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Rotator cuff injury?? Please advise

Discussion in 'General Discussion Subforum' started by Jules, Mar 2, 2017.

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  1. Jules

    Jules Well known member

    I need some feedback please and soon.

    For the past few months, on top of a great deal of TMS symptoms, I have been having these symptoms:

    • Severe shoulder and traps pain at night (during the day, manageable, but still hurts)
    • Achiness
    • Tingling and numbness
    • Loss of motion (can't turn shoulder back without severe pain)
    • Clicking or popping of the joint
    • Loss of strength in affected shoulder
    • Extreme tightness

    This is steadily getting worse, and no matter what TMS work, I do, it won't go away. This time, I feel its not TMS, due to a lot of strenous lifting, but if anyone has had similar issues and was healed, please let me know. I am so sick of pain!! Why can't I just overcome this already?!?! :arghh::mad:
     
    Eric "Herbie" Watson likes this.
  2. MindBodyPT

    MindBodyPT Beloved Grand Eagle

    Hi Jules,

    As you know these symptoms can also be TMS-caused. It is possible there is an issue with your rotator cuff but this usually does not involve tingling or numbness. Like any muscle or tendon in the body, the rotator cuff can be a target of TMS pain. Did you have an accident that would have led to a fracture or massive tear recently? Just usual lifting should not cause a rotator cuff issue that would need further intervention. Persistent pain from a small or medium rotator cuff tear or other shoulder issue is also known to be a TMS variant if it persists beyond usual tissue healing time. Remember the symptom imperative can happen and it will want you to believe the new pain isn't really TMS, and that something else is wrong with your body!
     
    Eric "Herbie" Watson likes this.
  3. Eric "Herbie" Watson

    Eric "Herbie" Watson Beloved Grand Eagle

    Yes, it's tms. Same problem I had while recovering. You just need to lose your focus on the area you are feeling the pain. Be outcome independent here for this issue and soon you will feel better.
    The pain might move to another area so be aware using awareness
    Mindfulness is a powerful antidote too.
    Are you still being aware of your stressors too?
     
  4. Jules

    Jules Well known member

    Yes, I'm trying. My therapist thinks I need to learn to identify the triggers that keep the pain going and not give into fear. (easier said than done) Also, because I'm been conditioned to feel pain, every time I feel stress or free, it triggers pain, but what does the pain trigger? That's the key to my puzzle here. She said I need to figure out what I'm trying to avoid, and if pain is the excuse to avoid it.

    Its a vicious cycle and I feel like I'm going around in circles.
     
  5. Eric "Herbie" Watson

    Eric "Herbie" Watson Beloved Grand Eagle

    You have to be patient, yes after all these years patience will be your friend.
    Become "out come independent" too.
    I'll leave the definition below.
    And stop trying to find the structural reason, if they didn't find anything wrong then move on and heal ya know.
    I'm saying this for you, to help you.
    You have to stop pre occupying all your time to the structural and focus on your psychological side.

    Outcome Independence

    1. Think how outcome dependent you tend to be with the pain. Assume you have Back Pain when you take a walk (or some comparable situation.) Every time you take a walk, you monitor it. "Okay, today the pain started after a block. Yesterday it started after a block and a half." "Today it was a 3 out of 10 when I returned home. Last week it was a 7 out of 10 after the same distance."

      When you have a good walk, you feel happy, optimistic, feeling like you're on the right track. When you have a bad walk, you feel down, defeated, bad about yourself and your prospect of ever getting rid of the pain.

      This attitude, this outcome dependence is feeding the pain cycle. It's reinforcing its very purpose.

      Change your definition of success. Work on it. Success is no longer measured by whether or not you have a good walk. Success is measured by how little you care.

      At the beginning of your walk, tell yourself, "It doesn't matter how much it hurts afterward. That isn't an accurate measure of monitoring my progress with PPD anyway. What matters is how little I let it affect me; how I refuse to let my mood, my self-perception, my feelings about the future be determined by how much pain I'm in afterward."

