If left untreated a frozen shoulder can result in damage to the neurons, and cartilage, limited mobility in the shoulder and scapula, and pain in the neck, upper back, and arms. To address a frozen shoulder all components of the joint need to be considered.
In this article, I will cover 5 consequences of leaving a frozen shoulder untreated.
Frozen Shoulder can cause dull or acute pain
The pain may be accompanied by a “cracking sound” originating at the back of the shoulder. The pain/discomfort is often exaggerated during movement which may restrict exercise and performing daily movements.
Frozen Shoulders can be linked to neurological damage
Stiff shoulders may be due to or cause a neurological disfunction (ref). There are 5 neurons that feed the shoulder and arm: musculocutaneous, axillary, radial, median, and ulnar nerves. In such cases, unless the recovery of the neurons is supported, the underlying problem will be untreated and subsequently get exaggerated.
Frozen shoulder will cause stiffness
The inability of the shoulder joint to move freely will cause stiffness in the muscles that support it but potentially also in the lower and middle back, neck and wrist. The reason for that can be traced to the compromised function of the fascia.
Frozen shoulder will limit lymphatic drainage
Lymphatic drainage depends on our ability to move. Our extremities are the most mobile parts of our body and their movement results in circulation of the lymphatic fluid, ultimately allowing bacteria and toxins to be excreted from the body. Immobile shoulders may compromise the function of the lymphatic system and thus contribute to the accumulation of toxicity.
Chondrolysis can cause frozen shoulder
Chondrolysis is a rapidly progressive loss of articular cartilage and can be diagnosed with arthroscopy. Chondrolysis is more likely to occur after an operation.
Frozen shoulder can: (a) be caused due to a number of reasons & (b) compromise multiple functions in the body if left untreated. Addressing it early with a protocol that includes: mobility, strength, nerve recovery, and supplementation to support the healing process can prevent further complications.
A headstand (also known as Shirshasana) is an inversion where the practitioner is balancing on their head. A common question to those new to the idea is: Is that supposed to hurt? No, a headstand can be pain-free!
Why would a pose practiced over millennia, by people of different body types and biological ages be meant to hurt? Unless the technique is compromised of course! In this article, I will cover all the mistakes I’ve seen during a headstand practice that can cause pain and offer some advice on what to do to stay pain-free.
Disclaimer 1: While I consider the analysis below to be valid for everyone, reading the information doesn’t guarantee that you will be making the suggested corrections when practicing on your own. To that extent, it is highly advisable to get feedback from an external eye, preferably someone that understands the biomechanics and ideally an instructor. Also, those with a neck injury may benefit from some prior strengthening work in their trapezius, latissimus dorsi, and deltoids.
Neck pain is by far the most common complaint among those starting out with headstanding. The root cause of the problem is the shoulder joint setup. The position of the shoulders determines how much pressure will be on the neck. If I was to elevate my scapula I would increase the pressure on my neck even while standing. In all versions of the headstand, the scapula should be depressed.
You can find a brief review of all scapula movements here.
While headstands should be performed with the scapula depressed the scapula should be elevated in forearmstands and handstands. If you are interested in learning how to forearmstand you can read this article on Triyoga’s Blog.
How to deal with neck pain in headstand?
If you are experiencing neck pain you should keep your scapula (shoulder blades), depressed and slightly protracted.
By ensuring your shoulders stay away from your ears at all times the scapula will be depressed.
In your effort to keep your scapula depressed it will help to pay close attention to the position of the hands as well.One of the easiest ways of learning to headstand on a tripod is by keeping your hands, at shoulder distance. However, those with weak shoulders or tight traps may find this hand position, unstable or suffocating. If that’s the case for you I suggest you widen the distance between your hands while maintaining the elbows as close as possible to each other. You can also use a yoga strap to help you achieve that.
Initially for some practitioners maintaining continuous scapula depression is not possible partly due to weakness in the rotator cuff and latissimus dorsi and partly due to a lack of adequate neuro-connections with this part of the body. For that reason, the 5 step process I follow when teaching headstands, initially involves one or both legs on the floor. You should come out of the position, as soon as you feel pain as it is a sign that you lost the correct shoulder joint setup.
Pain on top of the head
Some individuals have a flat skull at the top, while others have a peak. It is common at the beginning for practitioners to feel some discomfort, especially if they belong to the latter category. Folding the mat or placing a towel underneath the head should alleviate some of the discomfort.
If you are feeling pain on top of your head in a tripod headstand it is probably due to how sensitive your skin is in this area and/or the shape of your head. In a supported headstand, the pressure on the head is often minimized as the forearms can take a lot of the body’s weight, provided they are pushing down.
How to deal with pain on the top of the head?
