De-Mystifying Shoulder Pain

“Richard” was a tall, young athletic man who worked long hours as a computer consultant. He suffered a rotator cuff injury years ago in a car accident. This left him with chronic shoulder pain even after months of physical therapy, massage, and medical treatment. He said that he had never felt the same since and, despite the fact that he was only 38-years-old, he was beginning to think that he was just “getting old.”

His daily computer usage only made his already painful right shoulder – the side on which he used the computer mouse – tighter than ever. He was close to developing a “frozen shoulder.” The truth was that his shoulder wasn’t frozen – the center of his body was! The shoulder joint isn’t just the joint itself; the muscles that move and stabilize the shoulder and coordinate synergistically with the shoulder insert into the center of the body. When you learn to release and relax the center of the body, movement in the periphery (the shoulder) will improve.

Richard was motivated to figure out how to reverse his shoulder pain and regain control of his muscles for two reasons: he had been physically active before his injury, and he had a six-month-old baby he wanted to hold without experiencing pain.

Accidents can cause accumulated muscle tension throughout the entire body.

I wasn’t surprised that Richard’s right side was so tight; he’d had several car accidents, one in which he flipped his car and hit a tree. He had also fractured his left leg in a sports accident without realizing it and had continued to play, compensating strongly with his right side. His right side had been accumulating muscle tension for a long time before his shoulder injury became apparent. His brain had done an efficient work-around; he was so used to using muscles he didn’t need in order to move while those that should have been moving his shoulder were so tightly contracted that he couldn’t release, nor control them.

Muscles learn to stay tight, so they can learn to relax.

In our first session, I taught Richard to relax the deep muscles of the back of his body (the Green Light muscles), including the muscles of the shoulder: the upper trapezius, rhomboids and lower trapezius. I taught him to pandiculate these muscles, so that his brain took back voluntary control of muscles that had been involuntarily contracted.

After the session Richard was amazed at how much better his shoulder felt and how much more movement he now had after doing such simple movements. I sent him home with four basic exercises to do daily to reinforce the new and different range of motion that he had achieved.

Relax the core for faster relief of shoulder pain.

I saw Richard for one more session in which we relaxed the core muscles of twisting and bending. He also learned to release the tight lattissimus dorsi muscle on his right side. The lattissimus is the broadest muscle of the body and while it attaches up into the front of the shoulder, it extends all the way into the center of the body. By the time he left my office his pain was completely gone. The changes he had made, using his brain to re-train his muscles, were impressive. He left my office with a huge smile on his face saying, “this work makes so much sense” and vowing to continue his daily Hanna Somatic Exercises. I look forward to not seeing Richard again for any more sessions: he now has the self-awareness and skills to take care of himself.

To learn how to relieve neck and shoulder pain on your own, you can purchase my instructional Pain-Free Neck and Shoulders DVD.

Piriformis Syndrome Part 2 – Releasing the Iliopsoas Muscle Video

Here’s what WebMD has to say about piriformis syndrome:

Piriformis syndrome usually starts with pain, tingling, or numbness in the buttocks. Pain can be severe and extend down the length of the sciatic nerve (called sciatica). The pain is due to the piriformis muscle compressing the sciatic nerve, such as while sitting on a car seat or running. Pain may also be triggered while climbing stairs, applying firm pressure directly over the piriformis muscle, or sitting for long periods of time.

From a Hanna Somatic Education point of view, piriformis syndrome is just another example of Sensory Motor Amnesia.

Piriformis syndrome is caused by habituation of the Trauma Reflex, a full-body reflex pattern that is evoked in response to an accident, injury, surgery, or one-sided repetitive movement. The muscles of the waist and trunk rotators (the obliques, lats, abdominals, iliopsoas muscle, adductors, and abductors) become chronically contracted on one side of the body, causing the pelvis to hike and/or rotate slightly. This pattern of muscular imbalance causes the piriformis muscle to involuntarily over-contract in an effort to maintain balance. Piriformis syndrome is in the same category as neck and shoulder problems, plantar fasciitis, chronic back pain, TMJ, sciatica, or joint stiffness. It’s a functional muscle problem in need of a functional solution: sensory motor retraining of the brain to muscle connection in order to teach the frozen, contracted muscles involved in the pattern of piriformis syndrome to relax and release. The end result is relaxed and coordinated muscles, restored muscle function, a greater sense of body awareness, and no more pain.