      This is not an easy transition, and you'll revert back to outcome dependence plenty of times. But if you keep at it, and continue to work toward altering your definition of success, you will strip the pain of its power, and it will likely lose its hold on you.
    And now to learn how to control your triggers. Ace 1, a great mind has put this list together. Learn from it patiently and heal. Bless you

    1. 1. Try to be aware of all internal reactions through your day

      2. Try to just act as normal but at ease (not fear) as much possible with the least concern to your symptoms that you can in a forget about your body type of manner. Try not to modify your behavior or do anything differently physically because of the symptoms as best as you can except being easy on yourself when you need to be.

      3. Worrying about or preoccupation with the symptoms (challenging, constantly evaluating them, reacting to them, or trying to make them better) makes you lose your ability to see that you're emotionally uncomfortable. Just use them as a sign that something’s not right emotionally. Interpreting the symptoms as anything other than a sign will impede your progress. Ask yourself; am I emotionally uncomfortable right now? Am I preparing too much for something, putting so much weight to it? Am I too focused or driven on something? What agenda do I have right now? Is there anything I'm just trying to get over with? Pause and look at the overall general picture to see how uncomfortable you may be and what it may be about. Also ask do I always do the same thing when the symptoms are there or especially bad? If the symptoms are especially bad ask, is there something different today from the other days (more work to do, deadline, event). Try to be as specific as possible. Once you find out why, the recognition helps in itself and you can use directed mind power techniques (see #10 below). Sometimes you will see these patterns in retrospect and you will know next time you encounter them (i.e. You get pain prior to dinner but after you eat it gets much better. You think it must have been the importance you placed on eating and possibly the rush and intensity in accomplishing this. You think of this the next time you encounter the situation and use directed affirmations. And, yes, it can be something this trivial).

      4. Recognize that certain situations make your symptoms worse. This is because you have said a lot of negative things, thought a lot of negative thoughts, or done something with extreme intensity about these situations in the past. This may be related to being sensitized to the situation from your childhood or some other reason (like in the example stated in #3, your mother may have put too much importance for you to eat as a child). You have to decondition yourself to these situations. It is also important to recognize these situations and the reason for your symptoms every time you’re experiencing them and bring this recognition thought to the forefront of your thinking.

      5. When you are in these sensitized (conditioned) situations, don't run away from them, stay in them, sit in them and this time, take an approach that you are comfortable in the situation. Behave opposite to what you did before. If you have symptoms, don't let them bother you or sensitize you more to the situation as best as you can. Use your affirmations here. Sometimes just stopping for a moment in these situations and just taking breaths and trying to reach a deeper level of relaxation is helpful. This works by breaking the intense, focused train of thought that is present in these situations.

      6. Recognizing why you may be sensitized is helpful, but not essential to recovery. It uncovers ways you may mentally strain as a overall picture and allows you to apply directed mind power techniques. (Described more below #10) (I.e. you were picked on as a child, now any criticism from a spouse sparks very intense reactions, you see this and now repeat I forgive and let go easily)

      7. It is also important to note that situations that you have not deconditioned yourself to will produce symptoms in you that make you feel that you have made no progress even if you’re close to being cured. Don't let this disway you as you only need to decondition yourself to these situations as well. (Your symptom free most of the time but get symptoms at the beach, a place you haven't been to in a long time but it was a place you were you were sensitized to in the past. You could be sensitized to this situation just be because you had severe symptoms there before)

      8. The problem is really a mental strain (mentally excited, hyped up, held up, on edge, or anticipatory feeling) related to a perceived important/stressful situation that is then pushed into a physical strain/bracing/constriction in usually one part of your body which leads to symptoms. It can be to something perceived as bad OR good. This strain becomes somewhat a type of automatic HABIT and mode that you go into as a conditioned reaction. IT BECOMES A HABITUAL STRAIN that you don't see any more. The primary problem is the mental strain but the physical strain plays a role too. Therefore your goal is to be at peace with everything and do things with ease. If you begin to get the start of a symptom, don't strain into it more or try to force the affected area to function. Its ok to be still and accept the symptoms and work on the mental strain and conditioning. You will think that the way you react/feel is normal (and that you are not in a hyped up mode) because it is so habitual, but if you have symptoms, it is there. Also, it is your goal to prevent the strain or reaction/mode in the first place, because after you strain the resultant pain/symptoms do linger for a bit before they dissipate even if you try to relax.

