The Curious Case of the Missing Armpit w/ Missy Bunch
In this episode of the Unreal Results podcast, I had a chat with my good friend and colleague, Missy Bunch, on an Instagram live to unpack one of my favorite shoulder assessment clues: the armpit. We explore how scapular upward rotation, serratus anterior function, and glenohumeral hypermobility all influence what you see and feel during shoulder assessment. You’ll hear why many people appear to have full shoulder range of motion while quietly borrowing mobility from the wrong place, how serratus anterior dysfunction can hide in plain sight, and what happens when those compensations are left unchecked for years.
In This Episode, You’ll Learn:
Why a missing armpit can be a sign of poor scapular upward rotation
The relationship between the scapula, serratus anterior, and glenohumeral joint mechanics
How to assess scapular upward rotation and identify common compensations
A simple exercise I use to retrain scapular mechanics and improve upward rotation
The shoulder rarely works in isolation, and this episode will help you better assess shoulder function while understanding how small changes in scapular mechanics can create significant differences in long-term outcomes.
Resources & Links Mentioned In This Episode:
Ep. 16: Why The Shoulder Comes Last
Ep. 17: A New Picture Of Shoulder Mechanics
Ep. 69: Why Your Shoulder Treatments Might Not Be Enough
Ep. 140: Why Acute Shoulder Pain Isn’t Always a Shoulder Problem
Ep. 159: Long Thoracic Nerve Palsy: Anatomy, Assessment & Recovery
Save 50% on my course - Never Treat The Shoulder First (use code ARMPIT or ARMPITS)
Save 50% on my course w/ Missy - The Nerve Workshop (use code ARMPIT or ARMPITS)
Learn the LTAP® In-Person in one of my upcoming courses
Considering the viscera as a source of musculoskeletal pain and dysfunction is a great way to ensure a more true whole body approach to care, however it can be a bit overwhelming on where to start, which is exactly why I created the Visceral Referral Cheat Sheet. This FREE download will help you to learn the most common visceral referral patterns affecting the musculoskeletal system. Download it at www.unrealresultspod.com
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Anna Hartman: Hey there, and welcome. I'm Anna Hartman, and this is Unreal Results, a podcast where I help you get better outcomes and gain the confidence that you can help anyone, even the most complex cases. Join me as I teach about the influence of the visceral organs and the nervous system on movement, pain, and injuries, all while shifting the paradigm of what whole body assessment and treatment really looks like.
I'm glad you're here. Let's dive in
Hello, hello. Welcome back to another episode of the Unreal Results podcast. Um, where am I? I'm just kidding. Um, this week is a special episode. It's ki- sort of like a guest episode, but yet it's like I'm the guest. I don't know. Um, my friend and colleague, Missy Bunch, had me join her for an Instagram Live today, and we talked about, um, the shoulder, upward rotation, how to tell the difference between why you have no armpit.
Is it glenohumeral joint hypermobility, and it's because the head of your humerus is in your armpit, or is it from lymphatic congestion, or both? And, um, didn't really talk about what to do if it's lymphatic congestion, but we talked about what to do if it is the glenohumeral instability. Uh, this, uh, episode actually is gonna go perfect with last week's episode, where I shared the case of the long thoracic nerve palsy patient and all about the serratus anterior, so it's a perfect companion to that episode, so I'll make sure that Joe links that in the show notes.
And then also, it goes well with the other podcast epico- episodes that I've shared about the shoulder, um, about why you treat the shoulder last, um, and just, like, shoulder mechanics and things like that. So I'll make sure that Joe links those in the show notes. And then, too, special surprise, I guess, I decided last minute to create a coupon for everyone who listens to the IG Live, uh, for 50% off the Never Treat the Shoulder First online course, as well as the Nerve Workshop, which is the course that we, Missy Bunch and I, have together.
So, um, the coupon code for that is armpit or armpits. Both of them work. And, um, yeah, it's my gift to you. It expires Saturday, June 6th, so, um, if you're interested in those courses, now's a great time to grab them, 50% off. It's about the best discount I offer. Um, and that's it. I hope you enjoy it. It was super fun to chat with Missy and super fun to take her through.
If you have a chance to watch on YouTube, I definitely recommend that, 'cause I walked Missy through a really simple exercise that is great for the serratus anterior. So, um, enjoy, and we'll see you next week.
