Motion Stability's Blog


Could Uneven Shoulders Indicate Any Issue? by charlestlee

image source: helloamanda.com

Brian Yee PT, MPhty, OCS, FAAOMPT

Uneven shoulders can be observed in a couple of planes. One of the most common observations is when one shoulder looks higher than the other. This could indicate either a structural, muscular or neural imbalance.

Structurally, the patient may have a leg length discrepancy or a scoliosis that causes the shoulders to be raised on one side.

Muscularly, the shoulder blade or scapula has multiple muscles that stabilize it in position. Muscular imbalances can easily occur that cause certain muscles of the scapula to pull it in a certain direction. For example, in many single arm-dominated sports such as baseball or tennis, the dominate arm tends to over-develop the latissmus dorsi which is your ‘wing’ muscle. With more muscular development it actually pulls the shoulder blade down. In standing postures, most of these athletes will look like their shoulder is lower on the same side. This can create problem for the lowered shoulder, especially when the arm is required to repetitively raise over their head. With the shoulder lowered it takes greater work of the opposing muscles to raise the arm overhead. Over time, it can cause poor shoulder mechanics and lead to injury of the shoulder.

When someone has chronic nerve symptoms in their neck and arm due to a radiculopathy or pinched nerve in their neck, many times you may see that the shoulder on the same side looks elevated. This is due to the adaptation of the muscles to shorten or spasm to elevate the shoulder girdle and allows more room for the nerve to conduct. Patient’s with this pattern often feel tight in their neck and upper shoulder. When they try to stretching the muscles it makes their nerve symptoms worse. This happens because the muscle is not tight but in protective spasm keeping the nerve from being injured further. In this case it is important to treat the nerve first before trying to lower the shoulder girdle.

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What are natural treatments for nerve pain? by charlestlee

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Brian Yee PT, MPhty, OCS, FAAOMPT

In Physical Therapy, nerve pain can be treated naturally through techniques called ‘neurodynamics’. According to Michael Shacklock in Australia, a worldwide leader in nerve pain and rehabilitation, there are three major areas to address. This includes the mechanical sites that can compress a nerve, the nerve itself, and the tissue the nerve innervates.

First, nerve pain can be caused by a tissue that pinches on it. This could be a herniated disc, a muscle spasm, or arthritic changes in the spine. Such treatments as mechanical traction or soft tissue massage around the pinched area of the nerve can alleviate the nerve pain.

Second, the nerve itself can become injured. Physical Therapists use manual therapy techniques to mobilize the nerve itself to reduce its pain and improve it mobility. Similar to having a knee surgery, it is important to calm the swelling and pain down in a nerve while progressively improving the range of motion back to its normal length. Nerve is just as much of a connective tissue as ligaments or tendons are.

Lastly, when nerve pain occurs it becomes inflamed, a term called neurogenic inflammation. Like a hose spraying with water, when the nerve is inflamed it sends inflammation to its termination sites – such as muscle, joint, or ligaments. It is important to improve muscle or joint restrictions that surround the nerve to fully treat the nerve pain and its residual effects.