Sandro: “Hello everybody, today we have a special guest, and he is going to talk to us about shoulder pain. Sometimes our superficial pain can be adjusted just by strengthening and keeping some flexibility in muscles. But sometimes there is pain that is more complex and needs a professional like my friend Dr. Kent Albrecht. Also, before thinking about surgery, this could be another possibility in fixing that shoulder pain. Once again, this is valuable information, so let's get straight to it.” “Dr. Kent, Welcome, it's great having you here.”
Dr. Kent Albrecht: “Thank you for the opportunity.”
Sandro: "It is my pleasure. We want people to learn more about shoulder problems, as to how they can manage them or how they can fix them. So, talk to us a little bit about that.”
I'm going to cover today the four basic components that I've found over 33 years of clinical experience and having several clinics with sports injuries…
Dr. Kent Albrecht: “Well, what I'm going to cover today is the four basic components that I've found over 33 years of clinical experience and having several clinics with sports injuries, auto injuries and what we found is that the underlying cause of repetitive or chronic shoulder problems, that are of a non-surgical nature where there is no question that there's a dislocation or something surgically wrong, but it's just that annoying moderate to low grade shoulder difficulty range of motion or pain when you do certain activities.
Those are the types of problems that can really be helped with the components that I'm going to cover. So, there are two main factors. Number one is gravity. We all have to stand up and fight gravity. Now we don't think about that consciously, but the reality is when you die, you hit the ground, so to keep that in proper perspective, you're spending your entire day on your feet fighting gravity to stand up. So, posture becomes the number one component.”
Sandro: “And that's why it's important to exercise and keep good posture all the time.”
The major component of a shoulder problem is the fact that it's the number one most dislocated or injured joint in the body…
Dr. Kent Albrecht: ”Sandro is probably a lot more of an expert relevant to shoulder issues, and he’s not giving himself enough credit. Because the major component of a shoulder problem is the fact that it's the number one most dislocated or injured joint in the body, because it's a ball in a socket. So, the arm bone, the humerus, is basically just sitting up there with the ball on the end of it and this socket is held together by the tendon and ligament attachments in that shoulder joint. Not a lot of strength and control in the anatomy of the bone structure itself, just kind of hanging there. We found the muscles, even though they may have proper strength in position, can still cause chronic problems.
So, then we move past to where it's a muscular issue, which you can certainly help with, no question, just in proper strength, positioning, range of motion etcetera into the anatomy of the problem. So, the components are basically pretty easy to understand when we look at it in terms of how the body is constructed anatomically to support the shoulder. The Girdle, as we'll just refer to it, the whole arena of the shoulder joint, there are four components. The first is the neck area, the second would lead into the upper back area. The head would be up on the neck area, upper back area, lower back, etcetera. What's interesting about this number one is the starting point is that God created the spine to resist gravity and the way he did that was pretty interesting. The neck has a backward curve, the mid back goes the opposite direction and the lower back of course curves back again with the pelvis. So, we have these curves that are created; if you put a ball by the neck and a ball by the spine and a ball pelvis, you'd see the 30-degree angles. So it's not by a circumstance that it just kind of happened that way. This was constructed with a lot of wisdom because those angles allow maximum resistance against gravity.
When we deviate from our posture, which can either be from laziness or lack of muscle strength, you can create your own problems over time…
Now when we deviate from our posture, which can either be from laziness or lack of muscle strength and tone and balance, which is your arena, you can create your own problems over time. Let's just take the example of the person who ever since childhood just slouches all the time. They slouch sitting; they slouch standing; They let their head fall forward. All these problems can only go on for so long until you're almost stuck in that position you created. If we take this 10 lb. ball, which represents the average weight of a woman's head, a little heavier for men 10 to 12 lb, if you hold this ball in your hand backwards, to represent the backward curve of the neck holding the weight of the head, what they have found in research was that you will take the weight of the head, which is 10 lbs. on the normal position of the spine, and as soon as you straighten that out or let it fall forward that weight can go to 30 lbs.
Now, what supports that are the muscles from your neck, base of your skull down the neck out to the shoulder joint that's holding that weight all day. You kind of see the relationship structurally and functionally and how posture plays a role. What happens is, as soon as you start throwing that forward, everything turns around forward. Most people have a lot of strength in the anterior musculature and are very weak in the rhomboids, latissimus dorsi. Some of the other muscle factors are the rotator cuff group. So, you're trying to get them to strengthen the extensors as much as the flexors and have proper balance. Most people are naturally tighter and stronger in the front region and weak in the back. So, when you work with the client to strengthen that, they respond really well and even their shoulder function is much better and less pain and symptoms, that's where it's just a muscular postural issue.”