      9. One type of strain is that we expect our body/self to accomplish the impossible. We try to be faster than we can possibly be, angrier than we can stand, more afraid than what's good for us, nicer and better than what is humanly possible. That strain, in a way, is a pushing feeling beyond ones limit or capability. A lot of this in the beginning is consciously chosen due to one’s intense personality, but later becomes an unconscious habit. As you can see, this is a mental strain as there is no physical aspect to it. This leads to the hyped up feeling (a type of mental strain/reaction) and you start to use your body in a way as if it can accomplish this goal (which it really can't), which leads you to physically strain. This mental strain doesn’t ever help accomplish your unattainable goals (the impossible) all it does is breaks your body down and turns into a bad habit. It is the treatment of the original mental strain that should be your primary goal. Try to pay attention to this key especially when in a situation where you’re usually under time constraints like at work.

      10. Work on the mental strain by deconditioning and changing strained habits through the use of mind power, mostly affirmations and good self-talk and by behaving in a peaceful, relaxed manner. My main affirmations were "I take my time, forgive and let go easily" and "I'm calm relaxed, patient and confident". I also really like "I am always easy on myself" and "I am comfortable with doing nothing." It is always better to think of the meaning of the words and imagine what it would feel like to be that way as you say them, but saying them mindlessly still helps. In some situations just repeating one word over and over such as "relaxed" is more effective than the phrases, sometimes the phrases are more effective. You will just have to experiment. Do mind power on an as needed basis (EVERY TIME when having symptoms or psychologically bothered) and around sleep (5 min for each affirmation or visualization before and after sleep, the longer affirmation versus the one word is usually better here because it is more specific to your future goal). You may be doing this all day at first. You also have to be consistent with this on an everyday basis. CONSISTENT MINDPOWER TO REDUCE MY STRAIN WAS THE MOST IMPORTANT PART OF MY RECOVERY. Other mind power techniques I also used but not as consistently were visualizations. One visualization I used was imaging myself and what it would feel like to breathe in a white mist, with the mist representing calmness. When I exhaled the mist i imagined it colorless as if the calmness had been absorbed into my body. Another one is imagining yourself in a very peaceful place like a meadow with flowers - I did this when I was in situations where it was more difficult to relax. Visualization can be used in a different way also, you can use it to visualize yourself doing the thing that you are anticipating that is causing you to strain before you do it. You can even visualize yourself in the situation that causes you to strain while you’re ACTUALLY IN that situation, while seeing the objects around you in your mind. It is a form of recognition and from the perspective of the observer; it shows your mind that the situation is not a big deal. It also gives the event/task spatial time and value as opposed to before were you didn’t want to give the task/event any time and you wished it didn't have to be done. Obviously, as you do it, imagine yourself doing it in a easy fashion. One example is let's say you wake up and are feeling strained to rush to finish showering before going to work. Imagine yourself walking into the shower slowly and easily and imagine yourself easily doing and finishing the showering. Alternatively, you can just imagine yourself in the shower as you are actually showering while imagining the water, the shower head and everything around you (it doesn't have to be imagined in real time, it can be in clips but don't do it rushed). One more technique is palming, where you close your eyes and cup your eyes with both hands to exclude light. You could do this while saying your affirmation in the background (this really does work). An important note about affirmations/visualizations is I don't think they are enough by themselves. They are tools to help you break conditioned habits of strain, so use them to help you get to the state of relaxation that you need to get to in the various situations. So what this means is once you see yourself wanting to get too excited about something, you consciously stop from going down that line of behavior in addition to using the additional mind power tools.

      11. Eliminate all negative talk and stop yourself from going down a negative line of thinking. This is "negative" mind power.

