Your Shoulder Has Feelings Too
An approach to health and healing from inside and outside the Western Medicine box
Claire was seeing me for what I determined to be a frozen shoulder, also known as adhesive capsulitis. Her condition was apparently instigated by a flu vaccine. In her case, a severe inflammatory reaction ensued, rendering her shoulder terribly painful and restricted in motion. When she first visited me, she could barely raise her arm in front of her. She was miserable. That is, her arm was. As a person, Claire was delightful, engaging, and very attuned to her body and how it worked, and eager to do what was needed to bring healing to her shoulder. She was a former Craniosacral therapist and Reiki practitioner and accustomed to working outside the box of the Western Medicine (aka allopathic) model. She came to me expecting the latter approach and was pleasantly surprised by the weaving together of allopathic care with a bio-psycho-social process. Her shoulder freezing and the subsequent psycho-social-emotional challenges that it presented created a unique situation to address.
But first, adhesive capsulitis is an inflammatory process that creates fibroses in the shoulder joint. Fibrosing is a process in which an area that has been injured gets replaced with connective tissue rather the normal tissue. Connective tissue is tough stuff that is found in a variety of forms, including collagen fibers, as well as some other specific chemicals that aid in healing. It requires special enzymes to be broken down so that the tissues they occupy can be strong and stable. Fibrosing inhibits motion and creates problematic motor programs that jump in to protect the shoulder while significantly reducing function. Not what you want in a highly fluid and elegantly mobile joint like the shoulder.
Together, we designed her program of recovery. I taught her correct stretching of her joint, re-learning functional motions, and strengthening the muscles associated with those motor programs, along with encouraging the fibrosed tissue to give way to normal tissue through manual techniques. She was very dedicated to her program, and we both worked hard at regaining her mobility and subsequently her life. A fully functioning shoulder is a necessity for anyone, and as a hospice nurse, her quality of work was certainly being affected.
When the unconscious weighs in, pay attention
One day she mentioned that upon arriving at work, she could feel her shoulder begin to tighten up and retreat into its protective positioning: hunched up and curled forward. She would then spend the remainder of her workday trying to activate the correct muscles while quieting the compensating ones. This requires a great deal of attention and energy. It was exhausting.
She also mentioned she had yet another dream in which she could reach with her arm with the full range of motion. Both dreams were so real that after upon wakening she would check to see if she did in fact have all of that motion back. Alas, she didn’t. But the dreams gave her hope.
I considered her dreams, and what neuroscience tells us about how the brain continues to work while we’re still sleeping.
“Perhaps your brain is recognizing the presence of the range of motion and motor programs and reminding you that they are there. They haven’t entirely disappeared. Your brain is reminding you that your ability will return.”
She smiled and nodded.This resonated within her.
I also mentioned that her work environment was where she received her vaccine, and therefore was the site where she was “injured.” Perhaps a subconscious reaction occurred, whereby she automatically protected herself. But, here’s the thing: I hypothesize that a part of our body can react to an experience, while the rest of us may not be quite engaged or aware. A reflexive loop occurs, and the body part and brain get busy processing and re-processing it, while all we know is we are in pain yet again and without an apparent reason.
What I recommend then, is what I told her.
“Here’s what I suggest, Claire. Treat your shoulder like a beloved child or beloved friend, whichever resonates with you, and pat it gently, and then flick, kinda like you are flicking away the pain while telling your shoulder, ‘You’re okay. Everything is okay. You are healing, and it’s good to be in this place. This is a safe and good place. We’re doing good stuff here.’ Encourage it. I think there may be a subconscious dread of your work environment and your body is responding with protection.”
Claire’s eyes widened. She understood that our bodies can hold memory and emotions. We had several conversations that addressed this idea previously. Now it was time to really test drive it. She knew her injured shoulder in a way, had taken on a life of its own. While we were retraining its motor programs, the emotional and psychological piece of healing was now demanding to be integrated, and it clearly affected her shoulder’s ability to function in an environment where it had initially been injured. This psycho-social component, as we call it, can be a “switch flipper” in the healing process.
Now, I know this “flicking and telling your body everything will be okay technique” may sound “hokey,” even ridiculous, but believe me, it works. And I believe it works in part for a number of reasons. First, we are distracting the brain from concentrating on the offending body part and giving it something else to think about. Second, the soothing patting and flicking are being processed by sensory fibers, further sending information to the brain, which likes the soothing sensation, and in turn, sends a calming response back down to the body part, at least temporarily. Finally, the internal messaging and outward speaking “You are fine, you are healing, everything is going to be okay,” is both soothing and also requires processing by the brain. It is now focused on a new message, that of safety and healing, and works with that, again, at least temporarily.
I worked on her shoulder and afterward, she thanked me. She reflected on our conversation and considered again the concept that our bodies can hold emotions, this time turning it to her shoulder.
Claire said, “It’s interesting: every time I leave here, my shoulder feels not just comfortable again, but it literally feels happy, even joyful. It is a very happy shoulder. Thank you for that.”
