Shoulders

"I’ve seen many clients with chronic shoulder trouble, who have never found much lasting relief from conventional treatments. When we started to address the factors listed below, relief was soon to follow. I came to expect this with full confidence, especially in a client who had spent many years in treatment, pain killers, yoga, PT, etc…” -SH


Shoulders

There is SO much to say about shoulders; that’s partly because in modern culture we make a career, practically, out of living life with disconnected arms.

We type for hours without any involvement or awareness of our breathing, our feet on the floor, our rib cage and spine, or our sitting bones and pelvis. We eat that way. We turn pages of a book that way. We turn a steering wheel that way.  Even worse, we stiffen our upper back and chest, and shoulder girdle, thinking: “This is how to use the arms.” No, this is serious somatic disconnect. Musicians have an advantage; they are not so disconnected. This has to do with the fact that music from a disconnected body won’t sound very good.

Arms are disconnected from the ribs and torso, and that disconnect happens at the shoulders. It is not that the shoulders are a problem; they are more like a victim of abuse.  The elbows over work and our shoulders stay frozen, immobile, while we do all sorts of things with the hands and arms. It is completely against nature. In ancient days, people were gardening on all fours (which automatically connects the arms to the ribs and spine and pelvis), they were building and fighting and surviving and carrying water; all these things were done with connected arms, grounded shoulders and a pelvis that was participating in movement and weight bearing. The spine and ribs should be responding to every movement, large or small, of the arm, wrist, hands and even the fingers. In Feldenkrais we call such a person connected. And similarly, every movement of the hips and pelvis should be reflected or connected to the arms and shoulders.


When really authentic and functional people reach with palm out, for instance, their heart is in their hand, so to speak, each rib; all parts of the shoulder girdle are being mobilized, even if ever so slightly, and it is a beautiful – and very rare – thing to witness. Their whole body participates in even the smallest movement, just as Moshe Feldenkrais said should and could happen. Mother Theresa had such movement, in spite of her apparent postural disability. This can be seen, with a practiced eye, even in a still photo of her reaching her hand forward. Many others have such good movement as well; but it takes a trained eye to see it. Jazz musicians, and dancers especially the blacks, for some reason, also, have very functional and mobile shoulder blades. They are not fixating them as others do. Maybe that is a necessary thing to do, when creating collaborative jazz music.

Of course all athletes at a certain level, Olympic caliber or beyond, have very functional shoulders. But there is a caveat. When working out and performing they have athletically functional shoulders. What they do at home, eating, driving, typing with ordinary non-athletic movement may be an entirely different story. As Moshe Feldenkrais pointed out, athletic movement is not the same thing as human movement. And there are many good reasons why we should be interested in improving human movement, not much athletic movement. It is more authentic to the soul, for one thing. Athletic movement is performance driven, and there is much more to life than athletic excellence. Are all the top athletes in any sport happy, well-balanced  people from every point of view? Or are they rather distorted with over-developed athletic abilities and lacking in basic human qualities? It think that is a fair question.   

 

And as you will see, it is not just about shoulders. Immobility from staring eyes at a computer will translate also to frozen shoulder blades, as you sit and type. If we would learn to type with mobile shoulder blades, we could be more in touch with our heart and spine and body-sense about what we were writing or doing and our work would instantly improve.

You could try this right now, extend your arms as if typing at a keyboard, and pretend that your spine and ribs and pelvis, communicating through your shoulder blades, which are so mobile and intelligent and quick that they can direct the fingers what to type. Type as if it is “from” the shoulder blades, which are “listening” to the pelvis, the breathing, the spine and the ribs, even the pressure of your feet on the floor. This is mostly imagination and a typical somatic learning tool; play with it for awhile and see how much mileage you get before you get tired of it and throw it out (as is the case, eventually for all such devices). You’ll find many such learning tools on this website.

I can tell you, for sure, that if you really do type this way, practically any person who reads your writing would comment: “When you write like that it is easier to read. It is more embodied. It makes more sense. There is more life to your writing. It is not so theoretical and hard to grasp. It is more real to me."