      12. Be active if possible independent of the symptoms (not for overcoming your illness, but to be comfortable with your body) and do things you were afraid to do gradually, not to challenge, but just to do them. (I.e. if I play soccer and there is Back Pain, I will not think of using my back more or strain with it more to get it "used" to activity. I would just play soccer, and if in pain, just accept it and use affirmations if necessary). As you get into the game, you'll probably forget about it. This activity can be slowly and gradually increased as not to increase the strain. You want to coerce you body back to normality. There should be no activity or force directed in response to the symptoms. If symptoms are severe at a certain point, it is ok to limit activities temporally until you are in a better mental state to proceed with the rigorous activity.

      13. Recognize you are bringing your tension level set point down over time from a very high level and breaking habits which will take time. You are doing this treatment not for the moment but for the future. Until you get far along enough, you will not be able to stop the symptoms at will and that’s ok. Most people with severe or consistent symptoms will a lot of times need some years for full resolution.

      14. One of the biggest sources of tension and strain is being in a rush or wanting to be somewhere other than where you are right now. It’s not being fast per se, but the strain that can be associated with wanting to be fast. Another way to look at this is that one is always projecting themselves into the future or pushing their body even past its limit as if one can make it go faster, which one can't. One's drive can be so intense, that anything that gets in one's way will cause a conflict and thus symptoms. I also believe that the symptoms make the person want to rush more because when someone is in pain or uncomfortable, they just want to get tasks of daily living just "over with". I think this somehow intensifies the strain and illness and makes symptoms present almost all day, with every task present in life. Also a lot of times there is a feeling to escape the symptoms themselves and that perpetuates them by keeping the person out of the present moment even more so. When someone has symptoms and they can't figure out what’s bothering them, it is usually the need to be in a rush, to escape, or to just want to get a task just out of the way. Another one is the feeling that one should be doing something more productive than what they are doing right now. See if you can recognize these feelings when they happen and try to resolve them by not going with them, acting the opposite, and using the affirmations. One very good way to recognize this is by asking - AM I OK BEING IN THIS SITUATION I AM IN RIGHT NOW? The recognition in its self helps relax these rush feelings and helps you direct your mind power techniques. Recognition is VERY helpful.

      15. The URGE to just be finished with something or to want to get somewhere quickly so bad is I think equivalent to the pain/symptom, but it has just become dissociated from its original meaning, which why it is just pain/symptom. (This is along the same lines of what is said in #14). Another way to think about this overall concept is that you have made (conditioned) yourself to be uncomfortable in almost every situation and the urge is to escape. Try not to reinforce this urge by going with it. Act as if you have nowhere to go. Take your time and go slower. You have to just sit in these uncomfortable situations and make yourself comfortable again to get better. It is also helpful to recognize and put your attention on this urge/strain if you can find it and try to bring back its meaning to it, then use an affirmation in the background of this. Try to do your chores of daily living while resisting this urge and make this your new habit of how you do things.

      16. Along the lines of what is stated in #14 and #15, when in a rush to get something over with, we tend to hold our breath until whatever is completed so we feel we can breathe again. The lack of breath tends to accentuate the physical strain we talked about earlier. Therefore, when having symptoms, or when you get into a hyped up mode, it may be helpful to encourage continuous breathing without pausing. Also don't valsalva or bear down when put in a sensitized situation.

      17. Observe the strain if possible when you sit in it and do your mind power. See generally how hyped-up or in a overall excited state you are in. Also see the part of your inner body that is trying to push beyond its limit or what type of impatient or irritated urge you may have. You may have to stop and pause for a second from whatever it is you are doing to look and see in the big picture how hyped up (strained) you are. Now imagine how it would feel like if you were in ths situation without this strain being present. Somehow first seeing the strain allows you to be able to relax it and imagine what it would be like without it. Affirmations can be helpful here as well. One can also in general observe their symptoms/symptomatic body parts as long as they don't pull away from them or strain in to them more.

