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  Case Study: Avoidance of Rotator Cuff Surgery  
   Maureen McHugh, Feldenkrais Practitioner                                           703-751-2111

Barbara S: Avoidance of Rotator Cuff Surgery
By Maureen McHugh

September 2005

In the early 1990ís when I was just starting out as a Feldenkrais Practitioner, I worked in a physical therapy clinic owned by Elizabeth Derringer, PT. One of the first people Elizabeth asked me to work with was Barbara S.

Barbara was in her early seventies and a regular early bird swimmer. Lately, sad to say, her pleasure and stamina in swimming were in sharp decline because she was increasingly unable to raise her left arm.

Barbara had been to the orthopedic surgeon and had been told that she had a damaged rotator cuff on the left side. The good news was that it could be fixed surgically. Reluctantly, she agreed to the operation and a date was scheduled.

Two days before the operation, Barbara got talking with Elizabeth who swam at the same pool. Elizabeth persuaded Barbara to come the same day to the office.

Elizabeth worked with Barbara first and observed that the third rib on the left side was locked. Elizabeth was able to mobilize it, and then she sent Barbara over to me to look at her movement patterns.

When I asked Barbara to raise her left arm, I saw the problem immediately: she unconsciously held her ribs contracted while raising the arm. 

Try this yourself.
a. Stand and raise your left arm in front of you and see how high it goes. Then do the same with the right arm.
b. Next, contract your ribs as though someone had just punched you in the solar plexus.
c. Hold that contraction and raise one arm and lower it and then the same on the other side. Is your movement more limited?
d. Then hold one arm at shoulder height. Contract the chest as you make a downward movement of the arm and let the chest expand with the upward movement. Do the same on the other side. Does this pattern of coordination make the arm movement easier?
 

By showing Barbara how better to coordinate movements in the ribs with the movement in the arm, her range of motion increased dramatically.

For some unknown reason, she had gotten into an unconscious, unprofitable habit. Most likely, the habit had been acquired recently because it yielded quickly to the new insight.

Barbara went home and canceled the surgery. She came back twice more for review and variations, and then we didnít see her in the clinic again, but Elizabeth continued to see her at the pool.