In fact, it is easy to test this for yourself. Read anything written before computers or typewriters. Such material was written slowly word-by-word by hand, pen and ink, with a much more functionally connected body than we see today with computer users, typing away. I scarcely can bring myself to read the news, popular magazines, modern fiction and even non-fiction. Compared to literature from ancient days, there is no comparison.  

I’ve seen many clients with chronic shoulder trouble, who have never found much lasting relief from conventional treatments. When we started to address the factors listed below, relief was soon to follow. I came to expect this with full confidence, especially in a client who had spent many years in treatment, pain killers, yoga, PT, massage, osteopathic, etc., with little permanent effect. People like that became my favorite kind of client, since they were so appreciative, and I ended up looking like a hero.  What was missing for them was the educational, somatic perspective on shoulders that you see in the following items. After some years of working with clients, I got so that I could quickly see (often at a first glance) just which of the following items were going to give them the quickest relief.

But it was not quite like that either. We’d meet each week and something new would just come up, as if out of the blue, some new way to think about or use their shoulder to keep the healing progressing on track. What came up was usually something on this list.  


  • Definition of the word shoulder: three bones and the soft tissue with it. This needs to be understood first intellectually, then, gradually, in your body-sense.  You must include your collarbones in your idea of the word shoulder. When any part of the shoulder moves, so should the collar bone. Otherwise you are grossly distorting the proper mechanics of the shoulder joint. So we want a broader definition, and understanding of the word “shoulder”. It is NOT just that small area where the arm meets the torso, as most people think. If that is what you think, that is how you move, too. In reality, all three bones and all the attached soft tissue of these bones should be moving appropriately (or not) whenever we use an arm to reach or pull or grab. In other words, most people with shoulder trouble have spent most of their life with frozen scapulae and clavicles, so the only moveable part of their shoulder has been where the femur meets the glenoid fossa (shoulder socket). This is a very damaging way to use the shoulder; the really amazing thing is that they have not had more serious pain and trouble much sooner.  
  • Know the three bones. Unless you have all three bones in your self-image, you can’t have functional shoulder mechanics. The three bones are the collarbones (clavicles), the shoulder blade (scapula) and the upper arm bone (humorous). Spend 20 seconds a day with left hand on right collarbone, and move the right arm and shoulder around, feel the collarbone move. For many people this is a major revelation, and nobody has ever pointed this out to them. Repeat on the other side. Your shoulder mechanics will get a quick and permanent upgrade from even a few repetitions of this little drill.
  • Lie on foam roller ten minutes before bed.  This opens out the body, instead of being scrunched in, like a book closing from the sides. When we sit and reach forward with one or both arms (as in typing or driving or eating) we pull one or both shoulders forward, creating a lateral curve in the upper torso – like an open book being closed partially. Lying face up on a 6-inch hard foam roller for 15 minutes daily, before bed, will quickly correct this situation. And it feels SO wonderful as you just lie there, letting gravity do all the work. Unless this is addressed, you can spend years doing all kinds of other things, never finding good relief. One of my mentors, a master of the Feldenkrais Method, did this every evening for 15 minutes, and she encouraged everyone else to do the same. If you try this, you’ll love what it does for your posture, your ability to sleep more soundly, and relief from various kinds of chronic pain. You do not need a hard foam roller. You can use any blanket. Just roll it up tightly lengthwise and lie with your spine lengthwise along the rolled up blanket. Tie the blanket or use elastic so it does not unravel. You can do this, as my mentor does, whenever you travel.
  • Where is clavicle, learn to sense it moving. Most anyone with shoulder trouble has been thinking their clavicle is part of their upper chest, and like the ribs there, it should not move, but be held stiffly up, as in “good posture.”  The clavicles are not ribs. Put your right hand on your left clavicle and move the left arm around. Sense the clavicle moving. For many people, this is a revelation. Repeat on the other side. This is a repetition, but this bears repeating.  
