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From Ape to Modern Man: The Evolutionary Secret to Ending Shoulder Pain

Seemingly, every day, a new article discusses issues of back and neck pain, shoulder discomfort, and the often resulting chronic pain. While researching this article, I received a news alert suggesting that back and neck problems are the new major health concerns in the UK1. And this is all arguably self-inflicted.

Most of us go from sitting hunched over at a desk to hunching over our meals to reclining on the sofa at the end of the day. But we certainly weren’t designed to be this way. And there’s a simple potential solution: Brachial hanging.

I do this daily; it has helped me relieve shoulder and neck pain. My shoulder pain was likely from the years of abusing my body with the competitive sports I played. Still, whether your shoulder & neck pain is from sport or a sedentary lifestyle, the solution remains the same.

What is Brachial Hanging?

Brachial hanging is a practice in which you suspend yourself from a horizontal bar overhead. The aim is to heal shoulder pain and ease neck and back pain. The specifics of the practice depend on your current fitness level and the need for the hanging. Some people should start with 30 seconds a few times a week, whereas others can hang for three sets of 60 seconds daily.

From an anatomical perspective, brachial hanging involves extending your arms and hanging from an overhead support with an upper arm (humeral) position of 180 degrees. This movement taps into the natural flexibility of the shoulder joint, involving aspects like turning your arm outward (external rotation) and gently moving it away from your body (abduction) when reaching the high point of flexion (end-of-range). (If you’d like to gain a thorough understanding of the anatomy & physiology of the shoulder joint, I recommend watching this short video).

Some fitness experts promote hanging variations, such as single-arm, passive, active, or any combination. Today, we’ll focus on the pioneer and the scientific evidence that currently does exist.

The Pioneer

Brachial hanging cannot be discussed at length without the introduction of the self-proclaimed authority in this field, Dr John M. Kirsch. Dr Kirsch is a highly experienced orthopaedic surgeon hailing from Wisconsin, boasting more than three decades of expertise as a shoulder specialist.

As the visionary behind the Kirsch Shoulder Institute and the acclaimed author of the self-help bestseller “Shoulder Pain: The Solution and Prevention”, Dr. Kirsch is on a mission that defies conventional wisdom. Almost ironically, in a healthcare system driven by surgical solutions and profits, he provides an alternative and actively encourages it for his patients.

Dr Kirsch is so dedicated to eliminating shoulder pain without resorting to surgery that he asserts that his hanging regimen has the potential to cure a remarkable 99% of shoulder pain. He goes further, but I’ll let him do the talking (from an interview with Rick Ansorge for NewsMax Health):

“Man is the fifth great ape,” said Dr. Kirsch. “The others are the gorilla, chimpanzee, orangutan, and gibbon, all of which still swing from trees or brachiate.

“When we came down from the trees about 3,000,000 years ago, we stopped brachiating. But we still have the shoulders of an ape that’s supposed to brachiate.”

To treat and prevent such injuries, he has developed a simple protocol that simulates brachiating. It requires two elements: hanging or partial hanging from a pull-up bar and performing light weightlifting with dumbbells.

“It cures 99 percent of shoulder pain,” says Dr. Kirsch2.

So, we’ve heard from the pioneer himself. Nevertheless, consider consulting a healthcare professional before starting your brachial hanging journey. Eliminate the unlikely but more severe concerns. If discomfort stems from everyday rotator cuff tendinitis, start with a more measured approach. Begin with 30-second hangs a few days a week and build it up daily. Enhance your regimen by incorporating weightlifting exercises with dumbbells. The entirety of his protocol can be found outlined in his book3.

The Problem

Dr Kirsch hinted at the problem by referring to humans as the fifth great ape. We are animals. We have evolved from and as animals, but we live in a modern, developed environment that often tricks us into thinking we are not animals. And so, fundamentally, we are designed to move.

Our bodies adapt to our actions. Consider the poor posture of being hunched over a desk or staring down at your phone as the polar opposite of what brachial hanging encourages your body to do.