Missy Bunch: There she is. Hi. What's up? What's up? Hi. Hello there. Ooh, I haven't seen these new sets of plants, the way they are set up. Hi, babies. Hello. So good to see you. And the month... Oh my gosh, I haven't talked to you in s- well, we talk a lot, but I mean- Yeah ... I haven't seen your face in a long time. I know. What the hell?
We were just texting five point negative seconds ago, so. Oh, I'm so glad to see you Hi, Lute. I know, it's so good to see you. How's San Diego, like 70 degrees? Probably. Yeah I haven't looked. Yeah. Yeah. It's nice outside. I was just sitting outside. Hi, Joel. Yeah. Well, it's that nice that you don't need to check.
That's your answer. Yes. It's 71 degrees currently. Yeah It's sunny. Yeah. I woke up today and I was going to go for a walk, and I was like, "I'm not. I'm not going for a walk 'cause we're there now." Yeah, 'cause it's hot. 'Cause it's hot. But we made it to June, which- That's big. Usually April ... I feel like exact- So honestly, all of April, all of May- Yeah
not even hot. I love that. So I'm like, okay, are we gonna go June, July, August, September? That's fine. Yeah. That's fine. I'll take it. Hi, Jess. So Anna used to live in Arizona for 14 years- Mm-hmm ... so she knows all the Arizona things, and we switched places. I, I went to San Diego and so did she, and then I went to Arizona and she stayed in San Diego.
But I'm from, you know, California, so we just have that fun hoppity-hoppity. Yeah. Um, and Brittany Klein is on the call, so I was like- I saw that. Yeah. I, I love my girl Brittany. I know. Um, okay, so I love how all of this- Also, actually, Brittany was Arizona and San Diego too. She lived in- Oh, yeah ... Arizona.
Anna Hartman: Mm-hmm. Uh, yes. We're... Hello. And then, um, Padres, Diamondbacks- Hello ... like, yeah, so all the things. Yeah. Um, shall we throw Brittany on the live? Right. Yeah, great. Great. We'll throw you in the next one. Can you do a three-person live? That would be cool. I think you can do, like, four people nowadays. Wow. Yeah. Okay.
Missy Bunch: So what I was gonna say was, um, I love how this organically came up because I wore a shirt you got me the other day that said, "Party pupil in the house," and had these- Yeah ... eyeballs on it. And, um, like all of pregnancy I couldn't wear it 'cause I couldn't fit it. Right. And it was my first time putting it on.
I was like, "Okay, okay, I can fit the tank top. This is good. Progress." And then I just transparently shared how, like, I'm all self-conscious of my armpits now because- ... a gazillion years ago when I was... when you were at my house- Yeah ... I laid on your treatment table and, like, you know, put my arm up, and you were just like, "Yeah, you're okay.
You're supposed to h- You're doing a teaching moment." Yeah. And you're like, "You're supposed to have a pit, which Misty does not." And I was just like Yeah, cool. And so, like, now I'm all self-conscious of my non-pits. Yeah. Um,
Anna Hartman: and- I mean, to be fair, I'm self-conscious of my non-pits too. It was Philip Beach who originally told me that I didn't have- Oh
any armpits, and so I'm like, "Oh, you're right." And now when I see a really good armpit, which a lot of my at- my client, my athletes have good armpits, I'm like... I mean, some of them don't. It is not default. But, um, the ones who do, I'm like, "Oh, I'm so jealous of your armpit." I know. And I know the ones you're talking about because they're, they're- Yeah
Missy Bunch: they're muscular and- Mm-hmm ... have the pit. Yeah. And you're like- Yeah ... "Really, you specimen?" Yeah. Like- Jess just asked, "How do you know if you have an armpit?" Yeah, like, it... On, on, on people who are not hypermobile and do not have lymphatic congestion, uh, it is an actual pit, like a deep pit. Like, there's, there's a hole.
Anna Hartman: Mm-hmm. Yeah. Um. Oh, my baby's crying, so let me turn that up. Um, so, gosh, now I don't know- I can kinda make it on one if I, like, really am good about externally rotating my arm, my shoulder. External? Yeah, no. External. No, you can't. No. You're, you're more hypermobile than I am. Oh, this one, this one has m- wait.
