Join date: Feb 2004
Location: Nevada, USA
I do omit certain variables such as the joint capsule which wouldn't really be a fixable issue,
That is not true, sorry. The GH joint can certainly be released. One of my current patients has bilateral adhesive capsulitis and you can be certain that we are improving it, albeit slowly.
I hear you on the slow progression with capsular issues. I'm working with a athlete who had gone through an extensive shoulder surgery (capsular repair, rot cuff repair, labral repair), who also ended up getting adhesive capsulitis during the immobilization and healing. It is about a year post-op and we still have some small lingering ROM deficits with capsular tightness (which was to be expected after the capsular repair). But it is definitely possible to make capsular changes.
As a DPT student graduating into two months, I'd like to put my 2 cents into this discussion.
First of all, it is very hard to tell what "issues" someone is having by just looking at pictures. In order to properly diagnose a patient, a physical exam needs to be done. Based on the pictures, it looks like the left scapula when compared to the right is in a position of elevation and retraction, leading me to believe the upper trap is short on that side. It's hard to tell, but there also may be some anterior tipping, which would indicate a short pec minor. If this is true, then the lower traps are likely long and weak in a shortened position. The treatment hear would be to place the lower trap in a shortened position and work on exercises here.
Like I said, it's hard, or rather impossible to diagnose based on pictures alone. I heard some discussion on whether musculature or capsular limitations are affecting this individual. The answer is, it could be either, and it can only be differentiated by "end feel." So this question is up in the air.
I also heard some talk about the GHJ and no mention of the surrounding joints at the shoulder (SC, AC, ST). This is a common problem we've been learning about at school. During shoulder flexion, the first 60 degrees come from GH motion and the scapula sets itself, most of the remainder comes largely from those other joints which are often neglected during treatment. I'm not saying this is the exact problem the person has, just saying those joints need to be checked out.
All that can be said for certain from those pictures is that there seems to be some muscle imbalance, and while that is most likely not the primary cause of the problem, it is something that is a contributing factor, and needs to be addressed.
I'll straight up come out and admit that the only knowledge I have of structural biomechanics and anatomy comes from my own reading, but wanted to ask those more knowledgable if my own thoughts may have any merit. I was thinking- what about OP's hips? I remember reading a Cressey article which stated that the scapula are biomechanically linked to each side's opposite hip/ankle. If OP's issues with his shoulder are muscular, rather than anatomical, could an imbalance in the hips be the main contributing factor, rather than an issue in and around the scapula itself? It is my understanding that the body is geared towards maintaining a sense of alignment/balance- if his hips are out of whack- say, for example, from a dropped hip (weak glute medius)- could his body's own readjustments have inadvertantly forced an unadressed issue further up the kinetic chain, in this case his shoulder?
I'm probably missing something key here, or have misinterpreted or misunderstood something- I was just curious if anybody could perhaps give any further insight?
I am going to say something shocking that you will all argue about and ultimately dismiss, but it is right. Ignore it and the loss will be yours only.
Excess body hair in particular places is a sign of muscular dysfunction beneath.
This includes hair patterns on the chest, the abdomen, the glutes, legs; especially those muscles down the front that like to pull us into a primordial ball under stress.
In the case of the OP, there are unusual hair patterns on the shoulders and back of the neck. I don't need to name the muscles involved, as this can only start a stupid argument. It will be evident in a mirror where the OP needs to target.
Stretch the shit out of these muscles.
Weight training will make it worse. You are not in balance. You have muscles such as your delts and upper traps that aren't even contracting properly and you will only throw yourself further off balance. Regain your full range of motion in these muscles with active stretching, and only after that should you consider a weighted shrug or military press.
I had similar hair patterns. It took two years of stretching, but my muscles are almost all healed. Hair no longer grows there. This is my proof, not yours, but heed it if you would learn something new.