Postural Restoration Institute® focuses much of its intellectual prowess on the rib cage and how it influences your whole body.
Why do you care about your rib cage?
Because the causes of shoulder pain don’t always have to be the result of an injury.
They can be due to the position of the shoulder joint itself.
And the position of the shoulder joint relies upon what lies at its foundation: the rib cage.
So shoulder pain relief can often be accomplished without even treating the shoulder. You can focus on the rib cage and its position.
That’s my focus for this post.
The Gleno-Humeral, AKA, “Shoulder Joint”
A brief overview of the shoulder joint (the gleno-humeral joint).
– The shoulder joint is a ball and socket joint. The ball is the head of the upper arm (humerus) and the socket is the glenoid fossa, which is part of the scapula (shoulder blade). So what we call the shoulder joint is the intersection of the upper arm bone and the scapula.
– Obviously the arm moves in the socket. But what is less understood, and just as important, is that the socket (again, part of the scapula) can move on the arm. This is normal and desirable. However, if the scapula is positioned improperly (see next point) and thus unstable, the shoulder joint itself will be less stable and may end up causing shoulder pain.
– Normally, the shoulder blade (scapula) rests neatly on top of the rib cage. If the rib cage is positioned incorrectly, this will effect the stability of the shoulder blade, which will no longer lay flat.
– So if the foundation (the rib cage) is mispositioned, so too, will be the scapula. A loss of normal movement will occur in the shoulder joint as the arm can no longer move freely in the mispositioned “socket”.
Your arm will lose range of motion in certain positions because it is getting “stuck”, or being “impinged”. This impingement can cause shoulder pain since structures: tendons, muscles, bursae, may be getting pinched. In addition, certain muscles that attach to the scapulae will become long and weakened or short and overactive due to the mispositioned scapulae.
Restoring proper movement at the shoulder joint, by addressing the position of the rib cage that influences it, often causes pain to go away or allows injuries to heal more easily.
My Extended Spine and Elevated Rib Cage
What the video below shows is that my back in a state of extension (excessive curve in the lower back/spine). If you take a moment to arch your lower back, notice what happens to your ribs in front.
This “ribs up” position is how most of us are living every day. This position is natural, but we shouldn’t be living in this extended state continuously. We need to alternate between extension and flexion. However, for brain related issues, we get “stuck”.
I am a special case because although I can get myself out of this “ribs up” or “extension” state, I don’t stay there. It’s due to foot instability and my bite. Don’t try to figure it out. It took me 4 years of obsessive study and many thousands of dollars worth of seminars to understand
edit: as of August 2018, my bite and foot instability have been addressed and I now stay properly positioned. Again, I used PRI methods.
You’re Probably Not Me
Most people aren’t me. They can successfully perform a Postural Restoration® program and be good for the rest of their days. I, on the other hand, have a special brain that just loves to throw me into the ribs up extended position. Lucky me.
While it is a major inconvenience and the source of an occasional lower back mini-spasm, I am also a perfect test dummy for PRI methodology. I am the perfect patient.
I had just returned from work and knew my brain had thrown me into the “ribs up” position (I can feel it happening). So I decided to shoot this video. What you are seeing is my upper body getting out of a state of “ribs up” extension and into what we call “neutral”.
You know I have been successful because of the difference in my right arm’s internal range of motion. In the beginning of the video I’m lacking. At the end of the video I’m not. The change in range of motion indicates my rib cage has repositioned.
Keep you eyes on two things
– My upper chest. Upon my first inhalation, I don’t have very good chest expansion, meaning my chest will not rise towards the ceiling very much. This is because my spine and rib cage are in the state of extension that we are trying to get out of. When you are stuck in this position, your breathing is compromised. (In case you are wondering, it doesn’t matter if I am standing or lying down. I’m in extension no matter what).
As I exhale, you will see my ribs go down. That is me blowing all my air out. Getting the air out, and the ribs coming down, is what then allows me to get better air flow into my chest because my diaphragms are being utilized (if ribs are “up” diaphragms are compromised). You’ll see inhalations 2-5 result in much better chest expansion and thus better breathing.
– My shoulder internal range of motion. The first thing I show is how my right shoulder won’t internally rotate fully. This is because of the impingement that I wrote about earlier. My right arm is stopping because it is hitting part of my scapula. This special breathing exercise repositions my rib cage, which repositions my scapula, which then allows my arm to fully internally rotate. Essentially, I am moving my ribcage out of the way so that my arm can rotate. No stretching needed.
The process, which I don’t really explain in the video, is this:
– I inhale in a resting position.
– I slowly exhale while lifting my butt up off the floor slightly by engaging my hamstrings and external obliques.
– At the end of my exhalation, I wait 5 seconds with my butt still in the air, and then I return to my resting position.
– Repeat for 5 breaths.
***note: it’s important not to inhale until you are flat on the ground in the resting position***
Voila! You’ll then see that I have gained full internal range of motion of my right arm. It is free to move and operate as an arm should.
If you are interested in a more detailed explanation of what is going on, check out this post:
PS. I get many e-mails and comments about this issue. Unfortunately, there is no way I can diagnose anything or know how to help you without meeting you in person. In addition, there are other areas of the body, in particular the feet, pelvis, and neck, that can influence the ribs and shoulder.
If you are in the United States or the UK, please check the Postural Restoration Institute website for a provider in your area.