Yeah, a little bit better. It has a tiny, tiny bit. A tiny. Okay. A little bit. So, so I throw this up on my stories, and 100% of comments that came in- Yeah ... said, "Oh, your lymph lat- your lymphatically clogged, blocked"- Right ... whatever the word is, "Do the big six," blah, blah, blah. And I was thinking, "But that's not what"- No.
Missy Bunch: You know, that's not what we're doing. I'm pretty sure it was a bone, and then you were like, yeah, glenohumeral, um, hypermobility, what- Mm-hmm ... you know. So then I was like, "Anna, let's do a live." And she's like, "Yes, yes." So here we are. Yes. Yes. So- I mean, and that's the easiest, that, like... That's the crazy thing too, is when people are like, "Oh, no, it's lymphatic congestion."
Anna Hartman: I'm like, "Really? 'Cause when you palpate it, it's hard. That's not lymphatic congestion. That's a bone." That's like a literal bone. Like, you can literally feel the head of people's humorases. Yeah. Humori. Yeah, mm-hmm. Humori. And it's really common with people who are... lacks scapular upward rotation and therefore have excessive glenohumeral joint mobility.
That's what happens. Mm-hmm. They have a inferior anterior glide when they, an excessive one, when they lift their arm up overhead, and the head of the humerus literally pops forward. Which is so interesting because I don't consider myself having hyper... I don't feel like I'm hypermobile, but people tell me I am.
Missy Bunch: Like, it's h- Yeah ... they tell me that often. Well, I think, I mean, and you don't, people don't realize it in their shoulders very much because you're like, "Oh no, I can just lift my arm up to 80 degrees." But then if you look at where your arm, like, where your scapula is going to, full upward rotation is the inferior angle of your scapula reaching midaxillary line.
Anna Hartman: So if you have 180-plus degrees of range of motion, and like, for me, my, my inferior angle is, like, way, way out here. It should be here. Oh. I'm, I'm lacking about three inches of upward rotation, which is probably about 30 degrees Whoa. Yeah. Whoa. And that's, you know, and, and that's what ... You were my subject for, I was demonstrating upper extremity stuff, and so that was it.
Like, you were lacking upward rotation, but you make up for it at your glenohumeral joint. So, like, normal you're like, "Oh yeah, I got full range of motion," but you're not thinking about hypermobile 'cause you're not going into, like- Yeah ... 200 degrees of range of motion. But if you, if, but you have more mobility at your glenohumeral joint than you should because your scapula is not moving.
And this is, like, a pattern that we see, I see over and over again, is when people are upwardly rotating, or, sorry, w- flexing or abducting, their scapula is not wholly strong enough or mobile enough, right? 'Cause it's like sometimes it's a strength thing, but sometimes it's a mobility thing. Yeah. You know, I have a client now, actually I just, my last podcast episode I shared about him.
He had long thoracic nerve palsy, which is like scapular winging, but he also continued to strength train and work out, and super strong guy. His rhomboids, his levator, his downward rotators are so hypertrophied and stiff that even if his long thoracic nerve wasn't ab- wasn't paralyzed, um, he couldn't access upward rotation 'cause his downward rotators were so short.
So sometimes it's, it's a shortness, too, like too stiff and short of downward rotators, but sometimes it's a weakness of the serratus anterior, and most often it's a combination of two. Yeah. So, and I remember evaluating you. You did have, um, some mobility, you know, you were stuck. When I tried to s- put you in sidelying and passively rotate, uh, upwardly rotate your scapula, like, I could feel it not wanting to move in a certain diagonal.
Um- Yeah ... I can't remember 100%, like, which one it was. Yeah. But it's like, yep, I was like, oh yeah, so you were a combo of, you were probably not s- um, fully strong in your serratus to, um, but also you didn't have the mobility to, like, strengthen the full range of motion anyway, so. Um, and so then you make up for it at your glenohumeral joint.
And, and actually, you know, going to use him as a good example, his, his question to me was like, "Well, if I keep the rest of my shoulder strong and I can still lift my arm up overhead, does it really matter that my serratus anterior is-" So weak and like, you know, I'm winging so bad? And I'm like, "Well, yes and no."
