Shoulder Pain Treatment in Anchorage, AK

Shoulder Pain Treatment Directory

What causes shoulder pain?
What causes chronic shoulder pain?
How do you prevent shoulder pain?
How are shoulder injuries treated?

How Does Fascial Counterstrain Therapy Resolve Painful Shoulder Conditions?
What Does “Rotator Cuff Injury” Mean?
What Causes Shoulder Impingement & Shoulder Bursitis?
What is frozen shoulder?

What causes shoulder pain?

Studies show that shoulder pain is the 3^rd most common cause of doctor visits for people with muscular and skeletal problems ^[1]. The truth is that shoulder pain can be caused by many different things, from the simpler causes like muscle tightness, through to more painful or serious medical conditions. Your shoulder isn’t a single joint, instead it’s a complex area comprised of multiple bones, tendons, muscles, ligaments, and more that all come together to form a region of the body called the “shoulder complex”. The reasons why shoulder pain can be caused by so many things are because:

The health and function of the shoulder is dependent upon many parts of the body, not just the shoulder
The shoulder is one of the most flexible joints in your body. This joint flexibility comes at the expense of joint stability, making it more prone to injury.

Some of the conditions and issues that can cause shoulder pain include:

Rotator cuff injury (around 2/3 of shoulder pain cases are caused by this), frozen shoulder, impingement and shoulder bursitis
Overuse of the shoulder can lead to injury and damage to parts of it, these include:
- Broken and fractured bones or dislocated joints
- Worn, torn, or inflamed shoulder tissue like:
  - joint cartilage – rubber-like lining that protects and covers the ends of your bones
  - bursae – are thin, generally small fluid-filled sacs that reduce rubbing friction around joints
  - tendons – are the end sections of a muscle which usually attach onto a bone
  - muscles
  - ligaments – are strong structures that link between bones in order to stabilize their motion
Muscle pain and tightness from the shoulder and back
When someone is hypermobile their joints can be relatively loose, this leaves them more prone to joint damage
Ribcage tightness can cause shoulder pain – this has several causes
Degenerative conditions (like arthritis) can deteriorate joint cartilage, bone and tendons
Referred pain: where the source of the pain is not where you feel the pain. Back and neck conditions can cause nerve irritation that can refer pain into the shoulder. In fact, even issues in organs, like the gallbladder and heart, can refer pain into your shoulder area.

Fascia injury and dysfunction – the most common, yet least known cause of shoulder pain!

There is one thing that unites all of these causes of shoulder pain: that is, the presence and role of fascia in your body. Fascia is central to your ability to sense pain. This is because most nerve endings that transmit pain are housed in your body’s fascia, so the pain that you feel from any injury, condition or disease is actually coming from the fascia of that affected tissue.

Fascia coats all of our anatomy from head to toe; it interconnects across all parts of the body (skin through to the center of our bones). Fascia is effectively a key part of your body’s ability to sense and protect itself, and responds with pain, spasm, and inflammation when a particular area is threatened or harmed.

Fascia interconnects across and pervades through all parts of the body and coats all of our anatomy from head to toe (skin through to the center of our bones, including nerves, veins, arteries, muscles, discs, and more). Fascia plays a key role in your body’s ability to sense and protect itself. It responds with pain, spasm, and inflammation when a particular area is threatened or damaged.

Fascia plays a central role in protecting and healing the body from injury. Fascia is responsible for sending the “all clear, good to go!” message to your body after injury. Until this message is sent by the fascia, your body prevents the muscles and fascia that guard the injury from releasing. This is in part achieved by the “pain-spasm-pain” cycle. This is where pain causes both a protective spasm in your muscles and fascia and produces inflammation – which itself can lead to yet more pain. This creates a self-re-enforcing protective mechanism that produces inflammation, spasm and pain until your injury or condition has fully healed.

This mechanism becomes dysfunctional when inflammation gets “stuck” in the injured fascia – this fascia dysfunction prevents the “all clear” signal from being given to the body. This then creates long-term fascia dysfunction that lasts for years.

