Neck and Shoulder pain; help

[Bret]

My friend had a rollover accident a few years ago and tore her rotator cuff. She is still having problems with her shoulder and neck. I have worked on her a few times and she has alot of trigger points and scar tissue. Her neck is starting to be a problem now too. She can't turn to the left to well and the levator scapula is very tight and into the scalenes. The SCM has a few tiggers as well. Ive run out of things I can think of to help her. Anyone have more experience with this type of thing, I would appreciate some info.

Thanx

 

[cheese puffs00]

No one has any perals of wisdom? Im stumped as to how else I can help her.

 

[kroissey]

Hi Serenity,

I find some assisted stretching integrated with massage can really help improve ROM and relieve pain. First, massage the neck & shoulders well to increase circulation & warm up tissue. Then, add the following techniques. These techniques focus on the neck and are all done in the supine position.

I use Reciprocal Inhibition: We all know that muscles operate in pairs; when one contracts, its opposing muscle relaxes. The idea is to induce the inhibition response prior to stretching the muscle, thereby relaxing it and increasing its flexibility. Support your client's head and passively move their head so their right ear is moving towards their right shoulder (stretching the left side of the neck). Ask your client to tell you the minute there's any discomfort. At that point, move the head back slightly, until there is no discomfort. Place your hand on the left side of their head and ask them to gently press into your hand, is if they were trying to move their head back to the central position. Tell them you will resist/prevent their movement. They should only use 25% of their strength, and hold that contraction for 5 seconds. Count for them. After 5 seconds, tell them to relax, move their head a little bit in the direction they were pressing and then repeat the stretch you started with: moving their right ear toward their right shoulder (lateral flexion). Ask them to tell you again when/if there's any discomfort. Usually, they'll already be able to stretch farther than the first time. I repeat this contract/relax/stretch 3 times to each side.

I then use the same technique for neck rotation. Support your client's head and passively turn their head to the left (as if they were trying to look to their left). Ask your client to tell you when there's any discomfort. Turn the head back slightly, until discomfort disappears. Place your hand on the right side of your client's head, and ask them to try and turn their head back to facing forward. Tell them you'll be resisting/preventing movement and again, they should only use 25% of their strength and hold that contraction for 5 seconds. Count for them. At the end of 5 seconds, tell them to relax, turn their head slightly back toward center and then repeat the original stretch (turning their head to the left). Repeat as needed, like above. And do this movement to both sides.

Another technique that can be very effective is Active Isolated Stretching, which works on the principle of reciprocal inhibition combined with active stretches (client does the stretch), but for only 2 seconds at a time (before any guarding happens).

Lastly, it's sometimes quite powerful to have the client activate their muscle while you massage it. For example, while you are doing trigger point therapy on the SCM, have your client rotate their head the opposite direction. While you are massaging the posterior neck, again have your client slowly rotate their head (only slightly this time) from side to side. You can also have them slightly laterally flex while you work the posterior neck, too.

I hope these ideas help. Good luck!

 

[KLH]

try combining reciprocal inhibition therapies with Orthobionomy and see if that helps.....

 

[andypandy]

myofascial release, but that cannot be taught over the forum.

 

[Tim]

The levator scapula tends to respond quite poorly to direct massage, but that is my opinion only. Isometrics, direct stretching, and autogenic inhibition tend to work well. If you don't know how to use autogenic inhibitionin your favor for the muscles, I unfortunately won't tell you how. Not exactly something you can teach over the net.

 

[camy]

Rotator Cuff

I tore my rotator cuff and it rendered by shoulder and arm pretty useless. I did PT for a bit and finally went in to a orthopedic and he gave me a cortisone injection. Immediately after I was able to left my arm above my head for the first time since the injury. Now it's a fairly large needle and given I have Type I diabetes I had thought needles did not frighten me, but to be honest, it almost put me to the ground. If the orthopedic is experienced and can be trusted I would recommend it, and the trust comes in having the Dr. inject the cortisone in the right place. I'm not a big fan of this type of treatment given I work for a company that prides itself on natural ingredients, but I have not had a problem since and this was about 5 years ago.

 

[hippos_in_love]

In my experience the right order is the key.
I diactivate TP in scalenes, levator scapula, upper trap, subscapularis. Check on both sides. Than check for any latent TP in arms and mid-lower back. Than MFR or whatever technique you're comfortobale with to increase ROM. Than heat pack.

I had a client after 3 consecutive car accidents in very bad shape. Couldn't help her much until I reffered her to chiro. He did udjustments she came back to me and results were incredible.

about injections...you can find pain managment doctor in your area who does TP injection with seponin. Better than steroids.