Ever had a shoulder injury that concerned you - so you demanded an ultrasound, xray or MRI to figure out why things were pinching and bugging you so much?

Based on the shoulder survey we put out a few weeks ago, at least 10% of our newsletter responded that they have recently been dealing with some shoulder issues recently.

While there is a time and a place for digging deeper into diagnostics for why things are hurting, here's the other side of the coin:

In the associated paper from the above table, 96% of ASYMPTOMATIC people ages 40-70 had "abnormal findings" and pretty serious sounding injuries, despite being pain free and having zero clue.

It's been awhile since I took a math class but if I'm not mistaken, if 96% of cases have a "finding", maybe that should be categorized as NORMAL and not ABNORMAL?

This raises the question, if MOST people are walking around with these tears, calcifications, and arthritis's in their shoulders and NO pain, what distinguishes them from people who have these things and DO have pain?

The problem is complex and other researchers have tried to figure out why this might be, only to come up with all these complex reasons why someone might have (low back) pain:

The more angles someone takes to address their pain, the higher their likelihood of reduction in pain:

So if presence of degradation isn't predictive of pain, and pain is complex and multifactorial, as an exercise physiology and strength and conditioning professional - how would I tackle shoulder pain you might be wondering?

Mainly, with the tools I have in my toolbox, which are: biomechanical factors (is the WAY you're moving causing the problem), strength factors (are there obvious asymmetries or deficits that could explain WHY one area is getting overloaded), and individual factors (are there things YOU are choosing to do with your body that could explain the problem).

With a recent client, we did an assessment to find out just this, and found that there weren't too many strength imbalances that could explain her shoulder pain, and there weren't obvious biomechanical problems with the WAY she was moving, but individual factors came to the forefront. In a front raise exercise, a lat pull down, a dumbbell bench press, and other exercises, she would get a pinch in the shoulder with specific hand rotations. We found the positions that caused the least amount of pain, then trained through some pain, and increased the capacity of the muscles, tendons, and ligaments to help create a more robust system.
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​HERE'S A SNEAK PREVIEW of an exercise (from Shoulder Foundations, too) and how we might modify it for someone experiencing pain with the movement, just like we did with that client.

After a few months of training with us, this client was pain free in most or all shoulder movements and submitted this review:

So to answer the header of this email, we like to say: "Train with some pain".

With the recent release of Shoulder Foundations, you can start self-assessing these things too, for less than the cost of one appointment with us!

Let me know your thoughts - I reply 100% of the time.
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Yours in physiology,

Carla