This ability that fascia has to hijack muscles into protectively tightening for the long-term can’t be consciously overridden, thus your body will naturally use shoulder, torso, and neck muscles differently in daily activities to avoid stressing your injured fascia. These muscle-use changes can cause pain and increased force in your joints which, with time or overuse, can frequently lead to many common shoulder conditions (e.g., rotator cuff injury) – without the need for a traumatic injury-causing event.

It turns out that fascia dysfunction isn’t just caused by injury, it can also be caused by surgery, postural issues, overuse, infection, or can even be secondary to an inflammatory diet. In fact, fascia dysfunction is so common that it is the most common reason why many shoulder conditions become chronic; it is very often a major reason why you developed a shoulder condition in the first place.

A wide variety of fascia dysfunctions (e.g., fascia dysfunction of a vein, artery, nerve, bone, cartilage, and more) can cause and contribute to a specific shoulder condition. Normally it takes multiple fascia dysfunctions to cause a painful shoulder condition to develop. In fact, a fairly common area of fascia dysfunction that can cause shoulder pain is the fascia that surrounds the lungs and ribcage!

While fascia’s full role in injury and pain is becoming more widely known, many in the medical and therapeutic fields are still unaware of its significance or how to specifically address it when dysfunctional.

If you want know if fascia is causing your pain and how you might find and fix this, contact us for an assessment.

What causes chronic shoulder pain?

Studies show that about half of people who saw a doctor weren’t able to fully resolve their shoulder pain after 18 months ^[2]. While different body tissues heal at different rates, when you look at normal healing times, even the slowest-healing tissue (cartilage and ligaments) take between 6-12 months to heal – not 18 months or more. There are long-term shoulder conditions like arthritis and frozen shoulder [link] that either can’t fully heal on their own or whose recovery times are long; however, these conditions do not account for the vast majority of reoccurring and chronic shoulder pain cases. So why are we still seeing large numbers of people suffer with long-term shoulder pain?

There are those whom, for a number of reasons, just live with a condition. However, for those who have not been helped by standard therapies, but want to resolve their condition it can be hard for them to know if their condition can’t be helped or is just hard to help. Even when people have been told by a medical professional that their shoulder issue can’t be fixed, we at Body Systems are actually able to help a sizable number of these patients who come to us. We can do this because we can treat causes of shoulder pain that don’t show up on X-ray or MRI scan. It turns out that one of the most prevalent causes of chronic shoulder pain is problems in your fascia, which normally can’t be imaged by CT, MRI or X-Ray machines.

The last few decades of fascia research have explored the role of fascia in pain, injury and inflammation. It appears that when inflammation gets “stuck” in injured, damaged, or dysfunctional fascia, a faulty long-term self-re-enforcing “pain-spasm-pain” cycle develops [link to section above]. This creates a very common problem called a “Fascia Dysfunction”, which is at the heart of many chronic shoulder conditions. Fascia dysfunction effectively prevents the “all clear” message from being sent by the fascia to the rest of the body, thus certain symptoms from your condition, disease and injury can become chronic.

Fascia that becomes dysfunctional prevents the pain, inflammation and fascia spasm associated with an injury from fully resolving. When present, fascia dysfunction 1) restricts circulation which slows down healing times, 2) stops muscles firing properly, creating uneven stress across joints – which with time and overuse causes wear and tear of joints resulting in the development of many of the most common shoulder conditions, 3) increases pain with inflammation sensitizing the nerve endings, and 4) prevents the pain and condition from resolving.

It turns out that fascia dysfunction can occur in any type of bodily structure in any type of tissue including nerve, muscle, vein, cartilage, and many more. So in order to help chronic shoulder conditions you are likely going to need to be able to address fascia dysfunction anywhere in any type of tissue.

When you understand that fascia injury and dysfunction can underly many conditions that cause chronic shoulder pain, you might be interested to seek out a fascia-focused treatment. Fascial Counterstrain therapy is one of only a very small number of treatments that can identify, find, and treat all the different types of fascia in the body (whether that is fascia of a bone, artery, vein, lymphatic vessel, nerve, disc, cartilage, dura, ligament, organs, and muscle), anywhere in the body.

