Working the Frozen Shoulder

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.

Legal Disclaimer: Due to the litigious nature of many people I am forced to issue this statement: Any information contained within blogs, websites, postings, or news articles suggestions which I make to be open for interpretation that if you believe it may fit a concern or medical problem you may be having or suspect that you may have that you discuss it with your qualified healthcare practitioner including your physician. I do not take responsibility in any way for any content provided to you that you choose to act on without talking to a medical doctor or other qualified medical practitioner with legal standing of authority. You are free to act on any information from any source that you choose of which the consequences are your responsibility.

A word on Hypermobility

Do you have Hypermobility? This condition used to be A fun parlor trick when you were a kid being able to do something you could show your friends that might even gross them a little bit but now you're in adult so what do you do with it now? Where there was an interesting article in an industry trade magazine I recently came across by Mary Biancalana called MYOFASCIAL PAIN & DYSFUNCTION in which she discusses how her technique has led her to a better understanding the role of hypermobility syndrome in some people's health concerns. I wanted to take a moment to briefly summarize her article and talk about it in the context of how it works within my bodywork.

Mary started her career working with a special form of myofascial release and it has blossomed over the years into a very well-known practice in Chicago. She also takes part in an industry trade group which promotes and educate people on myofascial release. In layman's terms she is basically studying the connective tissue do it is in each and everyone of our bodies and how it impacts out health. They have been several recent studies which indicate that people that feel tightness in the muscles may be getting that sensation because the connective tissue to has recently been found to respond to stimulus in other words this tissue is also a sensory organ within the body much like our skin is on the outside. Her theory coincides with the generally excepted thought that the urge to stretch and the feeling of tightness within the body that makes us want to stretch is actually a lack of stimulus message from connective tissue. So now you might ask what does this have to do with Hyermobility? Some individuals that have hypermobile areas may actually complain of chronic tightness in other parts of the body and though there are many different kinds of connective tissue disorders hypermobility can be one of the most noticeable and in this case could indicate why people who are hypermobile have tightness feelings greater than those who do not even know it's not in the area where they may have hypermobility issues. There's also been a lot of controversy recently as to the purpose of stretching and if all of this yoga and other stretching regiments are even useful and lengthening muscle or relieving pain. What this article does so well in technical terms is explained to therapist why hypermobility is painful for people and some things I can do to help relieve the pain.

So now let's talk for a moment about what I can do to help those of you with hypermobile joints: 

1. Providing compression to those areas surrounding the hypermobile joints.

2. Have an open dialogue with me about your pain level other parts of the body during a massage session.

3. Encourage active breathing relaxation techniques to allow the nervous system to relax and to relieve tight areas as they are being worked out.

4. During the session help actively and passively stretch muscles throughout the body. 

This is yet another article that indicates home my massage techniques are integrated into each other and that one particular technique is not always the best answer for everyone. Whether you come onto my table for athletic conditioning, rehabilitation, or relaxation my massage and bodywork is complete and to your goals in a way that works with your body. If you have questions about this block please feel free to leave comments or contact me directly by email as listed on my website. www.tonyschwartzbodywork.com 

Legal Disclaimer: Due to the litigious nature of many people I am forced to issue this statement: Any information contained within blogs, websites, postings, or news articles suggestions which I make to be open for interpretation that if you believe it may fit a concern or medical problem you may be having or suspect that you may have that you discuss it with your qualified healthcare practitioner including your physician. I do not take responsibility in any way for any content provided to you that you choose to act on without talking to a medical doctor or other qualified medical practitioner with legal standing of authority. You are free to act on any information from any source that you choose of which the consequences are your responsibility.