Structural Integration for Shoulder Pain: A Myofascial Approach

I have times where I can’t move my arms due to my shoulder pain. I carefully alter my movements to not hurt my shoulder. I often can’t reach overhead. Why do I have shoulder pain?

Many people have shoulder pain for one reason or another: I hurt my shoulder too long ago; It just gave out doing something; It can’t change. These statements belie the situation, and give a deterministic view to movement. There is a path towards change and pain free movement. At Somatic Healing & Alignment, we offer a style of bodywork that alters postural alignment, often provides long term change, and catalyzes a journey towards pain free movement. The style of bodywork mentioned is Structural Integration, and specifically the Anatomy Trains Structural Integration, or otherwise known as the ATSI approach - link to other blog.

Why Shoulder Pain Is Often Not Just a Shoulder Problem

There are many aspects of the shoulder that can cause pain and discomfort. The Anatomy Trains Structural Integration (ATSI) view of the body lays an easy foundation to understand how dysfunction can occur within a dynamic system- link. As the name suggests, ATSI maps out longitudinal lines of direct tensional transmission. These direct lines of transmission fall into two general categories when addressing shoulder pain.

•  Specifically Shoulder Focused

Or

•  Support for the Shoulder.

  
  

There are Four Arm Lines that Deal Specifically with the Shoulder

• The Superficial Front Arm Line 

• The Superficial Back Arm Line 

• The Deep Front Arm Line

• The Deep Back Arm Line.

The roots of these lines are addressed throughout the whole 12 series offered at Somatic Healing & Alignment at the Lakeville or Edina, Minnesota locations.

The Myofascial Support from Underneath

The four arm lines provide only part of the picture for altering shoulder pain. Another crucial element for pain free shoulders is the supporting rib cage. For the ribcage to provide optimal support to the shoulders, all other Anatomy Trains lines need to be addressed. - link deep front line.

• The superficial front line

• The superficial back line

• The lateral line

• The spiral line

• The deep front line

The 12 series offered at Somatic Healing & Alignment will provide the necessary release and balance by utilizing myofascial techniques and movement to bring support to your shoulder.

A Structural Integration Client Example

The following example is not based on any one person. Jane came into the Somatic Healing & Alignment Practice in Edina. She expressed difficulty getting her shoulders to calm down. They were always dull-tense, mostly in coat hanger shape, behind the “angel wings”, and often nervy into the neck. These were the only descriptors she could think of at the time. 

A general goal of the series for Jane is to alter the alignment from toe to head that culminates in better support for the shoulder that allows for the levator scapula to only be used for the shoulder, and not to support the head. The levator scapula is commonly used to stabilize both the head and the shoulder, aka a forward head position. The levator scapula is only supposed to elevate the scapula/stabilize the scapula, and not hold the heavy head on top of the body.

A short way to remember why forward head generates shoulder pain is that the appendicular myofascia, levator scapula, holds up axial structures, the spine and head, while also stabilizing the appendicular shoulder girdle. This leads to those trigger points, pain, and knots. To reduce that tension, the appendicular myofascia needs to stop stabilizing axial structures, and have the axial myofascia stabilize axial structures. That means having the axial myofascia, semispinalis and splenius capitis, stabilize axial structures, the neck and head, while the appendicular myofascia, levator scapula, only stabilizes the appendicular structures, the scapula. The 12 series provides the necessary postural change to alleviate appendicular axial stabilization, and therefore after completion of the 12 series, Jane will have a new deep front line (core) of support for the shoulders to sit on top, as well as alleviation of shoulder pain.

Why the 12-Series Works for Chronic Shoulder Pain

The 12 series offered at Somatic Healing & Alignment is designed to balance, and resolve patterns held anywhere in the body. A common term that is thrown around is “forward shoulder”, and unfortunately the terminology paints a poor picture of how to address it. The phrase “forward shoulder” does not include in its description how the ribcage and spine are not supporting the shoulder girdle the way they should. If there are spinal extension, flexion, rotations, bends, and tilt patterns that deviate from neutral, these affect ribcage position, and therefore reduce support for the shoulders. These deviations are addressed within the 12 series to bring them back to a supportive neutral position. When the support underneath is not there, compensations arise within the shoulder complex and pain sets in. Some common areas of pain that will be addressed are but not limited to:

• Constant Pain in Front or Back of the Shoulder

• Pain from Movement in Certain Directions

• Restricted Movement Leading to Pain

• Occasional Pain or Discomfort Around the Shoulder

• Headaches from Shoulder Tension aka “Coat Hanger Pain”

The 12 series provides work from head to toe multiple times, addressing the superficial and deep aspects of myofascial (fascial) tension, allowing for a new support system within the body to arise, and create a path out of pain.

Key Takeaways: Structural Integration and Pain-Free Movement

Anatomy Trains Structural Integration works within a series of sessions that addresses the whole body along each of the myofascial lines. Each session builds upon the previous session in a non-linear manner. The final product upon completion of the whole series culminates into something that is greater than any individual session, otherwise known as gestalt. The series based bodywork done within structural integration provides an opportunity for lasting postural change, better movement support, and alleviation of maladaptive tension that develops pain patterns over time.