The majority of shoulder pain massage clients are forward and medially rotated to poor postural habits repetitive motions or trauma. The muscles in front of the shoulder such as pectoralis major, pectoralis minor, subscapularis become tight and contracted. While the opposing muscles such as rhomboids, middle trapezius, infarspinatus, and teres minor become weak inhibited and essentially contracted or overstretched.
The imbalance around the joint may enhance a neuromuscular response, attempting to restore balance, which also creates tension in the joint. This may lead to joint degeneration or arthritis as the cartilage wears down from being placed in a tight orient balanced position during shoulder movement. The resultant discomfort also limits range of motion possibly contributing to a formation of fascia adhesions inside the joint capsule.
The fascia and osseous membrane surrounding the articulating cartilage acts as superglue and essentially lose the human race to the scapula contributing to a condition called adhesive capulitis.
Adhesive capulitis usually begins innocently. Your shoulder is bothering you, so you don’t use it. There is something to be said for resting and overuse shoulder after a weekend softball tournament. But if you injured your shoulder or are suffering from chronic shoulder pain and you don’t use your shoulder for a long time your joint will stiffen up. From there it becomes a vicious cycle. Your shoulder gets more and more stiff and eventually the lining of the joint gets this and you cannot use your shoulder. Although adhesive capulitis and frozen shoulder are often used to describe the same clinical condition, they are quite different. And early onset fascial adhesion inside the joint capsule is the pathology that limits active and passive shoulder movement in early onset adhesive capulitis. The pathologies that may be involved in a true frozen shoulder includes not only adhesive capulitis, but also subacromial bursitis, calcific tendinitis and, rotator cuff pathology, and and other conditions such as shoulder impingement at all contribute to limited shoulder motion.
In general frozen shoulder can come on after an injury to your shoulder or a ballot with other musculoskeletal conditions such as tendinitis or bursitis. It can also develop after a stroke. Quite often it cause cannot be pinpointed. Any condition that causes you to refrain from moving your arm and using your shoulder can put you at risk for developing frozen shoulder.
But diabetes is also a risk factor for frozen shoulder. The medical community is still researching why one theory involves collagen one of the building blocks of ligaments and tendons. Collagen is a major part of the ligaments that hold the bones together in a joint. I was not always attached to collagen. In people with diabetes, the theory goes, this can contribute to abnormal deposits of collagen in the cartilage and tendon of the shoulder. The build up then causes the effective shoulder to stiffen up.
Women are more likely to develop frozen shoulder men, and frozen shoulder occurs most frequently in people between the ages of 40 and 70.
12 step approach to Shoulder Conditions
The good news, from the resolved in treating hundreds of Haitians in various stages of adhesive capulitis and, Katie frozen shoulder conditions, there is a protocol to specifically address each specific clinical condition. The inner fascial and capsular work must be performed pain-free, in conjunction with balancing out the muscle moves of the shoulder while systematically treating associated strains or strains. The deep fascial adhesions inside the joint capsule and be softened and mobilize with precise joint capsule technique.
Pain free movement, using the head of your is to create pressure, move, and slow the stretch to deed this investing fascia inside the joint capsule, can facilitate myofascial release within the shoulder joint. The head of the humerus and the use as a massage school release and repositioned the fascia or adhesions in the joint capsule. This is achieved bypre forming very gentle pain free movement using the articulating cartridges of the humerus to massage the articulating cartilage,, fascia, and osseuos membrane of the shoulder within the joint capsule at the exact area where you find a bone on bone like end feel in the shoulder.
And added plunging technique, by gently compressing and decompressing the scapula with the head of the humerus, seems to even organize it is organize collagen in the joint capsule itself. The author’s hypothesis is that when you gently, but he press the humerus into the scapula, it is a form of strain – counter strain allowing the fibrin formation in the joint capsule to relax. When you gently traction or decompress the capsule with the humerus, these lesions or fibrin formations create and eccentric force through resistance to your decompression. Thus, he believes that is what made better organize or realign the fibrin formation or disorganized collagen. The goal is to align with research experts to do clinical studies that will validate this result – driven hypothesis.
This can often release disclosure shoulder in literally one session, especially in early onset adhesive
capsulitis. This is a unique technique that is one of the author’s trademarks. Although some people in the health care industries were skeptical about the feasibility of releasing long term frozen shoulders, orthopedic massage practitioners using this technique have witness the release of frozen shoulder in many cases where the participants had precisely been diagnose with adhesive capsulitis and true frozen shoulder, by the physicians. This shoulder capsule work is one of the most revolutionary technique you will learn in this book.
The shoulder protocol involves moving between:
one. Soft tissue restrictions: muscle – tendon, fascia, scar- tissue
two: bone – on – bone – like end feel: joint capsule
three: client emotions: guarding, fear of pain
This is called “the dance,” as the protocol maybe different for each client. Your learn how to assess restrictions creating an individualized treatment for each client. The following conditions are covered in this chapter:
one – thoracic outlet syndrome
two – adhesive capsulitis and frozen shoulder
three – rotator cuff tear
four – supraspinatus tendinosis and supraspinatus impingement
five – infraspinatus tendinosis and teres minor tendinosis
six – subscapularis tendinosis versus bicipital and coracobrachialis tendinosis
seven –subacromial bursitis
eight – upper crossed syndrome
Imbalances in the hips can create distortions that affect the shoulders. It is highly recommended to perform pelvic stabilization before working on the shoulder.
Step two: Assess the client’s active range of motion for the primary single plane shoulder movements –
flexion, extension, abduction. adduction