Introduction
Hello everyone. You’re here because you’re wanting to learn how to take care of your shoulder pain or maybe for a loved one. If you have the following issues with your rotator cuff, shoulder pain, frozen shoulder, you will be learning about all of these things. And then the second thing is make sure you’re in a safe room where you have enough space to do any physical movement because we are going to be doing that and demonstrating.
It’s awesome to reach out to so many people across the world. Welcome to the solar pain and rotator cuff workshop blog.
Question
I am going to start with a question. Do you know the population of United States? Over 330 million people, give or take maybe a million. Now, for your knowledge, I can tell you last year, 30 million procedures were done on the shoulder itself. Any kind of, you know, non invasive surgeries and this is also not including of any kind of injection anybody took. This is not including neck pain or other issues that are going on. That is absolutely crazy 30 million procedures.
I’m going to talk about why so many procedures are performed. The question is are they really helping or not? Before we got started this way we sent out a poll to many of you, you guys filled out the poll form. You’d be surprised results. I just looked at the poll results. I’m more surprised because I’ve been doing this for a long time. 80% of you are women. I want to talk about that much more. My name is Subrat. I’m going to say that this is is my ID I have a really long last name. My last name is so long that my wife didn’t want to even take it. She has her own last name. She is an above average physical therapist, and Ive been practicing for the last 30 years.
Our Experience
Ive been practicing for the last 30 years since I graduated. So many things have changed in my personal life, so I decided to do something different. I’m going to talk about all that in a minute. What is really important?
Yes, so many of you are have been suffering for the last 10, 20, maybe even 30 years. When you are suffering for such a such a long time, you’ve get a lot of information. This makes learning difficult, but what is more difficult, is really unlearning. Until this learning happens, we cannot learn anything new.
I’ll ask you as long as you are with me, please try to forget everything you have heard so far. Forget all that for the time being. It is going to be hard for you to understand where I’m coming from and it is not going to make sense to you. So it is very important that you read this from beginning to the end to make sense. We are doing this workshop for you. It does nothing for me.
What really happens when we are treating patients is the patients come here who, have been through and done everything to get help having nothing work. You are probably in the same kind of boat. You have probably had many procedures to try and help you to this point.
This is going to be a good start. I talked a bit about me. 28 to 30 years pretty much, I forgot how long Ive been doing this. I was forced to learn many things, not only for me but also for my family, The way I helped people changed and evolved.
During that time I was working in many, many different places. In 2004 actually synergy became my practice by company. Since then we have grown a lot, We have multiple locations and we also treat a lot of people remotely through tele-health.
Synergy is very important for you to understand. Synergy is a word that is a very, very meaningful. It means when individual components that work together, create the ability to output much more.
If you do look at the word synergy, it is the environment that actually makes it work very synergistically they do not work against each other. The same way your body is part of nature. Every part of your body, when they work together produce bigger results. In 2004 we created the synergy therapy group. Everything else is history.
The Nitty Gritty
Before we get into the nitty gritty, I want to clear up the field, because we’ve we both are not on the same wave length. If we are not under the same understanding, it is going to make vague things very, very difficult. I’m going to talk about few things, we have found to be common beliefs. You probably believe , 100 people who are reading this today, and every one of them probably feels the same way, but this is true. If you have no pain, you have no problem.
Imagine you are coming here for a type of pain. If your shoulder is kind of achy, It is not hurting your back so you’re not gonna worry about it. Suddenly your pain goes through the roof and you get scared. We always relay when the pain level is high up, then we have more problems as long as we can kind of manage it then we are ok. So our main focus is basically the pain.
Ill give you one example. Have you ever had a sprained ankle? It is excruciating. When you have a sprained ankle, you think you’re going to die. It’s so painful. I myself have had a sprained ankle. My daughter has had one as well. It is very painful, but to be very truthful, it is not going to kill you. You will be down for six weeks or close to it. It is from here, you will be alright.
On the other hand, imagine having cancer where you have no pain, but by the time you get pain, it is kind of too late, the pain never happens because of the cancer. I’m telling you you have have to keep this in mind throughout the workshop then it is going to make sense. More pain does NOT MEAN more problems and no pain does not mean there is no problem number one.
