The four joints
Reaching overhead requires the shoulder joint, the acromioclavicular joint, the sternoclavicular joint and — critically — the scapulothoracic joint, where the shoulder blade slides on the rib cage. If that last one is restricted, the arm cannot go up without the shoulder joint compensating, and the soft tissues in the space above it get compressed. This is the mechanism behind a great deal of what gets labelled impingement.
What Feldenkrais looks at instead of the shoulder
- Whether the shoulder blade is participating. Most people with shoulder pain have a blade that barely moves, and usually cannot feel that it is not moving.
- The rib cage underneath. A rib cage that does not expand limits what the blade can do on top of it.
- The thoracic spine. A stiff upper back forces the shoulder to overwork.
- Breathing. The upper ribs are mechanically involved in both breathing and reaching.
- The opposite shoulder. Asymmetry here is usually large and usually unnoticed.
A revealing test
Stand, let one arm hang, and slowly lift it sideways to shoulder height while paying attention to your shoulder blade. Then do the other side. Most people find one blade moves much less, and often that is the painful side — or, counter-intuitively, the painless side that is overworking.
What lessons do
Typically: exploring how the arm hangs, how the blade slides, how the ribs move under the arm, how the eyes and head influence shoulder organisation. All of it small, slow, and usually done lying down so the arm's weight is supported. People are frequently startled by how much easier reaching becomes after work that never involved stretching the shoulder.
What it suits, and what it does not
It suits chronic, non-traumatic shoulder pain: overuse, postural load, rotator-cuff tendinopathy in its non-acute stages, and the stiffness that follows immobilisation. It does not repair a full thickness rotator cuff tear, reduce a dislocation, or replace strengthening — and acute tearing pain, sudden weakness, or inability to lift the arm at all after an injury needs orthopaedic assessment promptly.