  • The concept of GLUE. Shoulders can begin to lock down as we age. It can be very painful and disabling. Shoulder muscles are very strong and they are fully engaged when we are moving around our arm. So, logically, we cannot expect to stretch our shoulder muscles by any kind of arm movements. Most people with tight shoulders have never yet reached this conclusion – so obvious and fundamental. Instead think of putting imaginary glue on the palm of one hand, and “paste” the hand against the wall, or on the edge of a desk, or on a chair back. Keeping the hand “glued” in place firmly, walk around, forward and back, twist, and thereby “mobilize” the shoulder joint using your whole body weight. THIS is an effective way to stretch and open tight shoulders, NOT by waving or moving the arms around in some kind of contrived “shoulder stretches”. Be creative and use different locations for the glued hand, and be sensitive to that boundary of pain and comfort; you want to play that edge, for that edge is where you will get the quickest improvement. Too much pain, the body tightens up. Too much comfort, nothing is happening. For adhesive capsulitis, and extreme case of ‘frozen shoulder’ this concept of “glue” can be a lifesaver. That was the case for me, when I had this condition in both arms, one after the other.
  • Carrying a Suitcase, how to do it. First let it pull shoulder down, THEN tense and “anchor” the shoulder to walk. What most people (wrongly) do is to lift the shoulder up, and then they tense the shoulder like that. No! We need to tense and anchor the shoulder when it is fully down when carrying a heavy suitcase. That insures the clavicle is resting fully down on the first rib, not lifted even a tiny bit. If you are lifting the shoulder even 1/100 of an inch, you are taking the full weight of the suitcase and the shoulder girdle into the neck. It is important to learn this little trick and practice it. Re-read this paragraph until you understand it and drill yourself until it is second nature.
  •  Sleep With Arms LONG, Not With Bent Elbows. As we age we get more contracted in the shoulders and arms, and for some elderly folks, they can no longer even straighten their elbows. The arm and shoulder is too tight! Don’t let yourself get to that point. Keep your arms stretched out, long and by the sides, as you lie on your back. If you lie on your side then keep the top arm long, on top of the torso, and the other arm either behind the back (yes, this is possible and it is good for the shoulder if there is no pain). You could also place your top arm behind the back as well. My mentors were adamant that with a client on the table, we must be vigilant to keep their arms long, not bent with hands on chest, as most people like to do.
  • Let your left big toe talk to your right shoulder as you sit and also as you sit, stand or walk. Let your right big toe “talk” to your left shoulder as you sit, stand or walk. That is where support of shoulders comes from – the “diagonal connection” to the inner aspect of the foot (because it is more connected to the Tibia than the outside of the foot which is more connected the fibula). The connection is diagonal because the hip joint comes into the pelvis at a rather sharp angle (see any anatomy chart for details). You can also simply think – or sense - your big toes or the inside edges of your foot, and your shoulders, at the same time. Try dancing and keeping the dialogue with big toes and opposite shoulders. The “x” or two diagonal connections. There is a direct line of skeletal support, through the tibia and femur and spine to the shoulder
  • Throwing imaginary rice as you walk fast with arm swing. This one comes from Ruthy Alon, when teaching her version of “The African Walk.”  It is a marvelous way to create and sustain functional “sliding and gliding” of the shoulder blades in the upper back, to be in congruence with the counter-rotation of hips and shoulders, and the slight diagonal folding of the rib cage, that happens (or should happen) with a vigorous arms swing in fast walking (don’t expect all this to happen in slow walking which is an entirely different playing field). Imagine you have a handful of rice in each hand. As the arm reaches the end range of its forward swing, imagine you are throwing rice by rolling the thumb in and the little finger out (so that the arm internally rotates to throw the rice).  There is a pronounced downward thrust to the arm as well, necessary in order to engage the scapula. But don’t let that pull you into stooped posture. This will make it so that the little finger is the most forward part of the body, at that instant. Then, as the arm swings naturally behind you, do the opposite, rotate the arm in external rotation, meaning that the thumb rolls out pointing away from the body with the palm ending up facing outward.
    • This facilitates greatly the gliding of the scapula on the ribs in the back (most people in fact have frozen unmoving scapulae when walking, either fast or slow, with or without arm swing). When you can do this, you might think of another Ruthy Alon innovation – imagine that your shoulder blades are like eyes, and they are able to look around and mobilize easily in any direction, or while walking, they can glide and slide as if we were using them to see. You also need to know that you cannot do this when you are carrying a purse, briefcase, or anything else, whether in one hand only or both hands. So you might want to build time into your life, as I have, to be walking without carrying anything at all, and walk fast enough to get the arm swing.