Contact us if you want to find out more about how helping the fascia of your shoulder, spine, and ribcage can help you recover from the root causes of your chronic shoulder pain.

How do you prevent shoulder pain?

We usually cope with some amount of pain, but once a certain threshold is met, you might initially consider how you can help yourself. You can help prevent shoulder pain from starting or prevent flare-ups by doing things like:

Avoiding lifting or reaching for things above your head – try and use a step stool or ladder.
Counteract rounded, forward shoulder posture by changing damaging daily habits. For example, when using your smartphone, prop your arms and hands on something closer to eye height as often as you can.
If you have lots of screen time, ensure that you take mini-stretch-breaks and have good posture:
- When seated, ensure arm rests are at the right height. If they are too high or low, they can cause shoulder and neck pain.
- The spine can refer pain into the shoulder, so to reduce stress through it.
  - When seated have your hips at the same level of or just slightly above your knees a
  - Sit with your shoulders squarely above your hips.
  - Make sure you don’t unconsciously lean in to read on a screen (this might also indicate you need a vision checkup).
Restore muscle balance – common exercises tend to focus on the front of the body, try training the muscles in the back of the shoulder more e.g., reverse fly exercise, or rows.

If you depend on your shoulders being in strong working order for your work and daily life, you might want to get your shoulders checked out to keep them close to 100% “up and running”. Our bodies handle and work on a lot of problems before they start “telling” us about issues through pain. Therefore, waiting until you feel pain (or worse pain) means that you will need to spend more time fixing the issue.

In fact, if you play sports or enjoy active hobbies, you might have experienced having to pull back on the intensity or length of an activity, or gone through downtime after a shoulder injury. It turns out that treating fascia dysfunction can be the key not only to reducing the number of times you are injured and the down time injury takes, but also improves your performance by removing hidden dysfunction that can reduce strength, speed, and flexibility.

Fascial Counterstrain therapy is one of only a small number of treatments that can actually identify fascia dysfunction and correct it before it can develop into a painful shoulder condition. Correcting fascia dysfunction in the body then allows you to access more strength and more flexibility. Combine this with a healthy amount of exercise and you have a recipe that can optimize performance while keeping your shoulder strong and healthy in the long run.

Contact us if you want to find out how Fascial Counterstrain therapy can prevent injury and improve shoulder health and strength.

How are shoulder injuries treated?

When avoiding the risks of drugs or surgery, most people will usually first try physical therapy, massage therapy, rest, painkillers. A good number of people are helped by these, but when these therapies don’t work, lots of people feel forced into choosing between drugs, surgery, or coping with shoulder pain and the limitations it causes.

Even though many shoulder treatments can work, a common reason why these treatments don’t work is because they to target only specific parts of the body, such as muscles, ligaments or bones. However, the shoulder is a complex structure that is composed of a lot more than that (nerves, veins, arteries, cartilage, lymphatics, etc.). Therefore, a good therapy is one with the ability to treat all of the different parts that make up the shoulder, as well as other areas of the body that connect into your shoulder (such as the ribs and lungs).

As we have already explained above, fascia and inflammation have a central role in both causing and prolonging shoulder conditions. There is a way in which spasming fascia and “stuck” inflammation can cause a faulty “pain-spasm-pain” cycle which creates a fascia dysfunction. This fascia dysfunction can perpetuate many painful shoulder conditions for months or years as it prevents the body from fully completing the healing process. This faulty “pain-spasm-pain” cycle is a very frequent “feature” of the body, and, consequently, is often behind many people’s shoulder pain.

This means that the ability to unlock fascia dysfunction in all parts of the body in all types of fascia is key to helping many painful shoulder conditions. This essential ability is present in a very small number of therapies – Fascial Counterstrain therapy is one of these.

How Does Fascial Counterstrain Therapy Resolve Painful Shoulder Conditions?

Fascial Counterstrain is able to fix fascia dysfunction by correctly unlocking the faulty pain-spasm-pain cycle in fascia. This helps the body to resolve many of the conditions that cause shoulder pain. Fascial Counterstrain therapy is actually able to find and appropriately treat fascia pain, spasm, and inflammation in any type of fascia (nerve, arterial, vein, and more) in any part of the body (shoulder, neck, ribcage, etc.) – which allows it to resolve many of the hard to find causes of shoulder pain.

