Case study ~one side of shoulder pain~




Oh...Shoulder pain....

Especially only Left side...

I'm afraid of my posture balance...



hi. I'm a physical therapist and fitness trainer, Ikuko Murata.


Today, I report my client, she has a left shoulder pain.


This report will be a little help for the person who is afraid of the posture imbalance, for example one side of shoulder pain.



<INDEX>

1、The cause of her left shoulder pain was the posture that left shoulder is higher than right shoulder


2、To release this shoulder pain, is the way "stretch"? or "massage"?


3、To release this shoulder pain, we have to correct the posture that left shoulder is higher than right shoulder


4、Let's search the reason why left shoulder is higher than right shoulder


5、We could reach the cause, so we will be able to solve her shoulder pain


1、The cause of her left shoulder pain was the posture that left shoulder is higher than right shoulder

Client picture↓

You can see easily her left shoulder is higher than right shoulder.


And it is a little bit difficult to see from picture, but left shoulder is forward than right shoulder.

(It means spine is right rotation)


It's easy to judge that left shoulder muscle has stiffness.


I checked her left shoulder muscle, and it was so tight. (Upper trapezius muscle : concentric contraction)


The reason of her left shoulder pain is

・Left shoulder is higher than right so that her left shoulder muscle have a stiffness.



2、To release this shoulder pain, is the way "stretch"? or "massage"?

How can we solve this problem?


Maybe major way is the "stretch".

And massage.



These are not mistakes.


This client's left shoulder muscle has got shorter and tight,


so stretch can extend the the short muscle,


and massage can release the tight.


The symptom would be better...


But it's temporary...




I want to tell you that these are just ad hoc solution,


and these can not have a persistent effect.



3、To release this shoulder pain, we have to correct the posture that left shoulder is higher than right shoulder

To release this shoulder pain, we have to correct the posture.


Even if symptomatic treatment can release the pain immediately,


but the pain will come back with a high probability


when her left shoulder return to higher position.



If you read this far, maybe you think...


"Oh...She should let down her left shoulder...!"



Yes, that it.


It's not a mistake.


That kind of exercise and consciousness is important...


BUT...


There is a more important point.


More important point is finding out the reason


"Why her left shoulder is so higher and so forward????"


Without finding out the reason,


Left shoulder let go down exercise can not help to correct the posture.


Without delate the cause of the problem,


she can not escape from a shoulder pain.



Left shoulder let go down exercise is important, and of cause I thought it to this client,


but I think the exercise will become just a symptomatic treatment if we don't delete the cause .



4、Let's search the reason why left shoulder is higher than right shoulder.

So we searched the cause of problem.


First, I checked the shape of bone.


She had a difference of leg length.


Left leg was shorter than right.


But it was a little difference only and it was unlikely to effect to the shoulder.

(But it affected to low back and knee pain, I will upload another report later here)


The difference of leg length is not a direct reason for her left shoulder pain.


There should be another reason.


But other bone shape didn't have a problem.


It means the cause is a life style.


So I questioned about her life style...


How about the sport from childhood? → Noting, I was busy for help housework...


How about the bag? → Every time bag is light, and I don't walk a lot with bag because I use a car.


How about the sitting habit? → I don't have special difference right and left.


How about the hobby? → I watch a Korea TV drama in lying position.


How about the lying habit? → I don't have special difference right and left.


How about the standing habit? → I stand equal weight to right and let foot.


・・・so on。


I questioned a lot, but we couldn't hit.


she said


"I have no idea. I don't have such a habit raising my left shoulder..."


Finally I questioned about her working posture.


Her job is a nurse.


I've heard it, so that I questioned this last because I didn't grasp that the nurse have so strong right and left difference habit.


Her works only in Endoscope room for 20 years.


She continues this posture(↓) in endoscope room every time when she works.

Left shoulder is so so so higher than right shoulder...8->


・Display is in diagonally right, so she rotates to right every time.

→Left shoulder go up and forward


・She hands over a camera tube to Dr. by left hand, and right hand control a remote controller.

 →Additionally left shoulder go up more and more...


When she let me see this posture,


she noticed this habit is the cause of her problem by her self,


and she laughed because she said she don't have idea why her left shoulder is so high.



It's enough to fix this posture by 20 years of working.


I judged there is no contradiction in this inference.



5、We could reach the reason, so we will be able to solve her shoulder pain

The cause was her working posture.


It already in the bag.


You know already the solution, aren't you?


Massage?


Stretching?


The exercise left shoulder go down?




No, more more more important point is "How she manage her posture when she work".


She have to take measures.


So we considered together about the solution.


・For the display is in diagonally right so that her left shoulder is higher and forward 

→ Turn to the display from feet and pelvis, not only from the upper body.

 → Solved :)


・For she hands over the camera tube so that her left shoulder go up

 → How about hand over by right hand? → impossible :(

 → How about turn the direction of the bed? → impossible :(

 → How about move the equipment opposite side? → impossible :(

 →・・・How about quit the job?→ impossible 8->


We considered a lot, but we couldn't reach a solution.


In this kind of case, the important thing is to understand


"My left shoulder goes up when I work"


"My left shoulder pain will get worse after working without conditioning exercise".


First step is to understand by head.


Second step is to do the exercise after work.




So I thought the exercise to this client.

(Upper to middle thoracic spine left bend & left rotation exercise)


I wonder if she is doing exercise at this time.


I really hope her shoulder pain get better :)




※This client's session plan : on-line group session ever week and private session every three months.

※I don't deny about the massage, I think if we solve the cause of problem, the massage effect will become twice or more!


Summary

Daily life habit form your body steadily like this client.


If you have a one side of shoulder pain, you have a right & left difference around the upper body certainly.


Let's check the shoulder height by mirror or camera.


If you have a difference, I recommend to look back about your life.


(Of cause, There is a possibility the cause is in bone shape not in a habit. About a bone shape you have to ask to expert.)



I hope this article will be a good help for your wellness :)

Thank you for reading :)




Private session @Tokyo

https://www.yamatonadeshiko.net/assessment


On-line session @ZOOM

https://www.yamatonadeshiko.net/online-lessen


Group session @Tokyo

https://www.yamatonadeshiko.net/group-lessen

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