Number two, so now you hurt.
You need to know the cause. You know the cause now you go to your physician or you always say, oh boy, it is hurting. So you probably heard from your friends and family. You already know that something is seriously wrong. Now you need to know what is going on.
For this you are going to go for imaging. It depends. You know how much your insurance pays or how much you’re willing to pay out of pocket x rays really cheap. And you can go on and on and on. You can go with with MRI with contrast. And all this kind of stuff. So we believe that if we have an imaging done, I’ll know the cause.
Pain is bad. If I know the cause I am going to fix it. That’s it. So that’s why and seeing is believing, right? But I’m going to ask you something. do how do we know that imaging is true? Because your fingerprint does not match with anybody, not in the past, not in the future. Your genetic material doesn’t match with past or anybody in the future. So imaging Don’t get me wrong, it is a good tool. It is only good 2 to 3% of the time.
When I look at an image, we are looking for trouble. Usually trouble means something could be a tumor or something really, really serious. When you’re looking for cause of pain through imaging, we are wrong hundred percent of the time. If you had an image for 10 years old, then you became like 50 years old, or you became 25 years old.
So between that the only way we can compare that you look at yourself all the pictures, what do you have in your album, you can see how you have changed. So imaging what you see it is nothing more than just the changes that happen and that create pain. I’m going to go into little bit of detail down the road as far as your pain is concerned, imaging is pretty much useless. It is useful only 2 to 3% of the time. I’m going to get that in a minute.
Now for many of you already know maybe all of you hundred, so many people who are attending today, all of you, you know You see, well, are you happy? And you tell the your friend or maybe to your vacation, hey, I have serious pain.
They’ll say they’ll first question they will ask you, and you guys can keep commenting. And I’m going to look into the comment and I’m going to respond as I go along. Usually they will ask, how did you get hurt? That’s the first question. We always relate pain into trauma. Trauma happens.
You know, I’m not saying trauma does not happen. Trauma do happen two to 3% of the time. But we always put everything in trauma. I have actually few weeks back there is a lady come here, and he was has serious solar in a pain.
I just asked, you know what is going on so you won’t believe three weeks back, I was taking for my dog for a walk, and the dog would be really hard and I have a really bad shoulder injury. adopted me. And then I asked for what kind of dog do you have? And he said, Well, I have a job. See? Well, it sounds funny, but it is not funny.
I must said, they will say, Well, I say How did it happen? They’ll say, Well, I have a big comforter and are pulling my comforter. That is the time I hurt myself. Now think about it, is that is the level of injury, trauma can really cause injury.
So we always think if he’s a pain, it has to be trauma. Maybe it started with a trauma. You know, maybe you had an injury, you fail, you break your scooter, I understand that, that is trauma. But now you go back in six, seven weeks, eight weeks after you get treated, you get the x ray, the bone has heal, but why you still continue to have pain?
That is my question. So that actually does not answer the question. So we always think trauma so what Whatever I have talked so far, number one more pain does not mean more problem number two X ray MRI, they are not the right tool if you are hurting, to see yes you can you might be hurting for some true causes. True causes means I FCB people they have like tuberculosis or bone it can happen, okay. They have other kind of infection.
Yes, that time X ray MRI, they’re very good. But when you have that, you know the cause you get treated and you get better, but any other time that is 97 98% of the time. You cannot really tell the cause to X ray or MRI. And the third thing what I’m talking about trauma, we think when you hurt, everything is strong, we get hurt. So that is not true.
Then we are going to go to the next one. So now you know know all the all the bit but that is one last one which is extremely, extremely important. And I kept that, for the last. We always think of everything as body parts. If our solar hurts, your solar has a problem.
So now if you’re dacres, your neck has a problem. So if your back hurts, your back has a problem. But unfortunately, it does not work that way. I’m going to get to that in a minute. So you might have a problem in disorder, but that might not be the problem. So but this is what you are doing you ask? Well, my surgery is hurting.
