This topic came up because of a recent case it came to me. This person was in his 50s at the time within driving truck for decades. For those of you that do not know tractor-trailer trucks and dump trucks is a very large wheels over to help the driver maintain control and provide them with additional leverage while turning the vehicle in tight spaces. Technology over the last 40 years has greatly improved the health of the drivers but I cannot solve this very basic problem of causing shoulder pain and tennis elbow symptoms. Back to this person who came to me with frozen shoulder and like to talk a little bit about my initial verbal consultation and subsequent appointments series to help deal with this particular problem.
This person was referred to me by a chiropractic doctor who has concerns about the tightness of the shoulder region he felt that he had done what was reasonable with bones but needed somebody to work with the muscles another soft tissue to help keep the aerial looser and prevent further movement of the bones. My first consultation with this person was a simple five minute chat about what this person did for a living how long they had been doing it and what their average routine was like. I thin that a simple diagnostic palpation to see where all of the areas of concern were in comparison to those brought up by the doctor to the patient prior to me meeting them.
Nonstick palpation showed that the muscles in the forms in the elbow and in the shoulders or extremely tight and in some cases adhesions or a fancy term meaning muscle stuck together had occurred. Or a sore shoulder for frozen shoulder differ tends to be in the movement of one of the bones in the upper rib near the deltoid called the clavicle. Officials or becomes too tight or liable to tear some of the tissue in the Syria and because of the nature of some of the tissue want to just torn it is extremely hard to get it to heal properly and according to most doctors is considered permanent and unrepairable damage. The idea here is that if you experience pain because this clavicle bone is moving while trying to bring your arm level with your shoulder or hire there can be movement of that joint. In the case of this gentleman that has not yet occurred but was very close to doing so which brought urgency to the issue.
Based on the initial assessment I estimated that it would take at least three hours to break down the tissue and stare restoring the range of motion. Now where I differ from many therapist is that I have been around long enough almost all of my colleagues I graduated with leave the profession. Some of them for financial reasons others of them because of severe damage to their body because they chose to take cases like this and do the work in exactly the wrong way. This is not meant to criticize people in my profession but to illustrate point with people wanting good massage and bodywork. A good massage therapist and bodyworker works with the body instead of against the body. When you work against the body person doing the therapy always loose.
Working a frozen shoulder is a great illustration of how clients tend to demand extreme levels pressure for no more reason for psychological satisfaction when really what is needed by the body the body usually tells us is that it needs to be financed and worked slowly in order to release correctly.
So what I do to finance an area like this is to warm it with standard Swedish strokes alone tissue together blood and oxygen into the tight muscles and slowly apply more focused pressure as the entire region of the body would start to relax. When the time is right and I know the tissue is pliable enough I will begin to work on the deeper tissue within the body and not the surface spring tension that you feel when you press into a tight area the potty at pushes back on your hands. With a good working knowledge of anatomy and physiology I can then begin to manipulating Clavicle shoulder region by grasping the whole arm and shoulder in one hand and a line pressure with a fulcrum like fat on a different point in the same region to create what is called strain counter strain. This will instantly start to release large number of issues in the area of the shoulder.
First appointment like I said it's always about learning the person's body in the backstory so that you can formulate benchmarks to share with the person prior to any other hands on work. In this case the first appointment was in a chair for just a few minutes talking and just touching to see what is there. The second and third appointment was all about repeating this process of warm in the region bringing fresh blood and oxygen into the area and slowly increasing pressure and going into a narrower and narrower focus. Once his focus phone is particular points of trouble I couldn't work those areas the strain counterstain fashion and continue to stretch and release the area. The third appointment is usually about evening things out from left to right or vice versa because there's always some kind of a calm and sooth with in the body of bilateral level to deal with any dysfunction in the body. This case the right shoulder was starting to completely locked up called frozen shoulder but had not reached the point of causing complete tears or other dysfunctions. Third hour over a period of a few weeks and had to go back and start working on the left shoulder region in order to balance out right and left so that the compensation would start to level off and become more natural.
I strongly believe that if a person can learn from that experience with the bodywork or massage therapist but value of taking care of themselves all subsequent meetings give that person confidence to take care of themselves because they realize that most cases and ounce of prevention is worth a pound of cure.
It was especially gratifying to see this in this same client then came back to me for hip issues resulting from driving for so long as well.
I know this seems like a pre-post but again if you have any questions please contact me about your specific case and perhaps I can give you some general guidelines as to what to look for the bodywork professional if you're not able to get to me personally.
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