When you slouch with your head forward, it affects the position of your shoulder blades and the rotation of your upper arm. Slouching results in the shoulder blades tilting forward and rotating inwards. This can lead to rounded shoulders (altered scapular abduction and elevation, scapula protraction, with associated medial rotation of the humerus). Conversely, maintaining good posture involves pulling your shoulder blades back and down (scapular retraction & depression).

The rotator cuff muscles in your shoulder connect to various points on the upper arm bone (humerus), while the tip of the shoulder blade (acromion) is just above it. This crucial passage is where many tendons, ligaments, and soft tissues pass, known as the coracoacromial arch (CA arch).

Now imagine this: the rotator cuff tendons are positioned between the acromion and the humerus. Poor posture can cause the acromion to curve downward, narrowing the critical passage for ligaments and tendons. The consequence? Shoulder pain, most commonly subacromial impingement syndrome (SIS).

Essentially, the tendons become pinched or caught between the bones. Of course, there are other factors, such as gravity, injuries, inappropriate exercise or neglect. However, posture is the easiest to fix, and brachial hanging could be the solution.

The Solution

Take a moment to contemplate the slow and gradual pace of evolutionary transformations. Evolutionary changes span hundreds of millions of years4. Conversely, the development of modern civilisation has occurred in just the last 300 years. From this framing, it becomes evident that our biological adaptations have encountered a profound disruption in our contemporary environment. This partly explains how our bodies can change for the worse if we don’t know what is natural for us.

It’s widely acknowledged that our closest evolutionary cousins are the great apes, which include chimpanzees, gorillas, bonobos, and orangutans. Together with tree-dwelling gibbons, they comprise the hominid category within the primate family tee. Most interestingly, brachiating behaviour— swinging from branch to branch— came before our distinct upright walking. More interestingly, it is still a trait all the hominids have in common except for humans5.

Unsurprisingly, many elements of the hominid shoulder anatomy mirror our own6. From this evolutionary standpoint, hanging begins to make sense. But how does it benefit us? Bone is a living tissue that responds to mechanical load. This means that the shoulder joint can reshape over time, and doing so with hanging can potentially lead to healthy restructuring.

The core idea behind the theory of why brachial hanging might be effective begins with Wolff’s law, formulated by a German anatomist and surgeon named Julius Wolff in the 19th century. In simpler terms, it suggests that your body adjusts to the demands placed on it. Thankfully, research has come a long way since then, and we now understand the cellular mechanisms by which bone changes in response to mechanical stress7.

Dr Kirsch proposes that the act of hanging works to reverse the changes caused by chronic poor posture and unnatural movement patterns. The aim is to help reshape the contracted CA arch. Kirsch even claims to have discovered a new joint, ‘the acromiohumeral joint’, visible while hanging from an overhead support or bar. As per kirschshoulder.com: “when engaged, the humerus leans on the acromion bending this structure, providing more room beneath the acromion. This leads to healing subacromial impingement syndrome, frozen should and rotator cuff tear symptoms”.

In addition to the above, some also claim that hanging aids in spinal decompression, encouraging appropriate spacing between the ribs, potentially improving spinal alignment, and allowing for more effective breathing mechanics. But the science is still playing catch-up on these claims.

The Evidence

Unfortunately, the scientific literature on brachial hanging is scarce. Many self-proclaimed ‘movement expert’ influencers share anecdotal experiences, but it is essential to recognise that these accounts don’t necessarily constitute robust scientific evidence. This is especially important to note when weighing up health decisions.

According to Dr. Kirsch’s book, a scientific investigation called the Kauai study occured. However, this study hasn’t undergone the peer-review process to be published in any journal I’ve encountered.

The study claimed to have patients with the following diagnoses: SIS (n = 70), rotator cuff tears with MRI diagnosis (n = 16), adhesive capsulitis/frozen shoulder (n = 4), osteoarthritis of the glenohumeral joint with SIS (n = 2). Of the 92 subjects, 90 returned to comfortable activities of daily living and remained so after variable years of follow-up (1 – 28 years). Two subjects with ‘shoulder pain’ had been scheduled to have shoulder replacement surgery and were able to cancel that surgery; the remaining two subjects quit the study for personal reasons.