  • Quiet Hands and Bell Hand.  Shoulders are reflexive, meaning they work by reflex. They take their “orders” from the hands or at least from the movements we create to do something with our hands. If we want relaxed and grounded shoulders, think first of empty, quiet, non-doing hands. Many adults, and I have observed this in myself as well, past a certain age, cannot fully relax the hands, especially the dominant hand. After all, 80% of what we do in life is eye-hand coordination. And the shoulders are in that mix. The Feldenkrais Method has a novel, and effective, way to relax not just the hands but also the whole body. It’s called The Bell Hand and it involves making small, even invisible, little opening and/or closing movements with the fingers of a semi-closed (relaxed) fist, using the least possible effort. This can be done in conjunction with an inhale or exhale, or by ignoring the breath entirely. If you do this five minutes a day for several days, you’ll very much like what does for you – your nervous system, your shoulders, your hands, your ability to concentrate without having such unconsciously-tense hands and fingers, and your mood and attitude will improve as well (as in: “Life is not as hard as I thought it was; I was going around all day and night with fingers and hands WAY TOO TENSE”). The Bell Hand can be pure magic and it is a pity that it is so under-appreciated, even unknown, outside of Feldenkrais circles. The Bell Hand is traditionally done with one hand at a time; it is overload trying to do both hands at once. You’ll see: it takes all of your 100% concentration to focus on just one hand. In my Feldenkrais Training we’d often do Bell Hand twenty minutes at a time, and also while doing other ATM movements or activities, like standing and walking around and talking to people. These are ways to enhance the already-powerful effects of the Bell Hand.
  • Exhale and relax simultaneously the shoulders down, the belly and abdomen, and the floor of the pelvis area and the bottom of the feet. We unconsciously tense all four of these together, during stress, so it is good to release all at once as well. I spent years trying to relax the shoulders down, without understanding the full scope of the issue.
  • Shoulder Shrug Variations. Lift one or both shoulders as high to the ear(s) as possible. Stay there for 3 seconds, and then drop the shoulders. You’ll find they feel more “grounded” or settled and restful. You can do this slow or fast, with the inhale or exhale or not.  It is a common Feldenkrais practice to exaggerate a movement in order to then let it go. It is good to often drop down the shoulders slowly and mindfully, to remind ourselves the pathway to grounded shoulders. Otherwise, shoulders may stay chronically slightly lifted even for many years. Such people always look a bit too stressed out, but it is hard to know just why. If you look very closely you’ll see they are continually (but ever-so-slightly) lifting both their shoulders. And as we know, lifted shoulders (as in shrugging the shoulders up) can be body language for “I don’t know”, or “I give up”, or “who cares?”
  • Elbows Above and Behind Head. This is like a yoga stretch and you have to work at it. We’d all benefit by doing this daily. If this is difficult for you that means you especially need it. Start where you are and slowly you’ll improve. Those who can do this easily do not have head forward posture, their pectoral muscles are not fore-shortened (pulling shoulders forward), and their shoulders are open and loose. Their chest is square and not caved in from the sides. When the two arms are there bent behind the head, they are pushing the head forward strongly; by resisting this push (pushing head back) we strengthen the ability of our head to not be too forward.
  • Nerve Stretching. Nerves are cells and cell walls can tighten. This can even become chronic. The tightest nerves in the body are usually in the forearms (due to use of the hands); such nerve tightness (and muscle tightness) can greatly contribute to, or cause, shoulder pain and carpal tunnel syndrome. Some Osteopaths have said that a 15 second nerve stretch of the forearms is the single most important exercise we need to do on a daily basis. Stretch your arms at shoulder level out to the sides. Now bend back the hand and fingers so the fingers are pointing up. Push the two arms apart, “pushing” from the butt of the palms. You’ll feel a “nerve burn” all across your upper chest, and through both arms. It is a distinctive feeling, a sharper and more intense pain than just stretching a tight muscle that is full of lactic acid. I’ve seen chronic shoulder issues clear up from nerve stretching of the forearms. If you Google “Michael Young Carpal Tunnel Treatment” you’ll find a CD that gives directions to prevent or cure carpal tunnel by stretching nerves in the forearm. I use his technique on anyone with wrist issues and it really works. 
