelvis and the shoulder. In other words, your shoulder pain is being caused by other parts of the body acting on your shoulder, which is why more traditional medical approaches such as this surgery are ineffective.
According to the book, Cheating Mother Nature, what you need to know to beat chronic pain, in order to understand why we hurt, we must look at structure from an engineers point of view. Brian Rothbart D.P.M. in the 1990’s offered an explanation based on engineering principals called Bio implosion.
The idea is that people who have low arches or flat feet that fall in, will cause the compensation of the body and shoulders leaning forward. This can also be caused by high arches in people where the feet turn out. The fascial system that controls movement and acts like an exoskeleton will reinforce these postures and pull the shoulders forward. When the shoulders lean forward, they will cause impingement, as well as restricted mobility. Perhaps, this is why only certain people develop impingement which can lead to tears of the supraspinatus muscle the most common painful shoulder problem.
While the recent NPR article on this discussed the condition, it is apparent from their discussion with Dr. Richard Baron, president of the American Board of Internal Medicine Foundation, that medically, they may be missing the point on shoulder impingement due to reductionist thinking, meaning they are looking at the part, rather than the person attached to the part.
Chiropractic sport physicians are more holistic in their approach and may be a better source of how to effectively treat most shoulder problems. From impingement, to frozen shoulder to chronic shoulder pain and dysfunction, most shoulder problems involve the body and posture. If you have ever watched anyone lift or grab something, they are using more than the shoulder joint; they are using the legs, their back, their mid section and their core. If the core is distorted, it will pull the shoulder forward and can create shoulder pain. We inherit our body style which can predispose us mechanically to shoulder pain. Perhaps, doctors should consider sending these patients to chiropractors first.
The theory behind treating the area of pain (the shoulder in this example), while ignoring the body itself as a causative factor is reductionist folly. With so many medical specialties relooking at themselves through the recent choosing wisely campaigns, perhaps, they need to reexamine how they examine and question the idea of limiting evaluations to the painful part, which is standard practice in most orthopedic offices. Painful part evaluation is part of our medical culture and needs to become more holistic in their evaluation and treatment methods, looking more at function, rather than where it hurts. Perhaps, this is why most orthopedic surgeons cannot understand why the procedure has failed to relieve the problem; they simply are ignoring the rest of the body.
Here are 3 things you can do now that can improve shoulder function and chronic shoulder pain.
- See your local sports chiropractor. Manipulation to the pelvis, and soft tissue manipulation can greatly improve shoulder function. Look for doctors who perform myofascial release, instrument assisted soft tissue treatment and give exercises to improve core function, stability and shoulder mobility.
- Do exercises to improve shoulder posture including capsule stretches as well as superman’s, bird dogs, planks and other postural enhancing exercises.
- Wear a foot orthotic to level the hips and improve foot posture and do foot drills to improve foot posture which will improve core function.
Read Cheating Mother Nature, available through Amazon.com and other booksellers.