I'm like, "Right now in this moment, no. If you had to lift something over your head, you could do it because you're strong in your other muscles." I was like, "But over time what's gonna happen is you're gonna wear out your glenohumeral joint and exchange a winging scapula for a dislocated shoulder or a labral tear or, you know- Yeah
a capsular tear, that kind of thing." I was like, "So it's like you can only use that pattern for so long before the hypermobility catches up with you, right?" Yeah. That, that piece right there is like the sirioso piece where like you're fine right now. Yeah. But let's talk in 10 years, 15, 20 years where we all hope to be alive.
Right. Yeah. Um, you know, so when you're saying, like when you're saying, when you're talking about the winging Yeah ... you're saying, for example, with my shoulder, it's not winging appropriately. No, no, no. I was giving the example of him. He had a winging scapula 'cause he had long thoracic nerve palsy, so his serratus anterior was- Oh
not even doing anything. Got it Which, you know, so your upward rotation is a combo of, uh, a coupled, a coupled motion of serratus anterior, upper trap, and lower trap, and a little bit of mid trap to get your arm up overhead. Mm. Full upward rotation. So he was lacking the serratus anterior part, which creates a medial winging of the scapula.
You don't have that. You just, you just are not using your full scapular rotation, uh, scapular upward rotation probably because you... Well, this is the problem when you get hypermobile, like, there's no reason to. If you've got the mobility in your glenohumeral joint, let's just- You do the things. Yeah. You, you have to do some real- But-
specific retraining of your scapula, of, of your serratus anterior to, like, force that to get stronger. And what happens when, when, when I take people through that and it gets stronger, like, what happens is they're like, "Oh, it feels so much better to lift my shoulder up overhead. I didn't realize it was kind of hurting when I lift my shoulder overhead."
And I'm like, "Yeah." 'Cause you're so used to it. Mm-hmm. So, so in this situation, I think I am this, like, 10, 15 years later person because- Yeah ... I have discomfort by my scap. Yeah. And you know, for me, I'm like, first of all, I don't have pain. Yeah. So to have it, I'm like, "Oh, heck no." Right. But I find it in a lot of movements.
Missy Bunch: I'm talking down dog. Mm-hmm. Even just a simple incline bench I was- Mm-hmm ... doing the other day, I'm like, I have pain around my scap. Mm-hmm. And Ryan's like, "Don't you, don't you know someone who teaches, like, if, don't move through pain, you know?" Yeah. And I'm like, "But also, I really like to do bench presses."
Yeah. So, like- Mm-hmm ... I mean, I'm talking all of it, overhead- Yeah ... down dog, and I feel it- And one ti- even in yoga, like, I think it goes... Yeah, if you can't s- but if we do, you know, boom. Yeah. That hurts, so everybody else goes this way, and I go this way. Yeah. Well, and so that's easier. Like, m- probably if you were to measure your upward rotation right there, how many fingers away from midline you are, when you go to abduction, I bet it goes farther.
Anna Hartman: Like, it looked like it went farther. Like, I don't know if you wanna check that. Um, which way farther? So you're, when you, you know- Oh, this? Yes, exactly. Is it closer to mi- the midaxillary line now when you do your arms overhead that way? Oh, I wonder. Okay, I wouldn't know. I mean... Well, feel it. I- this? No, with your other hand, like, feel where the border is.
Like this? No, no, no. In your armpit here. Like, up. You gotta love my holed shirt. Oh, it's, it's for the talk, right? Yes, yes, of course. You, you cut the hole for this talk. Yes. So here's my inferior angle right here with flexion. Okay, flexion. Uh, it should be, it, right, it should be here So I'm lacking that much Oh my gosh, no way.
If I go abduction, it goes farther for me. So here it is now where it should be right here. So I get, I get about an extra inch- You did ... of upward rotation with abduction, but that's because abduction is easier. It is much easier. 'Cause of, right, 'cause of the lever difference and, like, easier in terms of the mechanical advantage on the serratus anterior.
Missy Bunch: So- So that's what it is. So I'm, I'm cheating And since that feels better for you, then that just confirms that, yep, if you got your scapula stronger in upward rotation, you would probably not have as much shoulder pain. Yeah. Yeah. Okay, so what- And how it goes to, like, bench pressing and stuff, the same thing, is when your serratus is weak and, like, not super active, like we tend to do everything, the, the, the pattern we tend to get in is instead of the, instead of the, um, scapula pushing the arm up overhead, we tend to move the arm and pull the scapula with us.
