Physical Therapy of "Shoulder/Arm" Pain (PT Visit)

People often believe that if one does yoga then one should never have any aches, pains, or injuries.  If only that were true.  In fact, my own journey has taught me that aches, pains, and injuries are just part of life, regardless of the disciplines we study.  The difference is how we handle them and what we do about them.

More than 12 years into my own yogic pursuits, I now consider ailments (aches, pains, & injuries) to be a learning opportunity.  These seemingly unfortunate things actually have taught me a tremendous amount about my body and have generally led me to new, enhanced practices which leave me wondering how I could have missed all that new stuff before.

As a result, I now visit the PT monthly whether I need it or not.  At these meetings we go over issues that ail me minor ways and revisit situations from the past.  He shows me how he'd address it on my own body, discusses what he sees in other people, and then we talk about how I can tie it back to my yoga students.

Today we looked at a minor issue I've been having: pain on the anterior of my shoulder, just below the clavicle - kind of where shoulder meets bicep & chest.

Over the last few months he has explained to me that this pain is actually near the origin of the short head of my bicep tendon and that it's probably the result of the head of my arm bone moving forward and essentially rubbing the tendon origin against my clavicle - which irritates it and causes pain.

The case gets more interesting when you consider WHY the head of my arm bone is floating forward.  Isn't that something that we're always trying to avoid in yoga?!  Maybe I just stink at yoga?  Or maybe it's not as easy as simply willing it to be so?

Darrell, my PT, ran a series of simple range of motion and strength tests to determine that, like most people, my rotator cuff muscles are not strong enough to keep my arm bone where it should be during the activities I'm performing.  He's very specific about that.  Darrell says that if I lived a "normal" life and didn't engage in such challenging asana, then I probably never would have had this problem.  He contends that my range of motion & strength are actually pretty normal, but since I'm doing abnormal things, I'm getting normal pain.  Hence, this is indeed a caseof pushing myself too far. 

So why continue?  I often go over this myself wondering if I'm trying to impress someone or if I'm just a busy body.  And in some ways, those explanations have some truth, but so is the explanation that I want to really LIVE with this body and understand how it operates both in an effort to understand it for myself and for others.  It's like exploring inner-space for me and I'm willing to assume the risk.

So, a little more about the muscles...Here is an excellent graphic I found of the area in question:

Source: http://droualb.faculty.mjc.edu/Lecture%20Notes/Unit%203/muscles%20with%20figures.htm

Darrell believes that my Infraspinatus is stretched long and is too weak for what I'm asking it to do.  So, the head of my arm bone floats forward, which compromises the position of my inner (short head) bicep.  This bicep grinds on my clavicle and I get pain.  In the meantime, the head of my arm bone also floats up because my Supraspinatus isn't doing it's job either.  This leads to other muscles coming to their rescue: my Levator Scapulae rises as the arm bone rises and my rhomboids over-work.  Additionally, my lower back (opposite side) even comes into play when the other muscles need more help.

The lesson is clear: One little imbalance can lead to a huge chain reaction of other, unforeseen problems - which themselves may seem like a problem, but are actually just symptoms.  Getting to the root of all problems is my yoga.