Fascial Counterstrain therapy is designed to relieve pain by releasing of the associated “stuck” inflammation and spasm, which provides long-lasting pain relief. This allows the body to relax and return back to a more properly-functioning, “factory settings,” painless state.

The way Fascial Counterstrain therapy works is that it releases your body’s fascial tissue using precise and gentle positioning that is guided by the presence of specific painful Tender Points.

Tender Points are small diagnostic points that, when painful, indicate the presence of a fascia spasm in a certain fascia tissue in a specific part of the body. Tender Points are similar to Trigger Points, but unlike Trigger Points that are located only in muscles, Tender Points can be located anywhere across the body.

This simple solution can have profound effects for anybody with a condition or injury, even those with complex physical problems.

The three main benefits of Fascial Counterstrain Therapy:

1) Pain reduction and elimination as “stuck” inflammation is effectively released.

2) Reduce wear and tear across joints by resolving improper joint stresses by releasing fascia spasm

3) Slow down, stop and even sometimes reverse degeneration of affected tissue by improving circulation of blood and lymphatic fluid (lymphatic fluid is key to your immune system and helps the healing process).

All of these together give your body the healing and recovery tools to achieve optimal long-term healing and health.

Contact us to find out more about how Fascial Counterstrain therapy works and how it can help rid you of your chronic shoulder pain.

What Does “Rotator Cuff Injury” Mean?

The most common shoulder pain injury is a rotator cuff injury. When injured, the rotator cuff can be inflamed, damaged, degenerated, or torn, all of which can cause shoulder pain and stiffness. Typical treatment might involve rest, ice, physical therapy, and massage therapy. If the injury is severe enough, surgery might be recommended.

Rotator cuff injury involves damage, inflammation, and dysfunction to a subset of four shoulder muscles and tendons: the subscapularis, infraspinatus, teres minor, and supraspinatus muscles. These rotator cuff muscles and their tendons surround the shoulder capsule and primarily stabilize and move the shoulder. Rotator cuff injury is typically caused by overuse, and is often thought of as a “wear and tear” injury, but it can also occur with trauma.

However, as we described above, these typical treatments may not tackle the underlying causes of the condition or why an injury continues to remain in pain. This is because typical treatments do not always directly address important problems in the fascia.

Because of this, people suffering from chronic shoulder pain from a rotator cuff injury might feel like they have only three options left to them if other treatment has not helped: surgery, coping, or taking pain killers long term (like opioids that have serious health risks). However, these are not necessarily the only other options, thanks to the growing medical research on the role and treatment of fascia.

When fascia has “stuck inflammation,” it can get permanently locked into a faulty “pain-spasm-pain” cycle that prevents the body from fully healing as it otherwise should (read above section for more info). This issue is called a fascia dysfunction and it turns out that this is a very common cause of rotator cuff injury. This faulty, stuck inflammation creates long-term tightness and muscle compensation patterns that can contribute to the irritation and damage of the rotator cuff. This means that a problem in the fascia can actually be the origin of a rotator cuff injury. In fact, there are multiple areas of the shoulder, neck, and ribcage fascia that, when injured and dysfunctional, can cause pain, irritation and muscle imbalance across the shoulder. This leads to the shoulder being more susceptible to overuse and injury. Thus, very often several types of fascia in the shoulder, ribcage, and neck (including fascia of veins, arteries, nerves, bones, muscles, and more) may need to be addressed in order to fully resolve the symptoms and underlying causes of rotator cuff injury.

Given that a rotator cuff injury can need several parts of the body’s fascia to help fully resolve the injury, you will likely need an approach that can treat all types of fascia, wherever they may be in the body. Fascial Counterstrain therapy is one of a very small number of treatments that has the capability to find and treat problematic fascia of all different types, across the whole of the body. For the many people suffering from a rotator cuff injury, this almost unique therapy provides a very effective way to help heal a rotator cuff injury.

