Lets talk about Pain !!!
Specifically Back pain..
Very often people will come into my practice and indicate they are having lower back pain. At that point I have to ask exactly where the pain is coming from. More often than not if my client is female, the pain will be in the sacral pelvis area. Women are 6 times more likely to have sacral pelvis issues. Men are more likely to have lumbar spine issues. L1 to L5
The pelvis is a simple, yet complex structure. On the one hand it is simple in that there are no muscles that comprise the pelvis. It is held together exclusively with a web ligaments. Remember ligaments connect bone to bone. Tendons connect muscles to bone.. On the other hand it can be complex because it is surrounded by muscles.. Muscles that are constantly introducing forced on the pelvis and sacrum.
The human body in many ways operates in a lever and pulley system. Your bicep pulls you arm up. Your opposing tricep pulls your arm down. We have to keep this in mind when thinking about what might be the source in the pain or irritation.
The hamstrings and adducters are pulling down on the ischium. What if one side is tighter than the other. This can shift the pelvis. It can be tilted. This can even make one leg appear shorter than the other.
Not only do you have to consider the muscles but also the nerves that innervate the structures. A nerve can be pinched or even run through the muscle tendon that be irritated when it is flexed.
Add in the Sacrum. Attached to the base of the spine. Just like the tip of a whip , it can take exaggerates the of the forces of the spine. Even in a very mild scoliosis, where the spine is curved. When the spine is curved, it is also rotated. Causing strain and torsions in the sacral joints.
Luckily there are ways to address each of these conditions.. Loosening tight muscles, separating fascial bags between the muscles, working to strengthen weak or stretched muscles, introducing blood flow to ischemic muscles and tendons are some ways we work with patients to increase mobility and reduce pain.
I hope this helps in understanding how the myoskeletal system works a little better
FROZEN SHOULDER and the underlying cause
The Shoulder is a vastly complex structure. Seven joints are involved in the functional movement of the shoulder girdle. Each of these joints are interdependent on the integrity and function of the other joints. They include the glenohumeral , suprahumeral, scapulohumeral, scapulothoracic, acromioclaviular, sternoclavicular, first contralateral and costovertebral joints.
The glenohumeral joint is considered by many to be the most important joint in the shoulder girdle. When all tissues associated with joint are functioning normally, it has a greater range of motion than any other joint in the body. Even when other joints of the girdle are restricted , if movements are of the glenohumeral is healthy, the arm may be functional and allow some use of the arm. At least to some degree. But if the glenohumeral joint is restricted, there will be very little or no use of the arm.
The convex ovoid humeral head exceeds the surface area of the glenoid fossa, with which it articulates. Only a small part of the surface of the humeral head articulates with the glenoid at anytime.A fibrocartilaginous rim extends the glenoid into a modified socket and provides additional surface area. Since the highly mobile head of the humerous is capable of many combonations of swing and spin. This extreeme mobility is necessary and useful. It also results in a relatively unstable joint.
Stabilization of the humeral head is provided through muscular support by supraspinatus, infraspinatus, teres minor, and subscapularis. The SITS muscles or rotator cuff muscles. The fibers of the SITS tendons blend with the joint capsule. which make them vulnerable since they are so close to the joint itself.
Subscapularis, is a particularly important muscle when considering shoulder dysfunction. It is almost completely hidden from touch. It has a broad attachment to the subscapular fossa and spans the glenohumeral joint to attach to the humerous. It passes over the front of the joint capsule and lies horizontally to the two tendons of the bicep.
It is a large thick but only a small portion can be accessed.
The primary indication for treatment of the subscapularis is loss of lateral motion and or abduction of the arm. Common symptoms of FROZEN shoulder syndrome. It may be injured or torn when a person throws their hands back to catch themselves when falling backwards. This impact will force the head of the humerous forward against the joint capsule. The tendons of the subscapula and the subscapula bursa may become inflamed and play a role in FROZEN shoulder. A condition associated with adhesions within the joint capsule.
As a practitioner I can access the subscapularis both supine and sidelying to affect muscle to increase range of motion as well as blood flow to the affected area. Usually this area is very tender to the touch. It virtually never gets touched by human hands. So feedback from the client is essential so as to not exceed the therapeutic value of the session.
Chaitow L, Delany j 2000 Clinical application of neuromuscular techniques, volume 1, the upper body, Churchill Livingston, Edinburgh