The client’s body in this case is compensating from the hips because of habitual patterns from his day-to-day. Shoulder pain was the symptom, but because of his complex structure, we have to consider correcting the issue starting from his hips.
The Problem
The client was complaining about shoulder pain specifically during pressing movements (bench press and shoulder press). The client is an OC sheriff, so work related factors such as gear used (belt and vest) and physical demand were considered.
The Assessment
First things: identify any direct tightness in the chest, shoulder and rotator cuff that would cause discomfort in his right shoulder. The table tests showed that his right arm could not internally rotate fully indicating tightness in the rotator cuff muscles in charge of external rotation. Considering the fascial sling, hip alignment is quickly checked and low and behold! His right foot (at the ankle) was elevated indicating a right side hip-hike. This is what is considered a complex pattern because it goes against the fascial sling concept. I communicated to the client that the long term solution would be to fix his posture from the ground up. First address the hip hike and then address the shoulder rotation.
The Solution
The client was very keen on the long term solution, so we started with addressing the hips. To allow the hip to relax, we need to mobilize his lateral line. In his case, this will be the right side lat down to his oblique along with associated hip (flexor) muscles that are pulling on his hip. Manual techniques such as ART, IASTM and dynamic cupping were used to address these.
I wanted to at least work on the shoulder a bit to get the client some relief for his main issue, his shoulder pain. PNF concepts combined with cups were used here to expedite shoulder mobility which was finished off with quick blade feathering.
Conclusion
Addressing shoulder pain is sometimes not so straightforward. If you do not consider the body as a system and correct it entirely, these types of shoulder pains will always come back to haunt you. We did achieve balanced hips for the OC Sheriff which was the first step in the long term solution to address his shoulder pain. His shoulder mobility was improved enough to get it into a great working range of motion to make the corrective exercises less painful and more efficient. It simply does not make sense if your body does not move correctly to do ANY corrective exercises. Corrective exercises included strengthening his core and hip flexors that were identified as weak as well as lengthening his right side lateral line and rib cage posture. The last part was to be more aware of work related posture and improve it when possible.
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