So that is why you can do the X ray. This is what you know in orthopedic that will give you a shot first, ask question later. Okay. So that is kind of not true. So now, you know all this for me. Those are the basic there’s more to this story. But unfortunately, I don’t have the whole time to explain everything. I have a limited time.
So those are the basic four things you need to keep To mind because towards the end user is going to make more sense especially when we are doing more stuff with you. Now we are going to go to the fact and I hope you know all the all the meat. Now we are talking about the meat now we are going to talk about the fact.
So the fact is if you are hurting the whole P is a process and that process is 97% of the timeand two to 3% actually it is kind of in a higher vein when I’m talking about is actually 2% of the time trauma can create or what I’m talking about trauma. Those are the real diagnosis clumping together. What does that mean car accident Yes, you can get hurt. You fall from a tree tree fall from you, three fall on you, you jump off a cliff. Yes, it can happen.
Like you might have other kind of infection, maybe only fiction, you might have a muscle infection. Okay, so those things are real, but that happens only two to 3% of the time. We are not going to talk about that 3% of the time because that is not why you are here.
I am mostly going to talk about the process because it even if you are like hundred 20 people, you guys are here today. I guarantee you most of the more than 95% of you, your pain happen as a process. I’m going to talk about that in a minute. And the process how it happens. It is absolutely different for men and women.
So I cannot really treat a man like a woman and hope it is going to work. So it’s sort of a pain in the map. It cannot never be like in a sort of pain in Women, I’m going to get to that in a minute. Again, most of this pain you are experiencing, it is mechanical in origin. When we have a fever, that is chemical in origin, a virus or a bacteria get into you, it create havoc in your body. So there’s a chemical imbalance is going on.
You need the medicine to balance your chemicals to kill the bacteria. Okay. So but most of the what I’m talking about pain is a process because your body has changed and how he changes is different in men and women. And that process is for 97% of the time.
So if we are treating the pain, like it is not a process is an event or is a trauma. We are wrong. If we are treating the same way men and women We are wrong 100% of the time. So this is the reason why I’m not going to talk about trauma. You guys know what happens to trauma like imagine yourself you get into a car accident.
Our modern medicine knows how to treat trauma. They do it very well. So you get into a car accident you know the paramedics know what you do, they will stabilize you. You need some medicine, some muscle relaxer all those seek to stabilize you. Sometimes morphine injection, they take you to ER and they are going to do imaging is extremely important. Remember I told you imaging is very important. Two to 3% of the time in case of a true trauma.
Yes, they need to know if you are having really torn or something is in your diet need surgery. Surgery is good too because then it thinks has to be done. So after a car accident, you come to me. I really cannot help you much. You need those kind of images.
Medicine, those things that are good, but now here The problem is we take the principle how to treat 3% and we apply 200% of the time. So anybody complaining of pain, we treat them like as a trauma, you get in a car accident. Immediately we give them muscle relaxers giving them injection. Then we are doing imaging to find the cause. Not to find or you know, we keep vague or bogus kind of stuff.
Now 13 we are going to do then we do the surgery to fix it. That is when the problem begin. Most of you probably attending this webinar probably have gone through that many go wrong. This is the reason why I do two webinars if I taught inspired, actually by all our patients, I only did professional webinars or or workshops I never did for the common people.
They are the one who said hey, if I know this kind of thing, I probably have never gone through all those Many go round for years and years and years.
You probably can relate it to with with all about all this kind of stuff. We really cannot focus on the trauma and we apply it to 100% of the time. So where do we apply that? 200% of the time 90% 7% of the time, we are wrong. But from now onwards, I said it, I’m done. I am not going to talk about trauma or those 3%. Okay, so I’m going to talk about only the 97% of the people.
The difference for Men and Women
Now, remember, I told you, it is a process. It is different for men and women. This is a big thing, and how it is different. I’m going to get to that in a minute. But there are other influencing factors out there, which really influences that process. process in the sense your body is changing. Okay, when your body is changing things are not the way they’re supposed to be.