Sandro: “So, what about people who actually have the right posture, but they have had some accidents?”
Dr.Kent Albrecht: ”So, what can happen there is the detail of the individual joint position and function that can create a problem. So, for example, the person with the proper posture, ears over the shoulder joint but still having shoulder issues, we're talking about the other components. And what happens is, for example, if you get into a situation where the inside of your spine and neck are in a forward position from an injury such as a whiplash injury or a snow skiing injury, multiple micro injuries over time, it can be 5 miles an hour at a stop sign, no big deal. You don't even think about it. It was a mild injury as you see it, because there's no blood, no guts, no broken bones. So, you walk away, no big deal. But if you hit your brand new car on a curb, potholes or railroad tracks, you eventually knock the alignment out of the front end of your car and your tires start to wear uneven. That's the same thing that happens to the body and you should come to me before it heals in the wrong way, because you will always heal.
This is where sometimes patients misunderstand what micro traumas do to the joints and internally to the body…
Micro traumas repeatedly over time can end up being a major trauma to the joints because you're going to heal dysfunctionally. So, diagnostically speaking, you know, when you have that case with the repetitive shoulder strain, the chronic shoulder issue. Even after everything you've done with working out and it's still a problem, now you have to diagnose what are the components involved here.
There are physical tests performed that would be the same as what an orthopedic surgeon would perform if he's examining you for shoulder pain because as chiropractors, we have the same medical training. X-rays can be the next part but not always necessary in every patient case. It's really simple, but usually in a repetitive problem or a chronic problem, X-rays are going to tell a lot of the story that's misdiagnosed by guessing; when you see the X-rays you see all the details, so X-ray films are extremely valuable because you see normal positioning to what abnormal would be that you just can't see with the naked eye and like a dentist looking at your teeth structure. They need to go and find out what the underlying reason is.
We already briefly described normal backward curve positioning and weighted head on top and neck and shoulder muscles and everything that leads to a lot of people with the forward head posturing from an old trauma injury or really bad posture. Now we're getting into the upper dorsal spine curvature problem. That is called a kyphosis and that creates a problem, because it throws everything forward and if you curve your spine forward and let this curve right here be excessively forward, with your head falling forward, you're going to start having problems with the shoulder range of motion right away. you're restricting shoulder motion but still using the shoulder.
How to alleviate shoulder pain...
So, that's the second component, which is the upper back arena of the bone position of the vertebral locking in the rib cage, scapula, and clavicle, all affecting shoulder motion. So now you're restricting shoulder motion but still using the shoulder. You're still out there shelving snow, later you can't sleep on your shoulders. Based upon what the exam shows, the X-rays may show to get a correct diagnosis, along with remembering the third and fourth components that come in this whole shoulder girdle. We talked briefly about how when the upper back curvature is too much, throwing everything forward. Now the scapula, which is your shoulder blade, has a huge involvement in shoulder function and many times is overlooked in therapies.”
Sandro: ”So tell me a little bit about yourself, I see that you have a lot of knowledge, where did you get your knowledge? “
Dr.Kent Albrecht: ”Well, briefly, because most people don't understand the actual hours of education and chiropractic college actually exceeds what's in medical college. For our education, we use the same textbooks and half of my faculty in my chiropractic college were medical doctors teaching us anatomy, physiology and pathology. So, the education for chiropractors, which most people just don’t understand, is actually the same length of time as in medical school. It's just we choose not to do drugs and surgery, our treatment goes towards nature. It's like if a person says they choose to eat organic instead of whatever foods someone wants to give them.
Sandro: “So, in other words. It's a smart decision. Thank you for teaching us how to alleviate shoulder pain; we have information about the shoulder. We’ve learned what to do for shoulder pain and also how we can avoid that by strengthening and stretching your muscles at the same time. Or if it's traumatic, seek the aid of a good chiropractor in order to receive the best treatment. Please share this article, comment and subscribe to our channel. We will continue giving you valuable information. Remember, we're doing this for you because we want you to live a healthy, happy life. Thank you so much.”