Advice/Help Request Shoulder area

[XCherryGlamX]

Hello everyone, this is only my 2nd or 3rd post, but I have been a long time lurker (I hate that word). Anyway, I have been practicing massage for about 3 years or so. I don't have any specialized training aside from swedish massage, but I am thinking about looking into Myofacial release training. My question is about a client of mine that I have been working with for about 3 sessions who is seeing me for issues with his right shoulder area. He takes very deep work (about as deep as I can give, which is significant), and I am trying to release his shoulder area which he feels is guarded in the first place --before we can even get down into the area that bothers him. Last session we found the Levator Scapula may be playing a big role in help release the area. I would bring his arm around behind his back and stretch and work on that muscle and he said that was helping but that the problem was "deeper". Anyway, without dragging this on for to long, I asked him to email me answers to a few questions, so that I could post them here to see if any of you would mind helping me with what could be going on so that I can be more effective for him. Thank you in advance for any insight you can provide.

When did you first notice the problem:
It has been about 3 months ago now.

a. What was the event that precipitated the injury:
I think I slept on my shoulder wrong because I woke up and had
a sharp pinched nerve pain.

Describe the problem area (please be as specific as you can)
I feel the nerve pain in my lower right neck when I look up or
move my neck horizontally backward, more in my upper right shoulder
where it begins to curve up to the neck when I look right and left. I
also have a constant tingling in my right thumb and when I put pressure
on the nerve by moving my neck I feel tingling down my right arm

When do you notice the pain/guarding of the area
When I sleep it bothers me and wakes me up occasionally. During
the day, it is like a dull pain in my shoulder/neck.

a. Times that it is better

b. Times that it is worse
There is really no better or worse times; it seems to be more
day to day. If I had to pick one, overall it is worse in the afternoon
after I have been at my desk all day


What have you tried to address it (therapies, medication)
a. Describe the effectiveness
Stretching, massage (obviously), Motrin occasionally (which
really helps but I try not to overdo it), that new massage curve thing
from Relax the Back, and trying to "pop" my neck. None stands out other
than motrin, but they all relieve it somewhat.

Are there certain movements that aggravate it
Looking up, reaching out forward to lift something, turning
right or left.


Please list any other information that you feel is relevant
Last night, my neck popped as I turned horizontal right. It
was a pop that I have not been able to do for months and I think (hope)
that it was "the one." My neck immediately felt better and feels better
today; I think if that was it, it will take time for the nerve to
settle down. Incidentally, it think the massage helped in that because
it allowed me to turn that direction more flexibly.

 

[ets_bond_trader]

I found this thread very helpful for my shoulder pain/ tingeling in the hand.
http://www.massageplanet.com/forum/viewtopic.php?t=11813&highlight=nerve+stretching
LiveGreen may be able to give more advice on what was already posted.

I am fairly new to doing Trigger point work, but I would suggest working the scalenus, Levator Scap, Latissimus Dorsi, Teres Major, Subscapularis, Supraspinatus, Infraspinatus, Pec minor and major, Subclavius, and Sternalis. I know that is a lot of muscle groups, but not all of them may be playing a roll in his pain.
I have found great relif working with Triggerpoint therapy on myself, and I am learning more and more about it.
Hope that is a good start!