Try these simple self-assessment tools to become aware of how piriformis syndrome is being created in your body:

  • Stand in the mirror and take a look at yourself. Are your shoulders level?
  • Close your eyes and sense the weight into each leg. Is it the same on both side?
  • Put your hands at the waistline, right on the top of the pelvis. Are your hips level?
  • Lay on your back and lift your legs up to 90 degrees above your hips. Look at your ankle bones. Do they meet, or is one ankle bone higher than the other?

If you notice imbalances in your posture, then you know that your movement habits are causing your pelvis to twist or tilt and your back and buttock muscles to work harder on one side than the other. Hanna Somatics can teach you to change that.

A daily routine of Hanna Somatic Exercises to prepare your body for movement is the first step to reversing the pain of piriformis syndrome.

A Somatic movement practice reinforces more optimal movement patterns. You will learn to move more efficiently when your muscles are fully under the control of your brain. There are times when it’s necessary to tweak these exercises, or target the offending muscles a bit more directly.

Remember that it’s never just one muscle causing the problem when you find yourself out of balance or moving inefficiently. In the video below you will engage muscles that would normally coordinate together with the piriformis.  Have a look and try them out for yourself. Let me know how it goes.

Visit the Essential Somatics® store for easy-to-follow instructional DVDs. Learning the basic movements of Somatics goes a long way toward educating you and your muscles to get rid of chronic back, neck, shoulder, hip, knee, foot or joint pain – and keep yourself moving pain-free for the rest of your life.

Continuing Education Credits for Massage Therapists Now Available from Essential Somatics

I’m proud to announce that I am now an Approved Provider of continuing education credits for the National Certification Board for Approved Provider Logo final pathsTherapeutic Massage & Bodywork (NCBTMB). The following courses are now approved for continuing education credits:

Somatic Exercise Coach Training – Level One – 24 CE credits

The Fundamentals of Hanna Somatic Education – 8 CE credits

These courses will teach you the basic principles, science, and assessment techniques underpinning what many in the medical profession are calling the “missing link in medical care.” Because Hanna Somatics addresses muscle tension and pain at the level of the central nervous system, pain relief is more long lasting.

How many of you are frustrated with working on a client whose shoulders (or neck, hip, back) won’t relax no matter what you do? How many of you aren’t sure how to help someone with major postural imbalances? How many of you are exhausted by working too hard to relax your client’s muscles – to the point of compromising your own posture and well-being? These courses will teach you information you can use for yourself and your clients, in order to learn to reverse your own muscle pain – on your own.

The mystery of most chronic muscle pain isn’t mysterious.

The fundamentals and basic Somatic Exercises of Hanna Somatic (Clinical Somatic) Education will demystify much of the mystery of chronic muscle pain and help you begin to help your clients more effectively. You will learn:

  • How to recognize the three stress reflexes (as described by Thomas Hanna in the book, Somatics) to better understand and assess your client’s muscular imbalances.
  • The root cause of chronic muscle pain – Sensory Motor Amnesia – and how it presents itself as low back pain, sciatica, TMJ, plantar fasciitis, piriformis syndrome, neck, shoulder and hip pain.
  • How reeducating muscles through movement, is the best way to reverse muscle tension and pain, and improve muscle function – for the long term.
  • How pandiculation, rather than stretching (whether static or active isolated), is the most rapid and effective way to reset muscle length, function and tonus.
  • How to teach your clients gentle, easy, profoundly effective somatic exercises that will release muscles faster and more effectively than passive stretching techniques.
  • Self care exercises that will help you reverse your own muscle pain so you can continue to move well and work for as long as you wish.

I have been practicing somatic movement for several months with good results, but having had a one-to-one session with Martha’s careful and precise guidance, I feel I gained an extra dimension to my overall movement quality. After just a 1-hour session my posture changed, my shoulders were more level, and my gait was lighter and more fluid.

I give Somatic Exercises to most of my patients and I would encourage anyone interested in health to explore the potential of Hanna Somatics, either in a private session, a group workshop or through the DVDs available.

– Dr. Andrea Franzi, Oseopath, York, UK


Martha Peterson is the author of the book, Move Without Pain and developer of the “Pain-Free” series of instructional Somatic Exercise DVDs. Martha graduated from the National Holistic Institute in Oakland, CA. in 1988. In 2006 she graduated from the Somatic Systems Institute in Northampton, MA and was certified by the Novato Institute in Novato, CA as a Certified Hanna Somatic Educator. Click here for her full bio.

She teaches workshops, clinical trainings and private clinical sessions in both the USA and internationally. Contact her directly if you would like to bring her to your area for a training or workshop.