The Clinic
About Massage
Common Disorders
- Upper limb
- Shoulder
- Back & neck
- Pelvis & hip
- Knee
- Foot & ankle
© Donald Budge 2001
SHOULDER
THE SHOULDER COMPLEX
The shoulder complex comprises the shoulder joint (humerus and scapula) and shoulder girdle, formed by the two bones - clavicle and scapula. The shoulder complex allows a 360 degree rotation of the arm. Poor posture and emotional stress contribute to many problems around the shoulder and neck region. Relaxation and basic Swedish massage can help prevent many latent musculo-skeletal disorders from developing into a painful condition.
FROZEN SHOULDER (Adhesive Capsulitis)
A true "frozen shoulder" refers to a condition where the shoulder joint cannot move passively or actively. However, it is often used to describe a condition where the mobility of the arm is severely restricted and pain is also present. In many cases, the patient cannot raise the arm above shoulder height. Treatment consists of a combination of passive mobilisation, muscle release, stretching, rest, ice and heat. Post treatment exercise significantly aids recovery time.
SUPRASPINATIS TENDINITIS
This condition is characterised by pain when raising a straight arm away from the body while the therapist resists movement, or a weight is being lifted. Pain should subside at rest. If the onset is sudden then ice and rest would be prescribed. Afterwards, passive joint mobility and muscle spasm release and exercise would form the treatment plan.
SUBDELTOID BURSITIS
Bursae are fluid filled sacs which reduce friction and provide protection between moving soft tissue (tendons) and bone. The Subdeltoid bursa separates the deltoid muscle, acromion process and the coraco-ligament from the shoulder capsule. It can be injured by a fall, a blow or secondary muscle injury to a fracture. Arm abduction will be limited and pain will be sudden and intense and may be continuous at rest. Treatment will aim to reduce the inflammation by the application of ice and rest. Ultrasound and massage therapy may be continued at the appropriate time. Thereafter, passive movements will encourage mobility, within the pain boundaries. The whole shoulder complex should be treated using therapeutic massage to increase circulation, mobility and strength. In extreme cases, steroid injections are used as a last resort. Several other bursae are present around the shoulder complex but are less exposed to injury.
NERVE IMPINGEMENT
The shoulder nerves are supplied from exits from the lower cervical and upper thoracic vertebrae. Should these nerve roots be subject to impingement through misalignment or muscle spasm, then pain can be perceived in the shoulder area. Treatment to the spinal vertebrae for any misalignment and mobility should help the condition.