Patients who are dehydrated cannot benefit from FSM. It has been observed that patients who are dehydrated. Athletes with large muscle mass and inadequate water intake and patients over 70 who are chronically dehydrated have the most problems. Every patient is advised to drink at least one quart of water in the one hour preceding treatment. Patients who are chronically dehydrated may need more water over several days prior to their treatments. No technique is 100% effective and FSM is no exception. The effectiveness of FSM depends almost entirely on an accurate diagnosis. Shoulder pain can come from muscles, tendons, bursa, discs, nerves or joints. FSM will treat all of these pain generators effectively. But, if you are treating for muscle and the shoulder pain is from nerves or the bursa you may change the muscle but you won’t change the patient’s pain since it is not coming from the muscle. This analogy applies to every condition.