Shoulder Pain and Limited Range of Motion Relieved in 1st Treatment

August 24, 2017

Client Info

 

Age: 62

 

Occupation: Retired Engineer, Former Pro Football Player 

 

Exercise / Type and Frequency: daily walking, summer golf 2 x weekly

 

[ This patient is very fit, however lacks flexibility. ] 

 

Currently Receiving Treatment from Another Health Care Provider: none. Had Active Release Technique (ART) 12 years ago. 


Reason(s) for Seeking Treatment: Shoulder pain right and left, greater on left, range of motion of left shoulder limited (cannot lift arm above shoulder height).

 

Frequency: Pain when swinging golf club, and when attempting to lift arm above shoulder.

 

Injuries or Motor Vehicle Accidents & Dates: Tore shoulder muscles in late teens playing football.  Right long-head of biceps torn 12 years ago. 

 

Surgeries & Dates: quad tendons over 10 years ago.

 

 

1st Appointment

 

1st Appointment

 

Tests:

  1. Range of Motion (ROM) limited on left shoulder; forward and lateral elevation produces pain on superior glenohumeral joint. 

  2. Strength test with arms in forward and lateral elevation: right arm 4 / left arm 5

  3. Manual pressure on cervical and thoracic vertebrae (-) produced no pain. 

 

Treatment Techniques:

 

Prone:

Myofascial Release of scapular and paraspinal muscles

 

Supine:

Myofascial Release of pectoral and shoulder cuff muscles.

Counterstrain of Points (Tp’s) on supraspinatus and pectoralis minor

Muscle Energy Technique Post Isometric Relaxation (PIR) of humerus in external rotation.

Myofascial Release of lateral and posterior cervical muscles

Muscle Energy Technique Post Isometric Relaxation (PIR) for scapula depression and retraction with arms overhead extension.

Harmonic Oscillation of upper and lower extremities along coronal plane.

 

Result: patient reported complete relief of pain immediately following treatment. ROM increased by 30%. 

 

Home Care Exercise:  Structural Alignment Yoga Therapy - Shoulders, Neck & Spine Posture Optimization (Wall Fish Pose)

 

* Therapists' Note: This exercise is covered in my Structural Alignment Therapy Training, among a long list of amazingly effective exercises for various conditions. This cient has not needed any follow up appointments because she was taught how to adjust and strengthen her posture in a way that no longer causes her pain.  Learn more >>

 

 

2nd Appointment

 

Post-Treatment Report: patient is now golfing again and feels no pain during swing. Played golf 3 times: after playing one day felt pain and took Advil; the other two times only felt stiffness after playing. ROM has maintained 50% improvement.

 

Tests:

Range of Motion (ROM) limited on left shoulder; forward and lateral elevation produces pain on superior glenohumeral joint. 

Strength test with arms in forward and lateral elevation: right arm 4 / left arm 5

Manual pressure on cervical and thoracic vertebra (-) produced no pain. 

 

Treatment Techniques:

 

Prone:

Myofascial Release of scapular and paraspinal muscles

Counterstrain of Points (Tp’s) on infraspinatus and teres minor

 

Supine:

Myofascial Release of pectoral and shoulder cuff muscles.

Counterstrain of Tender Points (Tp’s) of right and left pectoralis minor, subscapularis, left pectoralis major, left levator scapula,

Muscle Energy Technique Post Isometric Relaxation (PIR) of bilateral levator scapula muscles.

Myofascial Release of lateral and posterior cervical muscles

Cervical Traction at trapezius insertion on occiput 

Harmonic Oscillation of upper and lower extremities along coronal plane.

 

Result: ROM increased by an additional 20% (= 50% total). 

 

 

Clinical Impression

 

Pain and range of motion limitation was a result of muscular imbalance and built up scar tissue caused by past injuries. Further treatment is continuing to further restore muscular balance and break down scar tissue.

 

 

 

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