You can call that as a posture, many people I know they will say, Well, my posture is changing, well, your posture is changing, not only one part of your body is changing, because your body is connected. So your other part of your body is changing too. So what are the things that is influencing those change? You believe me Do not the number one reason why your body changes, it is stress. You think about it.
If you have any pain, most of you probably have the time your stress level is high. Yeah. Your pain is high up to so you hear some bad news over phone or something stressful. So this is a stressful time is going on. uncertainty, your pain level is going to go higher. So How this phrase influences the pain and all this thing that is beyond the scope of this webinar. I cannot talk about that. But stress plays a huge role.
Second thing your overall health condition like do you have diabetes? And for Matt, whoever we’re watching, I never really disregard Mac. If you are, you know, having low testosterone that plays a huge role. Second thing are you on cholesterol medication that plays a huge role because that affects musculoskeletal condition. We met Do you have a hysterectomy?
Do you have any hormonal issues going on? Do you have any thyroid issues that plays a huge role in this process? Did you had any past surgeries so you have no days if you’ve gone through a lot more procedure, your pain may be okay for a little bit but the pain goes through the roof right after that. What kind of medicine you taking? The sudden medication helps to change much more faster.
The specialty the narcotic pain vacation, muscle relaxation, all these kind of stuff. And if you must know the narcotic pain medication, they are so dead so dangerous. That kills hundred 20 people every single day 120 people are going to die today because of narcotic pain medication. And muscle relaxant is another one. muscle relaxer is not supposed to be used long term.
If you’re using long term that the number one cause is responsible anybody above the age of 50 creating Alzheimer’s like symptom? Yes, you already Brett, right?
You can look it up that can cause Alzheimer’s symptoms. And that actually not treating the cause smoking can create problems, what we eat, how much you move, all these things influences the process. So this is what is going on your body is changing. There’s a lot of things influencing the process.
We think pain is bad. Now you take out the pain and I’ll be fine. Unfortunately things does not work that way. I’m going to move on to the next Alright. Now we are here to rotator cuff and, you know, sort of pain workshop. Okay? So this is just a symptom.
Okay? So, in order to understand all these things, I’m going to go back a little bit to the process. Remember I told you, it is always a process.
It happens 97% of the time, it changes differently for men and women in there, a lot of influencing factors are there, which actually creates the change. So now how that process really works differently in men and women. I’m going to just touch base a little bit with you. So I’m going to turn off these slides so that you guys can see me a little bit better.
Now you can see, this is a skeleton so If I ask you this is this is a male or a female skeleton, you probably some of you may know some of people may may or may not know, how do we know male or female, a distinctive characteristic, it starts with the pelvis. Okay. So you can see this is a narrow pelvis, the way the pelvis is, I can tell you this is a male skeleton because of the pelvis.
Okay, so to understand this process, you know, all this sort of pain or whatever I’m talking about, we need to understand this. So imagine this is the shoulder blade. Now, I am going to take a sharp knife and cut it through here.
So now we are going to have an upper half, then you have a lower half, okay. So the upper half, we call as upper quadrant, okay, upper quadrant or you can call it whatever you want to call it. And below this, we call as the lower quadrant. Now I can take a knife I can cut it from here.
If I cut, you have left side and you have right side. So now we have left upper quadrant, I have right upper quadrant, I have left lower quadrant now we have right last quarter. Now the rule is anything that changes in any quadrant, it is going to influence everything else. Okay, I’m going to simplify this a little bit more.
Because of this pelvis.It is different in women, the women they have wider pelvis. So because the pelvis is wide, everything got thrown off. And also there is a lot more other things going on. I can talk about all that. But the main thing is the pelvis is wide. Then because of the press female are anteriorly loaded. And second thing they have shorter make and they’re shorter neck muscle.
But there is more to the story, but this is the main thing. So because of all these things that certain diagnosis are extremely common in women, like for example, TMJ. Yes, I know you are here for shoulder pain, but I cannot really stop right there. I need to tell you the old study. So if TMJ pain never ever happens in man until unless is because of trauma, right? I’m not talking about trauma.