The enigma of health and healing
There were at least two implications of what this was. One was not only was I doing something helpful for the shoulder but that in fact, the joy in me, was flowing from my heart and hands into her shoulder. Another possibility was, in her words, her shoulder was able to relax and release in the presence of skilled technique combined with compassionate care. It felt safe, hopeful, and therefore joyful. And of course, it could be that she was feeling safe and relaxed, which allowed her shoulder to respond accordingly.
Whatever the explanation, it demonstrates that health and healing have some enigma attached, and I am comfortable with that, Westerner that I am. We do not know everything. We cannot explain everything, as much as we’d like to. Art is still wrapped inside our medical approach, and with it, mystery. With the mystery there is beauty, and recognizing that requires a mindset to welcome it. And in welcoming it, we really can go forward with health and healing.
I smile, as I again recognize there is such a thing as the gift of healing. And this healing can have many components, requiring more time than we expect. If indeed a body part can “feel” then perhaps our very cells know what they are programmed to do, want to get back there as soon as possible, and will try their darndest to do so. And then we help along that healing as we treat our parts and ourselves with respect, openness, and compassion.
And that is when Health and Healing occur both inside and outside of the box.
As Claire was leaving my office, she whirled around to ask, “Hey! Will I be able to resume my handstands in yoga again?”
I chuckled. “Of course you will.”
And she did.
During human dissection, fascia was just something we cut through to get to the good stuff. Decades later, we know that fascia is a sophisticated system of connective tissue that literally holds the body together. It supports and connects muscle, bone, tendon and organs, usually lying just below our skin, but it can reach much deeper too. Microscopically it looks like the cobwebbing you use at Halloween to decorate your porch. Multilayered, it should be somewhat buoyant but when too much tension is placed on it, fascia will begin to compress and stick together, twisting on itself and smothering or strangling whatever is within its reach. Because nerves and blood supply run through it, these structures get caught. Blood supply can be reduced, nerves can go crazy, either becoming hypersensitive or numb. Dysfunctional fascia can make a person miserable, with complaints of deep aching or burning sensations.
I applied my technique of soft tissue mobilization using a specific cupping method and some other fascial releasing techniques. Within that session, her symptoms dramatically improved and she was able to walk for the first time without a cane. She was over the moon with relief and excitement.
Her symptoms abated with subsequent treatments, even as we gradually returned her to her strengthening and functional retraining program. She achieved excellent progress. However, I began noticing a pattern of pain and reduced function coinciding with her expressions of frustration and anger. Which came first? And was one contributing to the other. I decided to explore this with her, if she was willing.
One day I asked her, “Tracy, what are you angry about? I suspect this may be playing into your pain.”
Having permission, she admitted to deep anger, and poured out her frustrations. She was angry with her surgeon. Tracy believed he had “botched” her knee the first time around, not implanting the correct size of prosthesis the first time around, and thereby creating the need for the second surgery. She was also angry with the insurance company for their agonizing slowness in authorizing the necessary surgeries, which she believed allowed her knee to deteriorate, along with adding to the pain and suffering that accompanied the entire experience. Most important, she was resentful that life had been stolen from her. She was sore from the inside out.
“Understandable righteous indignation,” I said. “Is that how you feel?”
She nodded. I didn’t affirm or give a judgement. Instead I asked another question. “What do you want to happen?”
“I just want them to admit they made a mistake.”
I wanted to respond, “Really? You think they will? And even if they did, do you really think that will make your anger go away?”
Instead, my outside voice said, “Well, I can imagine that would feel good to hear those words and be affirmed.”
Again she nodded. I took a risk and ventured out with, “Can we call this what it is?”
She hesitated. “Okay, what?” She knew the answer, and didn’t want to say it.
So I did. “Tracy, you have not forgiven them what you perceive as the great wrong they’ve done you. It’s a big grudge you’re holding.” I added, “No judgment here. It’s normal.”
She sighed, “I know. You’re right.”
Again, I asked for permission, “Can we talk about this?”
She nodded. I continued gently. “Lack of forgiveness, aka grudge holding, holds us back from moving forward in life. Grudge holding restricts us on so many levels, much like your malfunctioning fascia restricts your muscles, joints, nerves and vascular supply. You can see how, when your fascia is ‘freed up’, everything around it is affected and you can move again, and with minimal to no pain. When we forgive, we too, are freed up. We are released.”
Her face visibly began to relax. “But how do I forgive them?” she asked.
Glad for that segue, I replied, “The first step would be understanding and believing that forgiveness is important for you and your health. This is why Jesus tells us to forgive.”
We had a discussion on why forgiveness is a necessity in life, and why it is not dependent upon the other party apologizing. The reality is, most people don’t understand the impact of their actions on another; so they don’t have the insight that there is a need on their part to apologize. We assume that if they knew, they would apologize. However, pride can stand in the way, and withhold the apology. Whatever it is, waiting for the offender to act “rightly” places the power in their court. When we give power away, we make ourselves victims, creating a cycle of blame that never ends. And this restricts us from living.