Call us if you want to find out how Fascial Counterstrain therapy can help your rotator cuff injury

What causes Shoulder Impingement and Shoulder Bursitis

Shoulder bursitis is inflammation of one or more of the bursae that are in and around the shoulder. Bursitis can sometimes cause pain (particularly with motion), swelling, redness, or warmth. Your bursae (plural of bursa) are thin, generally small fluid-filled sacks. Bursae cushion and protect parts of the body by reducing friction and rubbing across your joints – similar to how oil lubricates a squeaky door hinge. While shoulder bursitis can be related to certain activities (like painting, swimming – anything that lifts the arms a lot), it often develops because of the presence of other conditions like impingement.

Impingement is where the space between the boney top of the shoulder (acromion), the tendons, and the bursa under the acromion can become pinched (see impingement diagram). This pinching can come about in two ways: 1) the bursa, tendons or soft tissues are swollen, reducing the space underneath the acromion available for them, or 2) the space for them is reduced by the acromion pinching down into them due to other shoulder conditions.

More often than not, it is the presence of another shoulder condition that causes impingement and bursitis to develop. There are several conditions that lead to these: rotator cuff injury, trauma, degeneration and inflammation of joints and muscle tendons, calcium deposits, and more ^[4]. Thus, if you want to resolve bursitis, very often you need to address the underlying condition(s) that caused the impingement in the first place. Treatment for bursitis and these conditions often involves rest, ice, physical therapy and sometimes massage. For more severe conditions, surgery may be required.

There is a significant number of people for whom the normal treatment hasn’t worked. In these cases, people often need to choose between surgery or coping with their condition. Fortunately, there are other treatment options available (depending on your condition), but knowing which is right for you can be problematic. A very effective treatment that can help you is a fascia-based treatment.

When you have some understanding of what fascia is and how dysfunctional fascia very often causes conditions that lead to impingement and bursitis, you can appreciate that to resolve impingement you need to address the fascia. This is described in detail in the section above. Essentially, you need to get the fascia to send the “all clear” signal to the body to allow the body to stop the pain by resolving the “stuck” inflammation and fascia spasm. This allows the stresses that cause the impingement to be removed and helps your condition to heal. Therefore, finding the right fascia treatment is important.

Fortunately, the choice is made even more simple if you filter out therapies that can’t treat all the types of fascia (read section above to see why having this ability can be fundamental to fully resolving shoulder pain). Fascial Counterstrain is one of only a very small number treatments that can help all types of fascia anywhere in the body, and as such, it is often able to help rid people of their bursitis and impingement for the long-term.

Contact us if you would like to find out how Fascial Counterstrain might be able to help your shoulder condition

What is frozen shoulder?

Frozen shoulder, also known as adhesive capsulitis, is a fairly common condition that causes pain and stiffness in your shoulder, with around 1 in 50 of us having this ^[2]. It severely limits the ability to lift your arm, and the pain can get worse at night, preventing sleep.

Healing from frozen shoulder can take a long time; it can then take from 1 to 3 years to resolve symptoms. Typically, symptoms will start gradually and worsen with time – this is called the “freezing stage”. After this you move into the “frozen stage”, which lasts for several months or years. This is then followed by the “thawing stage” during which your symptoms improve. This lengthy recovery can frustrate many patients suffering with this.

The reason for this lengthy recovery time is believed to be because of scarring (adhesions) that build up around the joint capsule, hence the term “adhesive capsulitis”. The joint capsule is a small fluid filled sac that surrounds the arm joint, which itself is surrounded by a group of ligaments and tendons that encapsulate it.

Frozen shoulder does not appear to be caused by one problem, and our experience suggests instead that frozen shoulder is caused by the presence of multiple issues within and around the shoulder. This group of problems doesn’t have to be the same for every person. However, what is consistent is the presence of multiple issues, and that they’re not all within the joint capsule. For example, parts of your shoulder such as veins, arteries, nerves, bones, ligaments, the labrum, and more can all contribute to frozen shoulder.

