Massage and Bodywork

CSI Massage – Shoulder Pain?

By March 8, 2014 No Comments

Have pain in your back, leg, hip or anywhere and been told nothing is wrong with you?
Does the pain linger and the doctor provide no answers?
Are you tired of medications that mask the pain and make you feel dopey?
Well, then it’s time to call in the pain detective: your clinical massage therapist.

When massage therapists arrive at the scene of an injury or pain, we have plenty in common with detectives. We may not wear leather jackets and chase bad guys, but we do pack heat in our fingertips, keep all of our senses on alert for clues and suss out as many details from our most important witness: the client.

Clients are experts about their pain — where it hurts, how long it hurts, when it hurts —  but they may not be able to connect the dots to find the cause. Or they may have been dealing with it for so long that they've shut it out just to keep going. As therapists, it’s our job to understand the pain's history, so it won't have a future. 

Like our law-enforcement friends, we get the details on paper first. We ask clients to fill out a history-intake form. But often the real work starts as soon as you walk in the door. Your therapist will observe how you're walking, how heavy that purse is slinging across your shoulder and just how long your head's been bent over that phone, always looking for clues to the cause of your pain.

And then we ask questions, lots of em, looking for more clues to why you hurt. We often discover forgotten or seemingly unrelated events that could be causing your pain. Once the massage starts, our real detective work begins as our hands search for tight muscles that may be pinching a nerve or hidden trigger points causing referred pain in a distant spot. We pay attention to where you hurt and also search for the true culprit.

Here's one case that shows how through solid detective work, therapeutic work and listening, a therapist provided answers and relief to a client.

Every Breath You Take

A client came in for relief from shoulder pain. Two years ago, she fell off her horse and broke some ribs. After the ribs healed, her back pain remained and her shoulder started to give her trouble.

My anatomical investigator immediately thought: thoracic trauma and strain led to back pain and eventually to the shoulder problem.. That’s a straightforward situation to address. But there was more.

As we worked the muscles of her rotator cuff, I noticed her breathing was quick and shallow. I suggested she breathe deeply to help the muscles release. Her response? “I can’t. I get an intense, painful spasm in my mid-back every time I try to take a deep breath. I can’t run because I can’t breathe.”  Aha, new evidence.

When I examined the posterior thoracic muscles, even moderate glides on the erectors caused painful cramping in her mid-back. So, treating where it hurt was not going to help. Yes, that happens. And when it does, the therapist has to ask what else could cause severe pain in the mid back that made deep breaths impossible?

Diaphragm? Yes! There are trigger points in the diaphragm with a known pattern of referred pain in the mid back. When we found the trigger points she felt the familiar spasm and pain in her back.  After a thorough diaphragm release we had deactivated the trigger points and she was able to breathe deeply without pain.  At the follow up treatment a week later she reported she had been able to run comfortably all week.  Breathing no longer caused her back to go into spasm. 

Another mystery solved!  Once the culprit, that nasty trigger point in the diaphragm, was uncovered and deactivated, she could breathe without pain again and she had more range of motion and less pain in her shoulder. Case closed.

Brenda Teal

Author Brenda Teal

More posts by Brenda Teal

Leave a Reply