Case Study Remedial Massage Curing Shoulder Pain

Curing Shoulder Pain With Remedial Massage

The Patient
Sharon was suffering continuous right hand shoulder and upper arm which sometimes radiated down into her forearm and gave her pins and needles in her fingers. Although she had suffered with the shoulder pain symptoms for some time, recent home decorating had aggravated her condition. Her job as a librarian includes quite a lot of computer work and she spends hours hand writing which she does as a hobby. She found it very difficult to brush her hair or fasten her bra strap.

Remedial Massage Curing Shoulder Pain – Physical Examination
Sharon’s right shoulder was definitely higher than the left and her upper back was rounded. Sharon had very limited movement in her right shoulder. It hurt her to take her arm above her head, although this could be done passively (with me taking it up for her). This might suggest weakness in the upper arm muscles. She could not reach up behind her back. This hurt even when we tried to do it passively.

I tested for shortness of her large back muscle, latissimus dorsi and also her pectoral major muscles that lay across the chest. Both these muscles attach to the under part of the arm so would have an impact on extending the arm behind her back. Many people have shortened chest muscles and overstretched back muscles as in Sharon’s case.

Remedial massages can help cure shoulder pain

Remedial Massage – Treatment Given
With Sharon lying on her front, I started the treatment by applying relaxing strokes down Sharon’s back, working quite deeply from the shoulders to sacrum and working up the back into the insertions of latissimus dorsi and teres major. By holding Sharon’s abducted arm in the crook of my outside arm, I was able to take the strokes right into the insertions and apply friction here where there was an apparent build up of tension. I spent some time using differing massage petrissage movements over and around the muscles around the scapulae. Since Sharon was unable to take her arm in to the small of her back to lift the scapula, I used a rolled towel to help lift the shoulder.

Supporting Sharon’s shoulder for further scapula lift, I worked from the spine into the scapula. There was lots of tension around the medial borders of both scapulae, particularly in the right and so I applied NMT. This is a wonderful remedial massage technique that I use a lot. The pain is pinpointed, held it at an agreed level of pressure and we wait for the pain to disappear. As is usual, there were several pinpoints to work on. Concentrating more on the right, I used my fist and knuckles over the right rotary cuff whilst rotating Sharon’s arm to help stretch out these muscles

Sharon then turned to lie on her back. I worked along the fibres of pectoralis major and minor aiming to stretch the tense muscle fibres. Holding Sharon’s arm out and working from the origins at the sternum and under the collar bone to the insertions under the arm and the front of the shoulder, being aware of my pressure as this can be a sensitive area. I petrissaged and rolled the deltoid muscles, gently taking Sharon’s arm in different directions. Then I used the arm mangle massage technique, which gives a lovely stretch down the arm. I finished by using MET for her pectoral and deltoid muscles. This is a non painful technique that uses the patient’s own effort and movement to help stretch and strengthen the muscle.

Helping shoulder pain with remedial massage therapy

Following Sharon’s remedial massage treatment I suggested the following home care:
– Circling arms with elbow bent, one at a time five times in both directions
– Arms at shoulder height, gently pull back arms and hold for a few seconds
– Arms at shoulder height, gently lift arms and hold for a few seconds
– Aim to hold one arm behind back and gently stretch it with the other
– Stand in doorway and use frame to push back the shoulder, one side at a time
– All these exercises should be done on a daily basis.

Remedal Massage After Treatment
Following Sharon’s sports massage treatment her shoulder pain had eased and she had a better range of movement in her right arm and was able to take it further back than before the massage. Lifting her arm above her head was still difficult, but I explained that she would need to work on strengthening the muscles. She generally felt looser.

Therapist’s comment
Sharon needs to carry out my suggested home care exercises as these will help strengthen and lengthen the relevant muscles. On Sharon’s next visit for remedial massage therapy I plan to again work on the shoulder cuff muscles and chest muscles but spend longer on the arms to incorporate the biceps and fore arms and further address the tingling in her fingers.

Article Submitted By

Dena Aronberg
Sports Massage & Remedial Therapist Chelmsford

Date Published
24/05/08

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