  • Place items high so you have to reach up often we do too much reaching down. I may put my cell phone or water bottle on a high shelf. We usually reach with the arms down and we want a balanced musculature.
  • Rowing machines, pulling exercises. These will not only help correct head forward posture, but will keep the shoulders pulled back as well. If you go to a gym, don’t neglect the cable pulling machines, the rowing machines and lat pull-down machines. Try to build in rowing movements on a daily basis, if possible. In my kitchen I had a chin-up bar across one doorway, and across the bar I had 5 rubber exercise tubes, each one about five feet long.  I would grab these and fall backwards with a straight back, and then, as my body was 45 degrees slanted backwards, I’d pull with my arms to come back up. It was very rhythmical, better than a rebounder, and corrected my head forward posture, and also took away any neck pain I was experiencing. I had a rowing machine in my kitchen! Or you could just pull your extended arms into the body isotonically (creating self-resistance while moving the arms) All of these tonify the upper back and counteract the strong tendency we all have to fold the body in like a book closing in the front of us; this comes from spending so long with our arms in front of us, pulling both shoulders forward. We need to reverse this trend if we want healthy shoulders and good posture.
  • Massage the pectoral muscles often, they hold unnecessary tension and pull the shoulders forward. Just a little five-second rub on the muscle can remind it to release. Google “pectoral muscles” so you have a clear visual image of the muscle.
  • Pull the shoulders down and back vs. up and back. Make it a rule that whenever you want to pull your shoulders back (to “correct their posture” as people mistakenly think) pull your shoulders down first, then back. The vector of force should be diagonally down and back. Most people are lifting the shoulders slightly and they pull them back too far. Lifted shoulders, even a little bit, are not healthy body language. This creates more head-forward posture. It is a neurotic habit. It does no good yet people do it their while life. On the other hand, pulling the shoulders DOWN and back has many benefits.
  • Walking with arms clasped behind the back. This can be healthy for the shoulders and the posture, provided the hands are pulled down and back, and also the low ribs are not being thrust forward (as usually happens in this scenario). Keep enough abdominal tonus to prevent this; this will force the stretching action of the pulled-down-and-back-arms to focus upon the upper chest, where it is needed.
  • Practice diagonal folding of the rib cage. This includes both front and backwards folding (as can actually happen in fast outdoors walking). This is what is supposed to happen as we reach forward with one arm. Most people hold their chests too stiff to allow this. Shoulders suffer greatly for this reason.  Shoulders need a soft and pliable rib cage to rest upon for optimal functioning. Any person will understand you, if you show them how to fold a piece of paper diagonally, from one corner to the opposite (not adjacent) corner. But they’ll have a mental logjam, right away, if you then tell them THIS is how the rib cage is supposed to fold, as we walk or run (but of course not so far as folding a paper in half); there is a contralateral movement of hips and shoulders, the spine counter-rotates, and the rib cage is meant to participate in that with such folding. It does not compute in the brain, because it is not in the body-sense. It actually took me many years out of my Feldenkrais Training before I got this concept, and then only because my mentor drilled it into me, folding a piece of paper in front of me, in extreme frustration that I did not learn such a basic thing from my Feldenkrais Training. From then on I used that idea to great effect in all my clients. Only soft ribs can do this. Most people are holding their rib cage far too tightly, either lifting the chest or with a collapsed chest while sitting or standing. This habit carries over to lying down, even sleeping, or lying on a treatment table (as any practitioner would testify). While some few people may understand this paragraph intellectually, not many will be able to do this. Such a basic human movement, and for most of us, Feldenkrais involvement is necessary to know about it. It is truly a sad state of affairs.