Chances are that you will be accustomed to the pressure after 3-5 sessions but in the meantime, you can double the mat or put an extra blanket underneath the head. Keep in mind that:
In a headstand, all your body’s weight should be on the top of the head – NOT your hands. It’s called headstand and not headhandstand for a reason.
In an effort to avoid the minor initial discomfort, some practitioners may:
❌ transfer most of the body’s weight to their hands. This is often accompanied by a planching line.
❌ place their forehead on the floor (instead of the top of the head).
❌ position their hands underneath their head.
This alignment often becomes a habit and might be a limiting factor later on when working towards intermediate headstand lines or transitions in and out of headstand. Instead of making any of the above adjustments place some cushion underneath your head.
Approximately 10% of those headstanding will experience headaches at some point during their practice. Usually, headaches occur in the learning phase and are due to either irregular breathing or excessive (and unnecessary) tension in the upper back muscles. Headaches are more common when practicing in heat due to dehydration.
How to deal with headaches in a headstand?
It is very common to breathe irregularly during the first few attempts of headstanding, so don’t beat yourself up. The extra load in the upper back muscles and diaphragm is likely to challenge your breath. You breathing in yoga will determine the amount of tension you are experiencing during the practice.
In a headstand, you should establish a slow breathing pattern, either by taking sips of air through your nose 👃🏼 or through ujjayi breathing.
The ideal breathing in a headstand, as well as a forearm stand and handstand, is diaphragmatic lateral breathing. That comes by default once regular practice is established – but not in the initial stages of learning. If you record 🎥 yourself in a headstand and your belly is moving you know you are not breathing laterally.
If the headaches are because of tension in the trapezius muscles, you should depress your scapula more. This will allow for a temporary release of the trapezius.
Lower back pain
Lower back pain in a headstand is due to poor posture in the lower part of the spine or weak lower back muscles. The use of a wall often promotes poor posture which is why it should be avoided at all costs.
When we are upside down the pressure on the joints of the upper body increases, as they need to carry the weight of the lower body. Depending on your weight distribution, the increased pressure can be small (if your hips and legs are light) or significant (if your hips and legs are heavy). For this reason, those with a tendency to maintain an exaggerated lordosis in the lumbar spine and those with weak quadratus lumborum are more likely to experience lower back pain.
How to deal with lower back pain in a headstand?
Correcting one’s posture upside down is not easy when starting out, as the proprioception is often limited.
To improve your proprioception of your midsection upside-down practice tuck.
Three main reasons behind that are:
✔️ in a tuck keeping the naval-in is easier. The naval in is necessary for the inner unit of the abdominals to stay active.
✔️ there is less weight in the lower back
✔️ the center of mass is low and at least for that reason, the balance is easier.
Those unable to hold a tuck can practice a stag leg version.
However, even practitioners with no excess lordosis may experience lower back pain. In both scenarios I suggest one performs:
• drills that improve awareness and
• conditioning sequences for quadratus lumborum, glutes, abdominals and obliques.
Everyone’s patterns are different so I provide each of my students with a different sequence. If you would like one to start with, I suggest you give this one a go.
Disclaimer 2: While our body’s anatomy plays a role in how easily we will learn to headstand it is only one of many parameters. To no extent should it be a reason to give up on learning. One of the benefits of inversions is that they give us the opportunity to discover our bodies. Whatever patterns we have are amplified when upside down. Use that opportunity to develop your practice and relationship with your body.
Can you injure yourself doing a headstand?
Without a doubt, headstands can lead to injury if performed incorrectly. The fastest way to develop poor alignment, bad habits, and inability to recruit the correct muscles in a headstand increasing your chances for an injury is by practicing against the wall.
When one or both feet touch the wall, the base of support becomes bigger.
The balance (in all inversions) exists when the center of mass is above our base of support. When the headstand is performed against the wall, the center of mass, instead of being over the head, will end up in front of our head (without us losing balance because of the wider base we have created). This is likely to cause an excess arch (lordosis) in the lower back and sequentially develop a pattern even when the wall is no longer needed.
The use of the wall in headstands, in my experience, is bad karma, so I advise you to use it only in homeopathic dosages.
Pain in the wrists
If you are experiencing wrist pain, you should first assess your wrist’s dorsiflexion ability.
How to deal with wrist pain in a headstand?
If you currently don’t have a 90-degree wrist dorsiflexion pain-free, I suggest you perform daily stretches for the forearms.
Ideally, you will be also strengthening the hand and forearms muscles.
While in a tripod headstand, make sure your hands are not too far from your head as this will increase the degrees of dorsiflexion & thus the pain. To reduce the pressure you can also turn your fingers out.
What to do when experiencing pain in a headstand?
Stop and assess what is causing the problem. In the process of doing that, it’s worth recording yourself too. What we are doing and what we think we are doing while upside-down is often two different stories. Once you identify the problem try to fix it by following the suggestions above. Working with an experienced teacher can save you time and the risk of injury.