When Is Shoulder Pain Not Shoulder Pain?

When it's part of a bigger movement pattern!

The reason why pain can linger, despite ALL the treatments, is when that part of the body that's hurting ISN'T the root source of the pain.

Humans don't use just 1 muscle at a time and we rarely move only 1 joint in isolation. We use our whole body to create fully integrated movement patterns.

Three of those full body movement patterns are the stress reflexes - Green Light, Red Light and Side Trauma reflex.

It was one of these stress reflexes that held the key to quickly relieving my sudden shoulder pain and a stiff neck without needing treatment. 

Read on to see how I resolved pain on the inside of my right shoulder blade and a stiff neck in 20 mins, without doing any specific stretches for my shoulder, neck or upper back. 

** The answer lies in the anatomy of the muscles around the shoulder and how they connect to the pelvis - I bet one of those muscles will surprise you! **

So what happened to me?

I woke up on Saturday morning feeling fine, but when I got out of the car to teach my second class I noticed a sudden, quite sharp pain on the inside of my right shoulder blade.

I hadn't done anything specific to aggravate that shoulder. In fact my first class was an indoor cycling class.

The pain wasn't any worse after teaching BodyPump (a weights class) and BodyBalance, but it was still nagging underneath the shoulder blade in the background.

As the afternoon progressed I felt my neck getting stiffer as my neck and upper shoulders began to tense up.

It's quite common to feel tension, tightness or stiffness in the shoulders, upper back and neck, especially if you work at a desk, use a computer, do a few hours of gardening or DIY, or go for a long drive. 

The usual advice would be to stretch the neck, shoulder and upper back muscles, foam roll, get a massage, rub in some painkilling cream, or take Ibuprofen, maybe Paracetamol.

What did I do to relieve the shoulder blade pain and ease my stiff neck in just 20 minutes, without stretching, massage, foam rolling or taking painkillers?

Before I answer that, let's dive into some simple musculoskeletal shoulder anatomy

The muscles directly associated with the shoulder blades, upper back and neck are the trapezius, rhomboids and rear (posterior) deltoids. You might assume that to relieve pain in this part of the body you would stretch, release or massage these 3x muscles.

But have a look at these images and there are some muscles that you may not automatically associate with the shoulder, neck and back:

Posterior (Back) of the body:

In the first image have look at the 2x muscles highlighted - Iliocostalis and Longissimus. They're two of the muscles forming the spinal extensor muscle group in the back of your body. as suggested by their name, these muscles create spinal extension. 

But you can see from the image that Iliocostalis and Longissimus attach from the back of the cranium (skull), all the way down the thoracic and lumbar vertebrae onto the back of the pelvis and base of the spine. They also attach to the back of the ribs and run underneath the shoulder blades - HELLO!!!!

From the second image you can also see Quadratus lumborum (QL) sits underneath Iliocostalis and Longissimus. QL is a deep muscle, whereas the spinal extensors are more superficial. QL acts a spine stabiliser when carrying load on 1 side of the body, for example, holding a bag in 1 hand. QL also creates lateral flexion or side bending of the spine when 1 side contracts and shortens. 

Anterior (Front) of the Body:

Check out how close the relationship between serratus anterior and the external obliques are in these two images.

Serratus anterior and the external obliques virtually merge to become one super muscle.

From these images of the posterior and anterior musculoskeletal anatomy can you now see how a pain underneath the shoulder blade and a stiff neck may NOT be originating from the muscles in this area - typically trapezius, rhomboids and rear deltoids?

Would you think that the external obliques could be involved in shoulder pain?

How Did I Resolve My Shoulder Pain and Stiff Neck in 20 mins?

Now with that anatomical information here's what I did, step by step to relieve my shoulder pain and stiff neck:

• I asked my body where the problem really was - no, really! 

Your body has the answers if we listen intently, without judging or labelling. So often we rely on our cognitive brain to analyse, rather than feeling. We all have a sense called interoception -  the ability to notice, recognise and respond to the physical and emotional states of your body. There's constant communication and signals from all your internal organs and body parts so you can regulate your internal environment and stay healthy.

Interoception is more intuitive than cognitive. It requires feeling, rather than thinking. 

When I asked my body where the problem really was, I got a sense that it wasn't my shoulder driving this particular pain, but my pelvis and hips being stuck and unresponsive, and my side waist muscles (obliques) not relaxing fully.

Yep, those pesky external obliques! Also, in my case probably a grumpy right QL muscle too.

• I did a short 20 mins somatic practice involving 3x movement explorations - Spinal Undulations (Arch and Flatten), Side Bends on both sides and Washrag.

The first 2x explorations take the body in and, most importantly, out of the 3x stress reflexes (Green Light, Red Light, Side Trauma Reflex), and then the Washrag integrates the upper and lower body.

As suspected, playing with Side Bends released my body from the Side Trauma reflex, and I could feel the tension melting from my waist muscles, my pelvis getting unstuck and then my upper body relaxing. 

When I stood up and walked around that sharp pain under my right shoulder blade had almost gone away and my head was moving more freely. By the time I went to bed all the pain had gone.

Summary

In this instance my sudden right shoulder blade pain came from my body suddenly going into and then getting stuck in a Side Trauma reflex.

This reflex is a protective reflex. One side of the body shortens and contracts in a guarding or bracing action. 

An example of a Side Trauma reflex would be if someone tickled your ribs and you weren't expecting it. 

Releasing the Side Trauma reflex stopped my pelvis and ribs from pulling on the shoulder blade and allowed the muscles to relax, easing the pain at source.

Next steps for me are to release tension from that grumpy right QL muscle, which I can feel more clearly now the distracting shoulder pain has gone. The plan is to pandiculate the muscle ie. go into the tension lightly and then come all the way out, followed by a routine osteopath check up. 

Our bodies will always go into these stress reflexes. They're a natural protective mechanism. We just don't want to stay there too long.

Recognising when you've gone into a stress reflex or got stuck there, and being able to come out of it will help you to relieve those odd pains that don't seem to have come from any particular activity or injury without immediately having to reach for the painkillers.

The BYB Method helps you to decode your pain so you don't get sucked into the obvious but potentially misleading. It's a skill that does take time and practice, but I believe that everyone can learn how with the right guidance.

NEXT STEPS

I'm planning a new 6 week intensive, small group course where you'll learn how to recognise patterns of tension and pain in your body, and, most importantly, simple exercises to release them. Please reply to this email if you'd like to be added to the early bird interest list.

• Come to a Stretch, Yoga or Pilates class with me - become a student of your body to begin the process of self healing
• Book into the "Moving Away From Pain With The BYB Method", a 2 hour workshop showing you how to reduce chronic pain and release muscle tension using somatic movements and pandiculation techniques so you can move with ease and joy again. Sunday 3rd September, 1pm to 3pm (fully booked).
• Attend a half-day mind-body retreat - these are deeply relaxing, fun, social small group experiences typically held in various locations within easy reach of Worthing, West Sussex. The next one is on Sunday 3rd December,
• Subscribe HERE to receive "The Movement Chronicle", a weekly e-newsletter delivering mobility and pain reduction tips directly into your inbox every Monday morning,

To find out more about my classes and retreats, or to join my email list you can contact me via any of these channels:

• Email at norma.pearson1@ntlworld.com
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• WhatsApp message to 07801 867361.