Unfortunately, frozen shoulder is notorious for not responding well to treatment, so many people just have to live with it until it “thaws” and resolves, which can typically take 1-3 years. Typical treatment consists of physical therapy, pain medication, heat/ice, injection therapy, and in more severe cases, surgical procedures may be needed.

However, because frozen shoulder appears to be related to scarring, spasm, and inflammation of multiple parts and areas of the shoulder, the most successful approach will be one that can treat all of these. Fortunately, this is made more possible due to a very important commonality that exists between all of these different affected parts of the shoulder. They all are either surrounded or have the same thing pervading through them: fascia. For reasons why fascia is very often the root cause of many shoulder conditions, including frozen shoulder – read this section, above.

In brief, medical research on fascia has shown fascia:

Spasms and tightens
Houses the majority of all our nerve endings that signal pain to us. Thus, most of the pain we feel comes from the fascia within or around that part of the body. For example, muscle pain is actually from the fascia embedded in and around the muscle fibers.
Produces inflammatory chemicals that sensitize you to pain and trigger spasm and tightness

The fact that fascia both creates all of these issues and fascia is present around and within every area of our body (in any tissue type, small or large,) means that if you can get the right treatment for all of these different types of fascia dysfunction, you can:

Improve the chance of full recovery if you are experiencing the initial symptoms of frozen shoulder, but haven’t fully developed a full frozen shoulder.
Reduce the amount of pain you feel if you have had frozen shoulder for more than 3 months, and improve the chance of shortening the recovery time.
Reduce the amount of healing time down to a 2-3 months if your frozen shoulder symptoms are less than 2-3 months old.

Even though fascia treatment looks to be one of the most promising treatment options for frozen shoulder, it unfortunately can’t always reduce the recovery time for people who already have had frozen shoulder already for several months. However, even for people with this situation, it can still significantly help reduce frozen shoulder pain, allowing for better sleep and less overall stress.

Given that fascia therapy can help frozen shoulder by reducing pain, tightness, and/or recovery times, the remaining important question to answer is “what is the right fascia treatment?” If you filter fascia therapies by their ability to help all types of fascia, anywhere in the body, you end up with a very small list of therapies. Fascial Counterstrain is one such therapy that can treat all types of fascia, anywhere in the body.

Contact us if you want to find out if Fascial Counterstrain can help your frozen shoulder

References:

[1] Artus, M., Holt, T. A., & Rees, J. (2014). The painful shoulder: an update on assessment, treatment, and referral. The British journal of general practice : the journal of the Royal College of General Practitioners, 64(626), e593–e595. https://doi.org/10.3399/bjgp14X681577

[2] Murphy, Richard J, and Andrew J Carr. “Shoulder pain.” BMJ clinical evidence vol. 2010 1107. 22 Jul. 2010

[3] 1998-2021 Mayo Foundation for Medical Education and Research. (2020, 12 17). Bursitis. Retrieved from MAYO CLINIC: https://www.mayoclinic.org/diseases-conditions/bursitis/symptoms-causes/syc-20353242

[4] 2009-2021 Physiopedia is a registered charity and is a physiotherapy knowledge resource (2021, 01 06). Shoulder bursitis. Retrieved from Physiopedia: https://www.physio-pedia.com/Shoulder_Bursitis[5] 1998-2021 Mayo Foundation for Medical Education and Research. (2020, 12 17). Frozen Shoulder. Retrieved from MAYO CLINIC: https://www.mayoclinic.org/diseases-conditions/frozen-shoulder/diagnosis-treatment/drc-20372690

Questions are welcomed!

Tel. 907-310-8101

9170 Jewel Lake Road, Anchorage AK 99502

Conditions Treated with Fascial Counterstrain Therapy

Fascial Counterstrain (FCS) therapy is a class-leading, hands-on method for the identification, assessment, and correction of one of the most common sources of pain and dysfunction in the body. It can help resolve chronic pain & inflammation, improve post-surgical outcomes, reduce healing times, reduce wear and tear across joints, & improve tissue health. Fascial Counterstrain therapy can substantially help many conditions, here is a list of a few, if you don’t see your condition ring us to find out if we can help.