  • Left rib cage and right rib cage.  Did you do a double take reading this? Many people do. That’s because the cultural understanding of “rib cage” is ONE thing, not two. Yet, not a single muscle or rib crosses the midline. We really DO have two “rib cages” and this should be manifest in every movement of an arm, every breath, every step we take.  Each rib cage can move fully independent of the other. In Feldenkrais Trainings, or doing ATM regularly, you’d come to this understanding in your own body sense fairly quickly. Outside of that, there are few other places you might pick up this essential piece of information for having healthy shoulders. It is not so difficult to sense this. Just move your left arm around while stiffening your right side. You should able to sense the left side ribs moving slightly, independent of the right side. Intellectually understanding this is the first step; second step is to begin to feel the reality in your own body movements.
  • Reaching with heavy elbows.  As you know by now, we want to avoid lifting our shoulders unnecessarily. Yes, they DO of course have to lift as we are reaching up. But reaching forward or down, as when we reach to type on a computer keyboard, we have no reason to lift the weight of both shoulders off the rib cage as we do this. Yet, this is exactly what many people in fact DO. Usually the lifting is very little, maybe ¼ “ or less; it is not easy to see it, except in a global sense that there is something not quite right, something inelegant about how they are reaching forward with their arms. Remember, lifting the shoulders even 1/100 of an inch means ALL the weight of both arms and shoulder girdles goes to the NECK, and this we don’t want. And if we reach forward that way, we are going to work all day long that way too. That is a tremendous abuse of the shoulders and the neck, and the prime reason why people feel burned out from working at a computer. 
    • So, I recommend that we practice ten times, reaching with each arm “heavy” each morning for a week, reaching forward and down as if the elbows had weights attached. This keeps the shoulders grounded. It is how all-martial artists punch. Do this for ten days; then your body will have that concept for life; you’ll easily reach forward with grounded shoulders and work that way, all day long. Otherwise, you work all day with an over-burdened neck, taking ALL the weight of BOTH shoulders, simply due to reaching with slightly lifted shoulders. The reason we use the concept of “heavy shoulders” is because the shoulders are reflexive, and they don’t “listen” when we speak to them “directly” as in “stay down as I reach”. You may be able to make that happen temporarily, but as soon as you are distracted, your old way of reaching with stressfully and slightly lifted shoulders will be just the same habit as always. “Heavy elbows” is a better way to go.
  • Raising the arm overhead: keep palm midline. This is one of the most difficult, or impossible, movements for an injured shoulder. People often complain of this. Surprisingly, there is a quick fix. The way most people do it is causing much of the trouble; they are raising the arm up while the arm is out to the side, not midline. The functional way to raise an arm overhead is first, bring the palm of the hand to the mouth (palm of hand against lips). Then, keeping the elbow and palm close to the midline of the body, raise the hand up, keeping the hand moving along the midline of the body. This is surprisingly easy and elegantly beautiful, like a dance movement. All school kids should be taught this, instead of raising their hands the other, inelegant way. With the hand midline, the deltoid muscles, which lift the arm, are much less stressed. You might do well to practice this every morning a few times, so that during the day, should you ever need to reach up, you’ll do it this way.
  • Grounded, restful shoulders requires: head forward correction and quiet hands and the quieting reflex (see below) and dropping floor of pelvis with a soft belly and relaxed feet at the instant of weight bearing, and self confidence and a soft rib cage, and eyes that can look up as easily and as long (no strain) as looking down and practicing reaching with heavy elbows and independent left and right rib cages and an effective stress reduction program, and also healing from shock and trauma, which many of us have endured – ALL of these are necessary. This is just by way of answering the common question how do I keep my shoulders down? It is not a simple problem and simplistic answers, while they may help for a time, are not enough. A global somatic approach such as involvement in The Feldenkrais Method is the only dependable way to cover all these issues.
  • Rolled sock under each shoulder sleeping on your back at night. Usually the shoulders are slightly lifted due to chest/pectoral tightness, so the two shoulders are lifted slightly off the bed surface and hence cannot relax, since there is no contact with “a supporting surface” to relax into. The weight of both shoulders, hanging in the air like that, as well, creates a pulling or tightness across the upper chest, making breathing difficult in that area. These problems are removed by placing a rolled up sock (or two) under each shoulder when lying face up. While some might say this could perpetuate or exaggerate forward shoulders, it is just not true. Bringing a body part “home” is where it can rest, with neutral muscle tonus all around the body part, and it is from that place even if logically it seems to be wrong that it can re-configure and even acquire a new “home”. This is Feldenkrais logic; the body works by this logic, but alas, most people cannot make sense of it at first. In a Feldenkrais Training, students practice holding and moving parts of the body with this idea in mind. It takes great sensitivity and the giving up of trying to correct the alignment, straighten out what is bent, etc.