      18. Anything that is annoying to you is a source of symptoms, so try not to let whatever it is become annoying to you, just accept it. Be aware that after having symptoms for some time even tasks of daily living become annoying. Anger or irritation that you can't stand obviously also applies. Don't add more fuel to the fire when this happens, observe it and let it go, while trying not to let your body strain inside in reaction to it. Affirmations in the background of this can be helpful. Try also not to ever think of yourself as wronged or a victim, this only leads down the path of negative thinking, conflict and pain. You can act, but don’t react and forgive.

      19. One additional technique that could be used is the following. Picture someone, something that annoys or bothers you, or something that traumatized you in the past that still affects you in your mind and use an affirmation like "I forgive and let go easily", over and over while seeing their face or picturing the situation. This works very well after just having had an argument with a spouse, family member or friend. Another technique that could be used would be to self-record a directed affirmation and have the player repeat it all night while sleeping.

      20. Remember, someone who can change their life to take out major stressors (quit a job, divorce etc) will get better faster than ones who cannot and has to accept their life the way it is and recondition themselves. Unless the circumstance is extreme or very easy to fix, it is to your benefit to recondition yourself than to change your life.

      21. When an event that bothers you happens, if you don't try to resolve it (bring the tension level/hyped up mode down first before carrying on), this will lead to symptoms. I think this is what is meant by repression. The tension level is allowed to go wild, and is ignored without attempts to resolve it in one's own mind, without calming down about it, or without reconditioning one's self. Another way of looking at this is there is the thought, I will only relax after so and so is completed, so you are on edge until you are done doing what you have to do. This is wrong thinking and you have to learn to be relaxed while doing whatever it is you are doing. You will want to go with the old habits, but you have to consciously make the choice not to do this.

      22. When you heal, the pain more so fades away, so there is no battle that is then eventually won. It's ok to be easy on yourself and on the symptomatic body part when the tension level is very high. Don’t feel you have something to prove or that you have let it beat you. Bring the tension level down first then you will see that your symptoms have subsided enough for you to function. The healing process is done very gradually, with a very gradual improvement in symptoms and ability to do things you were unable to do before. You cannot do anything physical to heal (which includes fighting).

      23. Everything to your best should be done with peace, calmness, forgiveness and ease (WITHOUT STRAIN or WITH FUNCTIONAL RELAXATION. You need mental control to achieve this.). Some people talk, behave and function in a strained way and this is to be recognized and modified for cure to occur. Observing a video of yourself may help to clue you in on this. Also be good to yourself.

      24. Try to think of the big picture when applying these techniques and when trying to achieve relaxation. Most people with symptoms are too detail oriented and are intense in that regard. They also try to apply this detail orientation and intensity to their symptoms and to trying to get rid of them. When one looks to see if they are emotionally uncomfortable or strained, it is better to look at it from a general/big picture sense than focusing and trying to find some tiny little detail. Then it is helpful to try to achieve ease in the big picture as well. Part of your cure is to stop thinking in this intense manner and to now be more laid back and think of the big picture. One may strain in normal little daily routines like eating, talking or doing small tasks and it is important to see this and change it, but the recognition and fix of the strain in these little things is thought of in the big picture.

      25. It is also helpful for some to make a list of possible things that bother them or cause them unease. Reflect on these bothersome things and try to fix them if you can and if it's easy enough, otherwise you have to decondition yourself to make them not a big deal anymore as mentioned above and this usually takes time.

      26. Sometimes one may think about a certain task, position, situation or movement and you may immediately get the feeling that you will get symptoms with this event. This is because you are thinking about doing this event in intense, get it over with manner, whether your aware or not. Try to rethink about this event being done in a very gentle, eased manner and that you will give it all the time and ease it needs and you will not get the same type of reaction to it. Never make anything that your about to be involved in to be such a difficult thing and do not make yourself feel so much resistance in doing it.

      27. If you're unsure if something you are doing is helping your recovery or not is to ask the following question - Is this helping me to calm my overly sensitized nervous system and build resistance to reacting to the events in my day?

      28. This has to be undertaken as a major project for it to work, with consistent all day practice. Also the time needed for recovery must be given no matter how long it takes. This type of recovery will simply NOT work if is undertaken in a superficial manner. You really have to practice all day to get good at this.