A research paper submitted as part of a master’s degree in Osteopathy can be found written by Khaled Zaza at the UNITEC Institute of Technology in 2020. While it involves a thorough and engaging review of the surrounding literature and has demonstrated significant results, its scientific rigour remains weak given that only 7 patients participated in the study. Again, as far as I can find, this work is unpublished and not peer-reviewed.

The Alternatives

The usual treatment options for the shoulder issues we’ve discussed range from physical therapy to surgical procedures. Emerging choices include laser therapy and ultrasound, as well as some established alternatives, such as acupuncture and steroid injections8 9 10. However, it’s important to note that the effectiveness of these alternatives varies, and they come with their own set of risks.

TLDR;

Brachial hanging emerges as a unique and intriguing potential solution in an era marked by increasing back and neck problems, chronic pain, and shoulder discomfort. But what can we say for sure? Well, hanging undoubtedly improves grip strength, and we know almost indisputably that poor grip strength is a better predictor of early death than blood pressure11. Beyond that, the anecdotal success stories and Dr. Kirsch’s claims cannot be easily dismissed nor confirmed until further rigorous evidence is developed.

I’ll leave you with some additional words of caution from John M. Kirsch himself:

“The hanging exercise is not recommended for persons with unstable or dislocating shoulders, for those in precarious physical health, or with severe osteoporosis (fragile bones). If you have shoulder pain that goes unexplained for several weeks, it is wise to obtain a proper diagnosis from your physician.” – John M. Kirsch from Shoulder Pain?

And so, remember, it’s not a one-size-fits-all solution. Add yoga or mobility routines a few days a week. Add cardiovascular and resistance training on the other days. And always consult a health professional.

Further Reading

Here are my suggestions for books related to the topic of today’s article. Let me know what you think!

  1. “Shoulder Pain? The Solution & Prevention” by Dr. John M. Kirsch – This book introduces Dr. Kirsch’s theories and the practice of brachial hanging as a solution to shoulder pain. It offers a deeper dive into his methodology and the potential benefits of his approach.
  2. “Move Your DNA: Restore Your Health Through Natural Movement” by Katy Bowman – This book explores the importance of natural movements in our daily lives and how modern habits have strayed from what our bodies are evolutionarily designed to do. Bowman provides insights into how specific movements can restore health and vitality.
  3. “Becoming a Supple Leopard: The Ultimate Guide to Resolving Pain, Preventing Injury, and Optimizing Athletic Performance” by Kelly Starrett – This comprehensive guide offers techniques on how to prevent pain and enhance physical performance through proper mechanics and mobility exercises. It includes ways to correct poor postures and inefficient movement patterns that contribute to pain.
  4. “The Story of the Human Body: Evolution, Health, and Disease” by Daniel Lieberman – This book provides an evolutionary perspective on how the human body has developed over millennia and the implications of this evolution on our health in the modern world. Lieberman discusses how some of our current ailments are due to lifestyle changes that are at odds with our biological heritage.
  5. “Deskbound: Standing Up to a Sitting World” by Kelly Starrett with Juliet Starrett – Focusing on the dangers of prolonged sitting and sedentary lifestyles, this book also provides practical solutions for integrating more movement into everyday life. It highlights the anatomical and physiological impacts of sitting and how to counteract them.

References

  1. https://www.theguardian.com/society/2024/jan/19/back-and-neck-problems-driving-major-uk-health-crisis-say-medical-leaders ↩︎
  2. https://www.newsmax.com/health/health-news/shoulder-pain-non-surgical-cure/2014/03/07/id/556647 ↩︎
  3. https://www.amazon.com/Shoulder-Solution-Prevention-Revised-Expanded/dp/1589096428 ↩︎
  4. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4031799 ↩︎
  5. https://doi.org/10.1002/ece3.4392 ↩︎
  6. https://onlinelibrary.wiley.com/doi/abs/10.1002/ajpa.1330860408 ↩︎
  7. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5410657 ↩︎
  8. https://doi.org/10.3109/14397595.2013.857798 ↩︎
  9. https://pubmed.ncbi.nlm.nih.gov/15162102/ ↩︎
  10. https://pubmed.ncbi.nlm.nih.gov/30774463/ ↩︎
  11. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(14)62000-6/abstract ↩︎

[NB. All images created using midjourney]

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