A patient with over two years of stubborn shoulder pain started treatment with me last week. She described the pain as starting “out of the blue” for no obvious reason. She couldn’t remember exactly… but she thinks she may have had a heavy gym workout a few days before the pain started but there was nothing to suspect that she had injured herself.
Since then she has slowly but surely had to do less and less with the shoulder to avoid worsening her pain. It’s sad to hear as she hasn’t been swimming or hiking or going to the gym, or doing all the physical things she use to enjoy. She still uses her arm to get jobs done that just need to be done, such as cleaning… but she pays for it for a couple of days with more intense pain.
Interestingly, her shoulder MRI results were clear, so from a structural point of view her shoulder isn’t damaged.
She was really confused about how her shoulder could be so painful but there not be any signs of injury on the mri results. So we chatted about the concepts of “defense” vs “defect” and how it’s really common for a painful joint to be painful because it is stuck in a kind of protection mode where the nerve endings are super sensitive an the surrounding muscles become very “guarded”.
The idea of her shoulder being “protective” really struck a chord. “I really sounds how I feel”, she said.
We talked about how underneath all that protective guarding, there is probably a shoulder that is ready to get back to swimming and exercise again. She seemed excited to explore that process and we will get stuck into a treatment plan next week.