      29. Recommended books are Healing Back Pain by Dr. John Sarno; The Power of Now/A New Earth by Echardt Tolle (I like the audio versions); and Mind Power into the 21st Century by John Kehoe (In this book, techniques should be used to achieve mental relaxation). Possibly read them in that order.
     
    Last edited: Mar 3, 2017
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  6. Jules

    Jules Well known member

    Wow, thank you so much for your incredible insights and forethought into my situation. This has been a very helpful comment, with tons of good tools for me, and I'm sure others, and makes a lot of sense. Its interesting you mention the affirmations as a way to decondition yourself. I started out doing that, but the ego took over and I stopped for the most part. I now understand this has to be constant and consistent for them (affirmations) to work.

    I have also developed a habit of just getting things done, without really taking them in stride and not rushing. I observe that when I can do things on my own timetable, with a well-thought out plan, the stress is much less. I also see when stress becomes overwhelming, I tend to stay in a contracted position, my stomach tightens, as does my neck, shoulders, and back, which of course creates tension and reduction of blood flow to those areas.

    Talking to my therapist, I realize something for the first time and that is fear has been a huge, driving factor. I am an empty nester, and have not had an outside job for close to 24 years. All three of my children within four years of each other, and purpose changed. The responsibilities of the letter that I use to edit has been isolating and lonely. Also, last year, I loved I have been born into part of my life for over four decades. Because of that, it isolated me from the community. I work from home, excepting a few years of working for the newspaper, but even then I still went around and did interviews, attended events and such, and attended meetings every week.

    I now realize the fear is driving my pain as well. I would love a part-time job to get out of the house, but the only skills I really have is that of simple clerical work and writing (which includes researching, editing, and proofreading.) I've been writing for 20 years and would like to try something new, but I'm afraid the pain will keep me from doing what I want to do, which just feeds the fear, which feeds more pain. This is the habit I want to break, but not sure how to do it, except to just do it, which terrifies me.
     
  7. Eric "Herbie" Watson

    Eric "Herbie" Watson Beloved Grand Eagle

    This is why you practice outcome independence.
     
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  8. SebastianM

    SebastianM Peer Supporter

    Hi Jules, Hi Herbie,

    I have similar symtopms concerning my shoulder pain. It feels like there is no blood in the area around the joint. If stress or emotional problems are bigger, my symptoms spread into several areas of my body. There is a clear connection. So I am convinced that ALL symptoms including my shoulder are caused by emtional things -> TMS.

    My TMS recovery is in progress and I learn(ed) much about my body and my psychological inside. Stress, repressed emotions and feelings, putting pressure on myself, not being in the current moment, depression, fear and anxiety are the reasons for (my) TMS. When I realized that my body feels different while exploring my emotions, I was convinced of TMS. Did you have such moments? I call it "my daily little enlightenments" :).

    The most difficult thing is to find a way to the inner middle, to the real needs and emotions: In the past I thought everything is fine. TMS forced me to explore my inside. After 1,5 years of psychotherapy I am now on a good way. But I still have good and bad moments/days. The pain is not gone but it does not have such a huge impact on my mood. I accept it but I also hope that it will leave me when I am constantly stay in my inner middle.

    I totally agree with you. Do you also have thoughts like "Oh damn, now it will be a bit stressful. I hope my body will stand the pain."? I think we need to convince ourselves that our body is okay and that he is able to stand stress if it is not constant or for a longer period of time. This is an important part of TMS recovery.

    In my opinion fear is the most wearing and destructive part of TMS. @Herbie: Your theory about outcome independence is a great support. Thank you so much. Since I have read it I think different. I am more brave and do not judge the pain. I only judge the nice activities I did without taking a look at the pain which sometimes is there and sometimes not.

    I hope you also get "daily enlightenments" and be good to yourself. Your body and your spirit are strongly connected. If the spirit is running, the body cannot relax and produces pain.

    Greetings
    Sebastian
     
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