Repetitive Strain Injury/RSI pain in arms and shoulders

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Question
I did a lot of yard work, raking, and then shop vac'd the entire house.  I woke up to spasms in my shoulders and deltoids.  I went to the Chiropractor who diagnosed me with impingement of the shoulders.  He gave me some stretches to do with a cord-like red band.  I faithfully did them and each day, my arms hurt more and more.  After three weeks, I knew i had ruined myself.  I had knots all over my biceps, my forearms, triceps, etc.  It was excruciating and I was totally debilitated.  It's been four months and six cortisone shots since.  I have had my shoulders done, my biceps, trapezius and my spine (a bulged disk in my neck which is actually an old injury).  I do not think it is my spine, nor do two neuropeople.  My muscles have gotten better, but I am still debilitated from doing my normal routine.  My shoulders are still impinged and giving me terrible pain.  I am on hydrocodone every day for the pain.  I am going to try to do some physical therapy, but I am still so tender that it even bothers me to type this.  Who should I see for help?  I am going to beg an orthopaedic person to inject my shoulders again.  There is hope for that to be solved.  My arms though, are sooo delicate.  My husband is growing weary of having to do the housework.  Would massage be best?  Or is this just a time thing yet?  Please help.  I am at my wits end with this in both arms.

Answer
Hi Linda,

From the sound of what you are describing, I'd say you have frozen shoulder. It sounds so innocent, but it's one of the toughest things I've personally ever dealt with through all the repetitive strain injuries I've experienced. I can hear your pain and frustration, and I'm happy to let you know that this can be treated very effectively and quickly, but stretching isn't the answer. Unfortunately stretching a muscle that has spasms in the fibers can definitely cause more pain, and may even tear the muscle fibers.  Imagine taking a 12" length of line, tying enough knots in it so it is 11" and then trying to stretch it back to 12". The same thing happens with your muscles.  However, if you first untied the knots (release the spasms) and then stretched it, you'd be successful.

Before we go further, I suggest you go to http://www.julstro.com and read the section called "Muscles and Pain" and "What's Happening Exactly."  It will give you a much better understanding of what is actually happening.  Your shoulder has more muscles attached to it then any other joint in the body.

The movements you did simply repetitively strained each of those muscles and tied "knots" (spasms) in all of the muscles.  As a result, the muscle in the front is pulling your shoulder that way, but the muscle in the back isn't lengthening so you can make the movement. At the same time, the muscles in the back (there are many) are pulling your shoulder back, but the muscle in the front is too short to allow your shoulder to go back.  AND, the deltoids (around your shoulder cap) are in spasm on the front, side, and back, each preventing easy movement in any direction.  There are other muscles that are lower down (specifically: latissimus dorsi, serratus anterior, and more) that are holding your arm down and preventing you from lifting it.    If you just release the spasms in each of the muscles that impact your shoulder (it's easier than it sounds) it will release the tension on the joint and your shoulder will be just fine.

I once had such a severe case of frozen shoulder in my left shoulder that when my arm was down to the side my total range-of-motion was 3" to the front, 3" away from my side, and I couldn't even bring my thumb back past the side-seam of my pants.  Absolutely every self-treatment that I teach people comes from that injury, and I became 100% better by releasing all of the many spasms in each of the muscles.

After you read the website mentioned, you'll see how you can learn how to self-treat each of the muscles.  Especially when it comes to the shoulder, it's important to know self-treatments because they need to be done several times a day.  I also suggest you hold off on stretching until you have released the spasms, and then alternate treat-stretch-treat-stretch.  It's not a short treatment program, but it will work.

You may also benefit by first going to a good massage therapist who is trained at doing trigger point therapy and myofascial release.  Tell the therapist not to stretch the muscles, just to treat the spasms. Then you can pick up and move it forward.

Wishing you well,
   Julie Donnelly

Repetitive Strain Injury

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Julie Donnelly, LMT

Expertise

I can accept questions that relate to chronic or acute pain caused by muscle spasms and contractions. Repetitive Strain Injury is actually Cumulative Trauma to muscles. Releasing the spasm &/or contraction will relieve the strain that is felt at the insertion point on the bone. I am the co-developer of the unique safe-stretching program "Focused Flexibility Training," which combines easy instruction for self-treating spasms throughout your body with proven yoga stretches. I have recently authored two new books: "The 15 Minute Back Pain Solution," and "The Secret to Your Best Golf Game EVER!

Experience

Since 1989 I have been working with endurance athletes and individuals suffering from chronic pain conditions. I have authored seven self-treatment books and three self-treatment DVDs and I have developed the Julstro System for the treatment of carpal tunnel syndrome, Trigger Finger, and other Hand/Wrist pain. I am a national and international presenter at conventions, seminars, and workshops. Principle topics are "Work Shouldn't Hurt," and "The Pain Free Athlete." In 2005 and 2006 I was the massage therapist for ultracyclists competing in the Race Across America (RAAM) 3000+ mile race from San Diego, CA to Atlantic City, NJ. I've taught the Julstro techniques to physical therapists at the Cleveland Clinic, to massage therapists in areas around the USA, and I've taught Julstro self-treatment clinics to dancers at Juilliard School of Performing Arts (NYC),the sprinting team at NC State, and I am working closely with several Olympic-hopeful. We have successfully eliminated the repetitive strain injuries that could keep them out of the Olympic Games, and the best part is they know how to do the self-treatments so they can stay pain-free and flexible.

Publications
Triathlete Magazine, Endurance Magazine, multiple national and international trade journals.

Education/Credentials
Swedish Institute of Allied Health, NY, NY - Initial education in massage therapy Licensed NYS Massage Therapist since 1989. SUNY Empire State College, Saratoga Springs, NY - B.Sc. degree in Interdisciplinary Health Education I was an Associate Professor helping to develop the massage training program for SUNY Rockland Community College

Past/Present Clients
Privacy prevents me from filling in this section without prior consent from my clients. Life Experience: I have been specializing in the treatment of chronic pain and sports injuries since receiving my NY massage license in 1989. A personal bout with carpal tunnel syndrome was the catalyst to my developing a self-treatment that heals the symptoms of carpal tunnel syndrome quickly and without surgery. My work with endurance athletes was the inspiration to teach people how to self-treat so they could stop pains even during a race or heavy training day. Both of these situations ultimately became the products that are sold on my websites: http://www.FlexibleAthlete.com and http://www.julstro.com. I currently treat people in my offices in Sarasota, FL, Cary, NC, or Pearl River, NY

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