03/06/2026
Shoulder pain is one of the most common things we see, and one of the most commonly undertreated. Not because people aren't seeking help. But because the help they're getting is only looking at the shoulder.
The shoulder joint has many possible pain generators; tendons, bursae, cartilage, nerves, muscles, ligaments, and even referral from distant structures like the ribs and spine. A thorough hands-on assessment will identify these. Good manual therapy, postural work, and progressive loading will address them.
But here's what most shoulder treatment never asks:
Why isn't this healing?
Because a shoulder that isn't responding, that keeps coming back, that stalls in rehab, that never quite gets there, is often a shoulder sitting inside a body that isn't in the conditions it needs to heal.
The things that delay and prevent shoulder healing are not what most people expect.
Poor sleep. Chronic stress. Gut dysfunction, specifically leaky gut, bacterial imbalances, and high inflammatory load from the digestive system feeding directly into systemic inflammation. Nutritional deficiencies in iron, B12, folate, Vitamin D, and omega-3s. A diet that keeps the body in a low-grade inflammatory state.
None of these show up on an MRI. None of them get addressed in a standard physiotherapy session. But all of them directly affect how quickly, or whether, tissue heals.
Steve's assessment for shoulder pain goes well beyond the shoulder. It includes a full lifestyle history, and where indicated, blood panels, inflammatory markers, insulin sensitivity testing, and stool analysis, because sometimes the thing standing between a patient and full recovery is not the treatment they're receiving. It's the metabolic environment it's happening in.
If your shoulder has been treated and treated and isn't resolving, that is worth understanding.
The shoulder is not failing. The conditions for healing may not yet be in place.
