By Arnold Askew, GCFPCM
The shoulder is a wonderfully designed joint that allows us to have almost unlimited range of mobility of the upper arm. The upper arm or humerus has a ball at the end that fits in the socket of the scapula. It reflects the similar type of ball and socket of the upper leg in the hip. Unfortunately, the shoulder is prone to a large variety of insults and injuries. One of these and probably the most common are strains and tears to the rotator cuff. This cuff consists of four small muscles that help hold the upper arm snugly in its socket. They assist the larger muscles in certain movements by maintaining a healthy joint position. When one of these muscles is compromised it destabilizes the joint causing limited mobility, weakness and a great deal of pain. Injuries can range from a slight strain taking a few days to recover to a complete tear which can take six months to a year.
Treatment and recovery, of course, depend on many things; the severity of the injury, the type of treatment, how healthy the person is, and a myriad of unknowns. Serious injuries often require medical attention to patch things back up. Healing from this emergency phase and medical intervention is the first necessary step. This is the time for keeping things relatively still, protecting the area as it begins to heal. Once the wound(s) begin to knit back together it’s time to start the rehab phase. Rehab might conjure aggressive and painful images, but on the contrary it should be very gentle and small, especially in the beginning. Rehab is about starting where you are and finding ways to improve that don’t set you back in the process.
One thing that helps this rehab process go smoothly is getting an accurate diagnosis and learning what it means. This gives everyone, patient included, clear parameters for what is safe and appropriate during the healing process. Once the extent of the injury is understood there are usually a number of options as to how to approach it. One would think that the least invasive option would be tried first. But, many things may steer one away from this, including the sheer pain and fear of it all. If one of the muscles has completely torn from the bone, surgery is usually the best option, though this isn’t always possible. In such cases the individuals can eventually make do, but there will always be some instability and probably pain.
This is where a trained Feldenkrais® practitioner comes in: to assist in finding improvement no matter the situation. To be clear, a torn rotator cuff muscle is a structural problem. There will be scarring and permanent changes that will alter the original mechanics of the joint. But, that doesn’t mean we can’t learn how to work with those changes, and hopefully in a way that minimizes strain, thus avoiding a series of future injuries. Each new injury can lead to even more loss of motion and an increase in pain. It’s like any physical change to our bodies, be it knee or hip replacement, back problems, whiplash and even arthritic changes. Our best option is to figure out how to use what we have, almost like we did as infants. Infants don’t generally injure themselves trying to force a stretch or to get stronger. That usually comes later when they go crazy in the trance of trying to imitate or be better than others.
Feldenkrais practitioners take on the infant’s approach. They carefully listen and feel where a joint can move pain-free and without force. They help the client map out the changes, which is now new territory. And they help the student learn to move with this same gentle curiosity as if it were the first time they ever noticed their own shoulder. This process is very different from the treatment- and therapy-oriented modalities needed in the beginning of an injury. It is more like someone who loses a leg or has a stroke. After the initial healing, that individual has to relearn almost everything there is about walking all over again. Sometimes it’s slow and arduous and other times progress comes in leaps and bounds. The motivation, of course, is to get out of pain and back to what you’re passionate about.
One of the best things a Feldenkrais practitioner can teach you is to slow down and make micromovements. At the same time, paying close attention to where you feel comfortable as opposed to any boundary that might even hint of pain. By learning to feel this boundary we can begin to map out where it’s safe to move and where we need to wait for further healing. The dance is mapping out how much and how far you can move, not going into the boundary until the boundary disappears and you can go a little further without effort or pain. Once you learn this you can begin to explore. The more you look, the more there is territory to explore. There’s a world to explore. It’s back to that infant exploring their movement possibilities out of pure infatuation. As we move more comfortably, we begin to naturally increase our range of movement. In time we reach the maximum amount of movement available and usually the appropriate amount that our lives require.
Sometimes it is not just the injured shoulder that needs the attention. When we have an injury, we reflexively compensate in other areas to accommodate the injury. This means we may overuse the opposite shoulder or stabilize our posture through the spine. These compensations assist in supporting the injury, but over time are no longer needed. However, it’s not unusual for the compensation to become habituated so that it’s still active even after it no longer serves its purpose. This excessive activity is not only inefficient, it’s also exhausting.
Again, this is where a trained Feldenkrais practitioner comes in. By using the same gentle and slow movements, we can relearn how to adjust our posture for an improved overall organization. As we begin to appreciate the changes we can make through this Method we realize how many areas it can be applied to in our lives. Whether it’s recovering from an injury or wanting to improve our posture or how we walk, the Feldenkrais Method is an amazing system for self-discovery and improvement.
Arnold Askew GCFPCM has 30 years of experience in bodywork and movement education. For 17 years he was on staff at the Doleys Pain and Rehab clinic in Birmingham, AL teaching movement classes and seeing patients individually. Before moving to Tuscaloosa in 2010 Arnold was co-founderPhoto by GMB Fitness on Unsplash and senior instructor at Red Mountain Institute for the Healing Arts where he taught Neuromuscular Therapy for 15 years. Currently, Arnold has a private practice in the Tuscaloosa area where he works with a variety of clients helping them find their maximum level of function, flexibility and comfort. His website https://www.somatic.solutions