  • The Quieting Reflex – best thing for shoulders. Google this. It takes only one breath cycle. I can instantly raise your IQ; teach your kids this, they will be getting better grades. It is so simple you’ll think it cannot be worth much. Here it is: inhale softly, and as you exhale, say to yourself “relaxed body, alert mind.”
  • Minimize usage of armrests – lifted shoulders communicates stress, giving up, “I don’t care” etc. Armrests make us practice exactly that. Now and then a little while won’t hurt you. It might help in some ways; but if everyday you are using an armrest for many hours, it will cause troubles for you. You are learning to be comfortable with artificially lifted shoulders. What we want to learn is comfortable shoulders that are resting fully on a supple and intelligent set of two independent rib cages, left and right.   
  • First rib release. When the there is unrelenting pain in the shoulder area, and no amount of shoulder massage, mobilization or re-education can help, we must suspect an elevated first rib. It is a cause of chronic and unrelenting pain. The first rib is what the shoulder (collar-bone) rests upon, and it can be jammed up too high, from chronic unnecessary lifting of shoulders (as described in these pages). While you can do this to yourself, primarily it is an osteopathic protocol (or chiropractic) that gives immediate relief. MANY folks think they have painful shoulders when in reality they have a chronically lifted first rib. Again, no amount of shoulder stretching or mobilizing or weight lifting will fix that. But in time you can restore an elevated first rib to normal resting position by practicing these many concepts I present in these notes. That takes time, however. 
    • Here is the technique for self-care first rib release, for those who want to try it (it can’t hurt you and may give tremendous and immediate relief). You may have to read this paragraph many times and puzzle through it; I am trying to be as clear as possible here. Suppose your right shoulder is painful. Stand and put your right palm face down on your left shoulder. Raise the right elbow to shoulder height. Take your left hand and prop up the right elbow from underneath. Your left elbow needs to rest on your lower rib cage. Like this, press down with the right elbow, using all possible right arm strength (without strain or pain however). The left arm is preventing any movement.  Keep pressing down like that for at least 10 seconds but no more than 15 seconds. Let the hands drop to the sides. Now find a pole, or corner of a desk, or bookshelf corner, or door jam or door knob and grab it with your right hand. The right arm should be straight fully extended down to the side. Lean away as you continue to hold onto the support with the right hand. This will pull down strongly the right shoulder, including the first rib (which is now ready to drop into place after having been elevated even more by the first part of this technique). Alternately you could hold a heavy weight with the right hand, letting that weight pull the shoulder and first rib down strongly. You may have to repeat this up three times. If you have no improvement from three repetitions, give it up.  If this helps you, take it as a message to learn to keep the shoulders more grounded down, as described in these pages.
  • Why your shoulders keep lifting. Usually it is because of head forward posture; basically the forward head is pulling the scapulae up and forward. So if you want to work on one of the deeper causes of “ungrounded” or lifted shoulders, work on correcting head forward posture. Other causes of chronically lifted shoulders includes unmanageable stress levels, trauma or shock locked in the body, shoulders that have never learned how to be relaxed and supported, chronically over-tense and over “ready” hands, lack of perceived skeletal support in sitting, cultural agreement and imitation, standing and walking with the accompanying poor balance and compromised ankles, reaching with lifted shoulders, an attitude or helplessness or not wanting to take responsibility and finally – habit. If it has been going on for a long time, you now have that habit, no matter whether these other causes are still operative. For that, Feldenkrais involvement is the best approach.
  • How to go about acquiring “quiet hands”. There is an obscure yoga pose called The Flower Pose. Sit quietly and with one hand, make a gentle fist. Now, super slowly, open that soft fist taking at least 30 seconds. Most clients I tested had too much built-up flexor tonus in the fingers to be able to do this on the first try. Instead they’d finish opening the fingers in 10 or 15 seconds. Anything slower than that meant they did not have the power to override the flexion tonus. Another way to soften the hands and fingers is The Bell Hand, which I have described earlier on this list may be the best thing to do. Hands and eyes are related and we need to get involved with ways to soften our eyes and visual habits. This can be learned and soon I will have a book about this.