Anna Hartman: So same thing at bench press, we tend to not move the sh- uh, scapula at all and just bench with our shoulder, which is like, you know, asking for a supraspinatus tendonitis problem. Whoa. Or a, or, you know, even a pec strain or a bicep strain because- Yeah ... it's not getting participation from the serratus anterior.
Which is not necessarily, I also s- wanna say it's not terrible because actually when you're looking at, and this goes into, like, maybe a smarter person than me in biomechanics, but, like, the bench press with the, you know how when people are max bes- bench pressing they extend their spine? Mm-hmm. Um, the only thing that really does, it gets your chest closer to the bar so you don't have to move the bar as far, because it actually destabilizes the serratus anterior.
And so again, limits you from using your serratus anterior as a pushing muscle, which is what it is. Because the serratus anterior likes a curve. It's really hard to strengthen the serratus anterior without being in a flexed spine. You can do it, but it's just at a disadvantage. And so when I am taking people through serratus anterior strengthening, I start them with a curve Wow 'Cause it's way easier to find that muscle and give that muscle somewhere to move, um, because then the scapula can actually move on the roundness of the shoulder blade, like, I mean, the roundness of the, um, thorax like it's supposed to.
Missy Bunch: Yeah. Mm-hmm. Okay, so, so I'm right here right now. Yeah. What is one thing I could do? My favorite is a cross-legged lift, which is if you sit on the ground. Okay. Can you sit on the ground? Can, can we see that- Yeah ... in the camera if I sit on the ground? I, why not? Why not? Let me... I don't- And it's your, your, it's your left arm that is on you?
It's my right arm. Your right. Okay. So this is my right side. Okay. Thank you. Yeah. Yeah. You know how the camera throws us off. I know, like which way, so cross- So put your, cross your, um, legs so your left leg is in the front. There you go. Dorsiflex your feet. Yep, perfect. And then you're going to rotate to the right.
Okay, hold on. Dorsiflex. Yeah. Rotate r- from my spine. From your spine, yep. And then measure your arm distance between, your, so your, um, your... I gotta think where I'm gonna be here. You're rotated to the right. Your left foot's in front, right? Yeah. So it's your right arm. Okay. So your right arm's gonna be where your hip is.
Yeah. And then your left hand is gonna be where your knee is at. That's gonna be the width that we use, which is the width of your femur, basically. Yep. Oh, yeah, yeah. Okay. Now, reach your hands out towards the edge of the carpet. Like this? Like along the ground. You're gonna load your, you're gonna push, you're gonna be in like a pushup position eventually.
Oh. Yeah, yeah, yeah. With this hand down. So flat, but put both hands down. Yep. And walk it towards the edge of the carpet. Okay. See how your foot is already starting to be pushing on, into the ground? That's, that's our helper. So what you're going to do is you're gonna look to your belly button. You're going to shift your weight forward, bringing your chest over your thumbs.
Anna Hartman: Yeah, and then curl your spine, belly button to tailbone, and push and lift your hips up. Okay. And then into what position? Just lift your hips up. You don't even have to do anything. Okay. Like this? Yep. Keep pushing up. Up, up, up. Um, yep. Try not to, um, I know you're going into a pattern from a class you've learned.
Stay rotated.
But lift your butt up Yep, and then come back down into the cross leg. Yep. Do you feel how that loads your back arm? Yeah, it kind of hurt. It, it, it felt the hurt that I- Okay. Well, we don't want that. So what you're gonna do- Just a little bit. Just a little bit. That's fine. Okay. Just- The baby's crying. Oh.
Missy Bunch: Hold on. Give me two seconds. Oh my God, baby. Let me get Ryan. Hold on.
Anna Hartman: Oh, to be a mom at the same time Sorry, everybody. You're good. Okay. Okay. Go back in that cross leg. Okay. Boom, boom, boom. Okay. Now lean over, bring your chest over. Yep. And really push your... See how you keep rocking your shoulders back though? I want your shoulders over your wrists. Yep. And then curl, and then big exhale breath as you lift your butt up, and you let your foot help you up
Missy Bunch: Like that? Yep, and then lower back down. That feels good. Good. Do four of them. The exhale. Yeah, the exhale. Yeah, the exhale helps. Yeah. So you lean forward. Yeah. And really try to send your nose towards your tailbone too. Give yourself more flexion than you think. See, 'cause you like flat chest, so you keep- Okay
Anna Hartman: right there. Yeah. It's because you are, you know- Okay ... a good mover. Yeah, this is hard. So I want your, send your sternum through your shoulder blades. Big exhale as you do it. Look down, look towards your belly button. Push, push, push and lift. There you go. Yeah, it's really hard. When you really isolate your serratus anterior like that, it's like holy crap.