So TMJ only happens in women headaches, only women. Okay, and how that happens. I’m going to get to that in a second. Yes, man can have headache, but he man has a headache. We are talking about serious medical condition. Right. So Ruby, mostly women. 70% of them sees a man having a sort of pain usually, that it probably preceded by trauma, but that never really got resolved. Because that is the reason. This is the basic difference.
We are talking about upper quadrant, upper quadrant and we are going to lower quadrant. If change is happening in the lower quadrant it is slowly is going to affect your lower quadrant because your body is connected. So many of you You are coming here for a sort of a workshop, but think about it, you probably already have back pain.
Okay? And all I know 80% of you are women. So, you know, I’m going to show you you have pain, which is not even bad. That is a separate workshop and separately, you have pain right here. Okay? Because whenever it hurts, that’s what we complain. So you think oh, my back was hurting many years is never going to get better. So why I would worry about it, I can deal with it maybe or I can do this do that.
Now my shoulder is hurting. So the reason why your sword is hurting now because it probably start from your back. Because the body remember is a chain process. It is going to keep changing, it is never going to stop unless you intervene and change it. So it is going to keep changing. So the change can happen from here.
But in women, the change can happen from here to I cannot tell you which kitchen, you know, chicken or did. So, I’m going to get to it from where this change happens. So we are going to go to the next slide.
Subrat
Now I know It’d be easy. Yeah, I want you to get to see the skeleton and everything. So when I asked you what is your soul to join? You are going to show me this is my soul join right.
But my question is tell me how many really The shoulder joint It is very very important for you to understand. Okay, shoulder is not one joint. This is not only one joint. This is why we call this as a shoulder joint complex. So it is not one joint. Let’s keep counting. This is the shoulder blade or we call it the scapula, okay. This scapular it over the here this is the thoracic spine right?
This is where it is kind of holding on this is not even a true joint but this plays a huge role. Number one, okay. Now you know this gleno-humeral joint number two, this is the joint. Now we are going to go keep counting.
See that? Number three.
Number four, this is your collarbone Number four. Okay, this is number five. So it’s basically you can say four to five, I’m not going to get into more technical detail, four to five joints.
So they actually dance in everything has to be rhythmical. If any wanting of rhythm, everything is going to fall apart. So you might think this is my sort of joint, this is what we think. And this is what I have the problem and you keep getting shots here, but everything else is change.
So it doesn’t matter how many shots you get, how many surgery you have, nothing is going to change. In average, every single day. Whatever person we see here we see 30 people they already have two to three shoulder surgery and still they’re having excruciating pain. This is reason they are getting treated with disorder.
Nothing else is taken care of. So there are five joints for for us And they have to be very much like dance in in synchrony without that nothing else is going going to change. So, so that that is the key.
Yes, I talked about the quadrant quadrant already. Okay. So, what is if you understood those, you know, four or five join making disorder going complex, but the the main thing, what really influences Okay, the main thing that really influences it actually the thoracic spine.
Okay, how do you know when the main chain happens? All the women you are there. It is actually right behind your bra hook right here. And if you press You’d be very tender. If you attended Not now, it has to be tender, maybe many, many years back when you started having P.
So this is where most of the change happened right behind the Bravo. This is where most of the change happened. And maybe that can happen because of something is going on in your pelvis. Or he can stand in isolation. If someone has like a heavier breast, or they are kind of having a incorrect posture that can really do that kind of thing.
So you started feeling pain first here, then you started heavy pain, we do new sort of way. That is number two things happen. So when you were changing like this, so you your shoulder is getting very, very kind of unstable. So let’s do something. If you guys are sitting down, please stand up for me.
I won’t say something. If you are happy A lot of pain or if you’d have surgery in the last few days, don’t do this. But if you can do it, just try this. And I’m going to tell you how thing changes so quickly. So if you are up, let’s look me look up the chat. That’s cool.
Okay, so if you are up here, okay? Try to stand up tall, as tall as you can try to lift your arm up and just bring it down. And if you can go all the way up, that’s fine. Just go go as much as you can. Then you do like this. Now what do you do? Try to just do like this, you know just hunched forward a little bit and you lift it up and you’ll feel your soldier is feeling kind of stuck. Do you feel that but what changes, nothing changed here, everything is fine.