  • Stiff elbows and straight arms. If you do various arm movements, especially pushing out and pulling in- at any angle or direction – you’ll be mobilizing your shoulder blades in ways that don’t usually happen. That’s because most of us perpetuate our locked-down shoulders by over flexibility and mobility of the elbows. In Feldenkrais ATM there are a surprising number of ATMs where this fact is utilized to mobilize the shoulder blades. In fact, it is safe to say that if you do an ATM series (or even one ATM) on “Shoulders” you are for sure going to be doing movements with straight arms and locked elbows, at least some of the time.
  • Pulling elbow across chest to mobilize scapula. This is a simple little rhomboid stretch (you’ll find it on YouTube for sure if you Google it there) that can be easily and quickly done, practically anywhere. I’ve seen random people in a crowd do this now and then; so this must be one of the more popular stretches out there. You don’t see people touching their toes like that. Rhomboids get tight because we freeze our scapula movements. The rhomboids attach from the inner border of the scapula to the spine. When these muscles are released in clients on the table, there is always a sense of relief in their face, and the breathing right away gets more quiet, restful and deep. It is a great way to quickly relieve stress. If you want to supercharge the stretch and get 3 times the benefit in ½ the time, then while the elbow is being pulled by the opposite arm across the upper chest, resist that pull by pushing your elbow – hard as you can – in the opposite direction (thereby contracting the rhomboids even more). Then quickly release and strongly pull the elbow far as you can across the chest; you get maybe double the stretch, instantly. Repeat this three times; this is a quick path to restoring shoulder mobility. That’s because the rhomboids are the #1 villains in perpetuating shoulder blade fixity, and you deal with THAT, the rest is easy.
  • Why walking on all fours is good for your shoulders. It mobilizes the upper back, it strengthens the back of the neck muscles (which are used to prevent head forward posture), it puts a different kind of pressure on the hip and shoulder joints which can improve circulation and healing response, the spine is free to move independently like “a snake” when it is out of vertical weight bearing.  
  • Why a rotator cuff tear can be serious. A cut on your wrist will heal nicely; but why is this not true for shoulder muscle tears? It is because the weight of the arm is always pulling the shoulder down, and also because the shoulder muscles themselves are naturally very tightly strung. They don’t have a lot of mechanical leverage to move the heavy arm all around; shoulder muscles are dense and tight compared to other muscles in the body. At least an orthopedic nurse, who described to me how hard the doctors have to work to pull muscles back in place after major shoulder surgery, told me this. In other words, a minor surgery might be better for your rotator cuff tear than letting it “heal” naturally which means it will scar over and possibly interfere with normal shoulder movements. Or, you might find some MDs or PTs who are able to skillfully tape the shoulder to relieve the strain on the muscle tear, so that it can begin healing like a cut anywhere else in the body. I’ve been told this is a skill that some, not all, PTs and MDs have.
  • Extreme and excruciating and INTENSE shoulder pain even from a gentle touch. I have seen this numerous times. It is caused by lymphatic build up of toxic fluid in the shoulder area. It comes from prolonged and extreme muscle tightness. The only relief is to strongly mobilize the shoulder to get things moving again, so the lymph can drain. This takes skill and experience, and at least one or two full table sessions. This can be VERY painful for a short time, and then they experience the most profound relief possible. One young man had it; he was in the Army and was carrying around 75 pound field packs all day long. Yes, to do that you DO need tight shoulders, and nobody with any sense in the Feldenkrais Method would say otherwise, but what he was missing was strategies to restore normal movement after his day was over. When this kind of pain is seen in fragile and elderly people it will take very careful handling over numerous sessions, along with a little homework appropriate to their ability and willingness. The concept of “Glue” as explained earlier here, is the best long-term and restorative-corrective measure to prevent and heal such a condition. And basically everything else on this list, all of the items here will facilitate functional shoulder mobility.   
© Copyright 2015 Steve Hamlin  www.mybodycanlearn.com