There's a reason I only- That does not hurt. It's just hard. Very hard, yes. Yes. Round. Yeah, round. Oh. Lean over your hand. Yeah, do an exhale breath to help. The exhale breath to help is nice because the external oblique connects into the serratus anterior, so you get a little extra help. Oh, gosh. Which is also why we're doing it in this rotational pattern.
Basically, this rotational pattern, um, really connects the serratus anterior and the oblique together and, like, really isolates that connection to force you to l- use upward rotation to lift up. And then it's closed chain, which is nice too- Yeah ... 'cause that helps to stabilize your shoulder. But yeah, there's a reason why I give four reps, and you just felt it, is 'cause when you do it right, it's really freaking hard.
Missy Bunch: Yeah, if you d- good, four is... Four good reps would be like, "I'm good." Yeah. Like- Yeah ... need to take a break. Usually after the second one, the athletes look at me and they're like, "Is this supposed to be this hard?" And I'm like, "Yeah. Yeah." Yeah, so that- And then go ahead and, like, re-check and, like- Yeah. I mean, that doesn't hurt.
Anna Hartman: Yeah
Missy Bunch: Oh, but see, then I elevate 'cause it- You can ele- like, there's nothing wrong with ele- you should be elevating. Elevation is a component of upward rotation. Well, so okay, so when I ... I don't even know if I'm supposed to, like, pack the shoulders down for this, but I know we will elevate. No packing. You stop packing shoulders, never, never again in anything you do.
Anna Hartman: Do not pack your shoulders ever. Like, ever, ever, even lifting- If you're lifting your arms up overhead, no. Let, let those bad boys, bad girls fly forward and up. E- okay. So what, what's this called in yoga where you, like- Yeah, warrior one. Yeah, yeah. Yeah. Warrior one. Mm-hmm. Okay. I didn't know I could elevate, so I was always trying to, like- Yeah, don't.
No. Yeah, bad cue. Old cue. Old, bad cue. Packing the shoulder, shou- shoulders down and back, bad, bad. Let's all, like- Okay ... Men in Black, you know, like- Men in Black, staring into the light ... uh-huh. Men in Black, staring into the light, forget it. Let your shoulder blades move because they are the thing that's pushing you up and forward.
Missy Bunch: Okay. 'Cause now when you do a handstand training, you're upside down and they're like, "Elevate." Uh, and you're like, "Oh my gosh, I-" Yeah ... "This is loaded. This is hard." Yeah. And that cross leg lift, like, hopefully you felt too when you really shifted your weight over your hands- Uh-huh ... the more active you are into the ground with your hands, it starts to s- sort of, like, float your hips up, and that's the beginning- Yeah
Anna Hartman: of, like, a press to handstand. Okay. Yeah, yeah, cool. That, that was really ... I'm s- just started to sweat. Yeah, it's, like, hard. I mean, right at that moment, I was like, "Okay, it's also hot here," but so, so this- But also, like, I'll be demoing these for people, and I'll demo, like... I might demo maybe four, if even that, and the next day I'll be like, "Goddamn, I'm sore."
Missy Bunch: That's what I was thinking. I'm like, "I'm gonna be sore." Mm-hmm. I'm ... This is gonna be amazing. So- And the nice thing is once you start feeling it and how it works correctly, now you can take it into a more neutral spine and actually have the movement experience to know what it feels like to move your shoulder blade.
Yeah. And then, and then you'll start noticing too, like, I did a very modified, like, like, quadruped position to a Turkish get up kick through type thing- Mm-hmm ... in a neutral spine, and the next day my serratuses were so sore and I'm like, yeah, the only reason it was though is because I understand that connection between active hands and, like, letting my shoulder blade do it, do the, do its thing.