You just change it from here, then you see, you get stuck. This is what I call as biomechanics, wanting changes in one area, it is going to change everything in between. Okay, so that’s exactly what is what is going up. So when you are changing, remember I tell you everything is going to be affected. Now you do this. So now your front is getting tight. So this is exactly what is going to create any kind of arm numbness, but everything is pretty much blinded.
You know, you go to the orthopedist. You complain of your wrist pain, they’re quickly going to say, Oh yeah, your carpal tunnel, I need to do surgery, you’ll be fine. And you agree, yes, because surgery is fine. But our body does not work that way. This is the reason why I do workshop. At least for public knowledge. If you know you don’t Have to go through many era. And I have seen people I’ve seen people today. Two of them. They had one surgery to surgery, three surgery for surgery. So what this is person harvesting.
What is going on? Like you put a tomato plant a tomato every two to three years. So if you agree, of course, anybody who’s going to do surgery is all up to you how much you are going to learn? What are you going to do about it? So when you do like that, obviously, maybe your arm is getting numb, because everything comes out of here things are changing. So the very reason maybe you had headache, many years back. Now we think my headache is there because of my neck is creating a problem.
Yeah, but few years down the road, things have changed. Maybe you don’t have much headache, but he will change. You’re hurting here. Now you run along, fix that. Now because like this, maybe your arm is getting numb. Maybe your hand is getting numb. These are all symptoms and you keep fixing the center now This is not working maybe they are guessing from your shoulder. Lets take shot go through the process.
Now all these things are happening naked and are separate it is right there. Now we are having symptom in the internet. Everything is connected. One thing can change to another and these are different symptoms. So when we treat body parts, we are wrong hundred percent of the time and things it does not work that way. Okay. Keep coming. So, this is what I want to get impress upon then we are going to move on.
Okay, we are probably about diagnosis now. So let me recap. I talked a lot of stuff very quickly. Sorry about that. Because usually in the professional course, it takes me like two three days. too but I have only an hour something to present this so there’s a lot more information in a very short period of time. So I apologize to you at a time. But this is what gets me going and I do this every single day. So what I say all this diagnosis so what it says so far more pain does not be more problem it hopefully it makes sense to you.
Second thing X ray imaging he might be making here but imaging cannot tell everything around here. So it does not really matter. imaging cannot tell you what is what is going on with you. So not everything is trauma. Yes trauma can happen but I’m not talking about trauma here. Not everything is trauma, then you cannot read body parts and hope to get better. Okay, now we are talking about diagnosis diagnosis are wonderful. Okay. And mind you all the diagnosis I am talking today.
It is only based on x ray finding you already know about. All these diagnosis and all these so called diagnosis are made because they only have your symptom or they find something in X ray or MRI. I’m going to get to that. These are two beautiful diagnosis, pregnant strain and arthritis. There is a catch all diagnosis as if we are so weak muscle you can sprain it. Those are the most bogus diagnosis. Yes, you heard me right.
If if you are healthy, and you know you don’t have much problem, you go to Fisher, they cannot find anything wrong. They will put something there. They have to say something. So there’s only probably straining and then you probably be explaining so I had people they’ll say is sprain and strain. It is going on for last three, four years.
So what the heck is going on here. And the second catch all if they see something imaging, if I take like anybody, I don’t care years old. hundred people, all of you down the road. I do random X ray. I’ll find some bony changes. You might see 50 say some bony changes in me. Okay, so we put it on arthritis, okay? But then I don’t want to get into the Arthritis pill. Because that is bogus when you’re talking about arthritis.
We’re talking about osteoarthritis, that usually does not fit in non load weight bearing joints. Well, it can happen, but that is not usually the problem. It can happen sometime in the heat, maybe unique not in disorder, but that will be thrown in there as a catch all diagnosis and it can be thrown up. But again, that is not real diagnosis. Nobody usually happy just because of that. Okay, I’m just going to disregard I’m going to move on.
Subrat
Synergy Therapeutic Group
09/24/2020
