Case Study


Jane is a 33-year-old secretary who came to treatment seeking help for a repetitive stress injury in her arms and shoulders that she had for the last year and a half.

She stated that, "I have no power to keep myself up, I feel  like I'm going to drop any minute." She was also diagnosed  with tendinitis of her fourth and fifth fingers on both right  and left hands.

Jane described that she used the computer a lot and as a result her pain worsened to the point that she could not use the computer more than five minutes at a time. In the mornings, she experienced numbness bilaterally at the fourth (ring) and fifth (pinky) fingers. Jane added that she had physical therapy (including ultra sound and therapeutic exercises) that did not help. She then got lidocaine shots to her left forearm and cortisone shots to the right and left wrists, which did not either.

Jane's upper body was profoundly slouched with a protruding neck and chin. Muscle strength evaluation revealed poor strength in both shoulders, elbows and hands. Her main complaint, in addition to the physical disorders we found, was that she felt she had no strength to hold her arms and upper body up. It sounded as though she was experiencing lack of energy in her upper body from the waist to the neck area. When I inquired about her ability to be strong and assertive in daily life encounters, she pointed out that she lacked assertiveness when she needed it and she felt fragile.

My assessment of Jane revealed repetitive stress injury to her shoulders, elbows and wrists along with poor posture and "inner stuff" that has to do with no energy in the upper body, an inability to assert herself, and her feeling extremely fragile.


During and following therapy Jane described that she was more aware of her postures. She was able to make the connection between her posture and how she was affected by the presence of another person. For example, when speaking with her Mom, whom she loved, she was partially erect and more open in her chest area, but while speaking with her dad, from whom she was estranged, she slouched and experienced more weakness in the upper body. She was struck by the lack of energy she experienced in her upper body. Before therapy, she compared her upper body to a rag-doll body with no bones or firmness, susceptible to collapsing at any given time. The ability to protect her chest and upper body was foreign to her.

By the end of her treatment Jane had improved significantly. From being extremely frail she developed her self-esteem and inner strength, and learned to protect herself and her body so that she was able to face life with greater stamina and endurance.

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