Oh, cool. Mm-hmm. Yeah. That makes so much sense. So let's bring it all the way back to the beginning- Yeah ... where- You're, you're educating colleagues, right? And my demographic is also the same, and most of them see my armpits, and they were all saying lymphatic, lymphatic. So can you just help everyone on the call, like, really assess how, how do they assess it, what to look for?
Yeah. Is it just, like, palpate it? That's what, you know- Well, I mean, it can't be just palpate it. No, and y- you know, like I said, too, you can have both. You can ha- like, I tend to have a little bit of both of- Yeah ... you can feel the head of my humerus, but also it's a little, like, boggy in there. Yeah. Um, so, um, one, you can make sure that when you are palpating it, the person is, their humerus is externally rotated.
Okay. Um, and then you'll get a better idea, 'cause that kinda tucks this head of the humerus back in, and that gives a little bit better pattern of control at the g- glenohumeral joint. So I mean, even when you do that actively, you start to look like you have more of a pit. It was- Yeah ... all right. Okay, so you, you have, you cue it, they're lying down or standing, external first?
Anna Hartman: Um, whenever you're coming into shoulder flexion, I do a neutral hand, thumbs towards the ceiling. Okay. Yeah. But then track, then go more external, or- No, that's enough if you just go thumbs to the ceiling. Oh, okay. Just thumb- okay. Yeah. What us hypermobile people do, we can go full internal rotation and have our head of our hu- humerus stick out.
Yeah. Most people, um, most people, they need to have that little bit of a neutral position, thumb towards the ceiling, to clear the trochanter underneath the su- the acromion- Mm-hmm ... to not create an impingement. But when you're hypermobile, instead of needing to do that to clear the subacromial space, the humerus just does this.
Does that make sense? Yeah. So that's a good indication. If somebody can lift their arm up overhead and, like, be in, like, any degree, like, I'm like, "Yeah, you're hypermobile." Like all the ways. I wouldn't even know. Mm-hmm. You're like, "That's always been normal." Yeah, 'cause you've always been flexible.
Missy Bunch: Interesting. So that's one way, is like, you know, just being aware of that. Mm-hmm. But then, too, like, um, palpate it. You can feel the head of your humerus. Feels like a bone, hard thing. If you're ever unsure of what the bone- a bone feels like, go to your sternum and be like, "That's a bone. Oh, I feel a similar thing in my armpit now.
Anna Hartman: Bone, bone, bone, bone." Of course, there's tissue on top of it, but it's like very much bone. Yeah. Normally, the pit should be a pit. It should be like your, um, groin pit. Yeah. Or your knee pit. You don't feel a bone back there. Yeah. Mm-hmm. Or it should feel like it feels when your, you, when your arm's at your side.
Yeah. Yeah. So- Wow, this is- So number one, pal- palpating it. But then two, it's actually easier to s- assess someone's range of motion and assess the relationship between their scapula and their humerus in side-lying. Okay. Because then you get a very much a different look at the relationship between the two.
Missy Bunch: Okay. Mm-hmm. So- And- ... let's wrap this up with that. So that's step three. I'm side-lying. I'm the patient or client. Mm-hmm. So what are you having me do? I'm passively moving you. Okay, you've got the arm- Yeah ... and you're doing what? I'm bringing you into shoulder flexion. Okay. So on your- And then- ... side, you know, it's like this
yeah. Yep. You bring it into- And then I can even- ... flexion, and then you're- You can- ... doing all the palpating and- Still palpate. You can see if they have a pit. Um, you can start to see, like, oh, look at that, their arm can go up and it'll be reason their scapula is still on the back of their body, not on the side of the body Right?
Anna Hartman: And then now too you're like, "Oh yeah, that's just the scapula. It's not moving." W- and then you have to decide is it not moving 'cause it doesn't have to because the glenohumeral joint is so mobile, or is the scapula not moving 'cause it's so tight in the rhomboids and levator? Right. Mm-hmm. And then that's when instead of holding the arm now, I'll put my arm under their arm so my hands can be on their scapula, and then I'll see can I bring your scapula with us now?
