"Thank you so much for all your help. I thought I was going to have to have surgery."
These are the words from a young patient I discharged yesterday. I saw him 6 times over an 8 week period. He came to me with osteolysis of the R AC joint. Pain with sleeping and any R UE activity. An avid bench presser and upper body lifter, I knew we had to change his mindset and exercise habits if he was going to heal.
He paid for every visit out of his own pocket.
I spent 1 hour with him each session. We talked about the importance of muscular balance and flexibility about the shoulder joint. I stressed that tight lats and pecs weren't going to be beneficial for long term shoulder health.
I taught him a variety of overhead and multi-planar moments, starting initially with basic flexion and limited ROM ab/adduction. Each week we progressed a bit, adding UE exercises in weight-bearing and dumbbell pressing movements. I never once used a modality. The first few visits I did a few joint mobs and some PNF work. The final 4 visits were all movement and lifting-based.
Who knew behind the neck pressing with a barbell could be so therapeutic? Not heavy at all; just quality movement about the shoulder girdle.
No surgery; no meds; no modalities. I just assisted the body in healing itself. More importantly, I earned the trust and respect of the patient in the process. The impetus was on him to follow my direction and take responsibility for doing the necessary work outside of the clinic--not too much, not too little; quality was key. I worked with him, not on him.
This is the type of practice I have dreamed of building for the last 10 years. Not high volume; not high tech. Just the thoughtful, progressive application of movement to alleviate musculoskeletal pain and dysfunction.