Missy Bunch: Yeah. Does it move? Mm-hmm. Yeah. D- Does it move? Wow. It f- I feel like my whole life's flashing before my eyes. Like- Yeah. Yeah ... I can make my scaps move, I can, but it's not second nature- No ... for me personally. Like, I- Yeah ... I can. Having felt you, even though I know you have a little mobility restriction on at least one of 'em, whatever one I had evaluated for that video, um, I just have watching you move and, like, knowing you and your body, like- Yeah
Anna Hartman: I'm like, no, you just need proper strengthening, and then you'll be fine. Yeah, like- Yeah ... proper mapping to u- use it. Yes. And not, and, and I t- I too mean proper strengthening in terms of not like, oh, Missy, move your shoulder blades when you lift your arm. Like, yes, that's part of it, but no, it's strengthening of, in what I t- just demonstrated with you is, like, I'm choosing exercises that forces you to have to use it, so your body doesn't have a choice.
Missy Bunch: Right. It's- Even better. Yes. When your body has a choice, and, like, standing exercise, open chain ex- like, exercises without your spine being curved, it's always gonna pick the thing that's easiest, which is the thing it's been doing for the last 40 years. Yeah, yeah, exactly. Right? And so this is actually, you know, I talked about that on last week's podcast, episode two, is, uh, because my athlete's so strong, I need him to, I actually, every exercise we do for him is, like, manipulated the environment, the positioning, so he has no choice but to use his serratus anterior.
Anna Hartman: And he hates it. Why? Because he feels the weakness, and that- Yeah ... makes him feel like- weak. Incompetent That makes him- He's an athlete Yeah They don't like that. Yeah. Yeah. But it's also, like, yeah, but this is the way you get it stronger. Yeah. If you keep jumping to the way you've been doing it, you're never gonna actually get that muscle stronger, 'cause there's so many other muscles around it that can do a similar job.
And when your only desire is to get your arm up overhead, your body is gonna figure it out. Yeah. Yeah. It's gonna do it. Yeah. Which is nice. Yes. Nice- Um- ... but also not nice. Right. Okay, so I know a lot of people are gonna have questions about the shoulder, and you have this incredible resource called Never Treat the Shoulder First.
I, yes. Yes. Which is so cool. I think everyone needs to have it. So how do they get it? Yeah. Um, well, also, I decided last minute, I was like, you know what? For anybody who watches the live, who watches lives anymore- Yeah ... um, I put a discount on it as well, good until Saturday. Um- Okay ... the discount code is armpit You guys, discount code armpit Yes, but if you just go to the links in my profile, it'll, like, there's probably one- Direct you there
um, to my website, and then just click on online education. It'll take you right to the store, and yeah, it's called Never Treat the Shoulder First. And I also put, um, on discount our course that we did together, the Nerve Workshop. Oh, cool. Also 50- I did both of them for 50% off, code armpit, just for- 50? 50. 50.
Missy Bunch: Holy moly. Okay. Yeah, 'cause why not? What a gift. Yeah. Why not? Like, if, if anyone heard you say this- Yeah ... then they should get the 50% off. Yeah. Exactly. So- Oh, that's so wonderful. Thank you for that gift. Yeah, of course. And yeah, the Never Treat the Shoulder Wor- Never Treat the Shoulder First workshop, we talk about these mechanics.
Anna Hartman: We talk about the role the clavicle and the clavicle mobility play in it, and we talk about how oftentimes this pattern of the lack of upward rotation, um, is a neurological pattern when the body is protecting something else more important, like the viscera or the nervous system. And so, like, where to start and then, but also a lot of information on, like, shoulder mechanics like this of, like, yeah, we gotta get the shoulder blade to move.
Missy Bunch: Yeah. Yeah. Which is Anna's whole jam if you guys don't know this, like visceral referral, viscera refer- referred pain. Like, she's your girl. Yeah. Yeah. Um, so okay, awesome. What a, what an amazing gift. Thank you so much. Yeah. No problem. Um, I'll, I'll text you after. Thank you for con- con- your contribution and donating your time to- Absolutely
my community. Absolutely. Code arm- Code armpit ... armpit. Armpit. Oh, with an S. Oh, no. I think it's... Let me look. Let me double check. I think it's armpit. It might be armpit, not armpits. See, you think you try to make it simple, and then you realize- Okay, try both. Try, try S and no S ... yeah. Right? I'm like, it's either armpit or armpits.
Yeah, they'll try both. They'll try both Yeah. Yeah. Okay. Thank you so much. Appreciate you. Bye. All right. Love you. Bye. Love you. Bye