Try a new way to relieve shoulder pain by working on the opposite arm. This technique uses principles of physics to balance the body’s forces during healing. By focusing on the opposite side, therapists can reduce pain and improve movement in the affected shoulder. The method involves a seven-step process to assess and treat both sides, offering a practical solution for chronic shoulder issues when usual treatments don’t work. This approach benefits both therapists and clients, providing effective, long-lasting relief.
Key Takeaways
- Utilizing dynamic forces and principles of physics can offer a new approach to managing shoulder pain when conventional treatments fail.
- Addressing the compensating side of the body, rather than the injured shoulder, can help balance forces and alleviate pain.
- The longest point between two shortened, healed areas becomes a trigger point, where pressure and pain are most felt.
- The 7-step technique involves systematic assessment and treatment of both the injured and compensating sides to reduce pain and improve shoulder function.
- Patterns of shoulder pain aren’t limited to specific injuries but can develop from repetitive motion syndromes, affecting therapists and clients alike.
Unresolved Shoulder Pain? Try Working the Opposite Arm
If you are working with shoulder pain, have exhausted the options of muscles and tissues of that joint and it has not shown improvement for increased range of motion with decreased pain and inflammation, then this approach could be a possible solution.
This approach to shoulder pain has to do with dynamic forces and how these forces play into pain management and muscle behavior. These forces are concepts of suspension and are bound to physics; therefore, so is this approach to pain management.
Shoulder pain is a common issue, so I would like to deepen the information offered in my article, “Massage Therapist Self-Care: Upper Body Freedom of Motion.”
This discussion on shoulder pain starts with a general concept of how the body heals an injury and then how physics alters the outcome of that healed injury.
Physics, Inflammation and Pain Management
When you have an injury and the body begins the process of acute inflammation and healing, the result of that entire process creates a new force in the body. Perhaps we don’t perceive it as such, but the outcome is that the body has been permanently altered to some degree in this process.
A healed injury, with or without an external scar, typically becomes an area of greater strength.
A new holding force was built where the injury was knitted together through the process of inflammation. It cannot be the same as it was before and has therefore been altered in its ability to move with strength added due to the body using scar tissue to heal that area.
The result is an area that still functions but is more bound, solid and potentially shortened than it was previously.
Once the action of this new force has begun, the body must also form an equal and opposite reaction as a counterbalance somewhere else. This area will also be more bound, solid and potentially shorter. The body will always create these dynamic, balanced forces within the processes of acute inflammation and healing, and this is why.
Two of the governing forces on the body and the behavior of muscles come from Newton’s second and third laws which state:
• There can be no unbalanced forces in nature. For this concept, we are discussing how the body must create balanced forces for healing, inflammation and muscle opposition. Without this balance, the body loses function and the ability to contract muscles correctly.
• For every action there is an equal and opposite reaction.
Within the inflammatory process, healing causes dynamic opposing pairs of adhesions to form to keep force balanced. But also within this process, the balanced forces create length somewhere between themselves—and pain will follow.
The On-Going Tug-O-War from Healing
Because of the static, dynamic pull in opposite directions, somewhere between those two shortened forces, there will be a point of length. This point reminds me of a tug-o-war and this area is something I call the point of greatest strain.
This is a location where pressure and pain are felt the most. This is what I think a trigger point is: The longest point between two shorter points.
Even years after healing has occurred because the adhesions remain, this longest point can also remain active. When a client does not respond to direct work, this scenario is an option for the chronic pain your client is complaining of.
Opposing Forces Creating Shoulder Pain and ROM Issues
For our shoulder example, those dynamic forces show up in opposite arms in almost the same locations on each arm. This is how the greatest equality for balance will occur and how an injury in one arm can manifest as pain in the opposite neck, shoulder, and elbow.
The injury location and healed area are what I call a primary force. The reaction to balance this healing is a compensating force. Without the primary force, none of these reactions occur.
Since the injury side begins this process, it will dictate the entire progression. Therefore, most of the surrounding muscles on the side of injury are shorter as well.
Because it is a secondary reaction, the muscles on the side of the compensation will be slightly longer. This will place that point of greatest strain slightly more on the compensating side. I explain this because we will be using the side opposite of the shoulder pain to start.
The following images are basic examples of that healing tug-o-war with the point of greatest strain.
This first example shows a minor injury and a minor amount of healing from an injury. The pain the client feels is slightly off-center to the side of compensation in the levator scapula muscle.
| Levator Scapula Pain | |
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The second example shows an injury where there are thicker adhesions formed at the primary site of the injury requiring more compensation on the opposite side. This allows for more shortening on the primary side and more lengthening on the compensating side. This pushes the point of greatest strain further out along the arm and into the shoulder muscles and joints.
If there is a heavy and thick adhesion to an injury, it can manifest as elbow pain. Within this cycle, there is so much compensation going on in the primary and compensating points that the body will start to create other supporting areas to try to keep balance within all the force that is occurring.
| Elbow Pain “Tennis Elbow” | |
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The 7-Step Technique for General Shoulder Pain
To use this technique, the first thing to do is assess the motion of the shoulder before starting the work. Ask your client to comfortably move the shoulder in pain in several different directions and locate the area where the pain is and the intensity.
To quantify treatment, employ a pain scale and ask the client to rate their pain on a scale of 1-10 to have a basis for successful treatment.
1. Beginning on the opposite side of pain and in the location of a known injury or perceived restricted tissue, work through the muscle tissue, fascia, tendons, and on top of the bony surfaces. A common surface where adhesions are found is the upper one-third of the ulna bone near the elbow, as shown in the next images.
When the body heals an injury, it likes to anchor these shortened and solid areas to a non-moving surface. Especially during the acute phase when motion needs to be limited to heal bones or muscles. Once that phase is completed, the anchoring typically remains and therefore you will find more relief for pain when utilizing these surfaces.
2. Once you have thoroughly researched the primary-side tissues, have the client reassess the range of motion for the shoulder in pain. Then move to the side of pain and begin with the same compensating location on the arm.
3. Work until you feel the tissue softening and then check the client’s range of motion for the shoulder.
4. Make sure to also work on the area of pain.
5. Continue to work back and forth with the primary and compensating sides until the pain drops at least 4 points on a 10-point pain scale.
6. From this point, the frequency of further massage treatments is key to creating lasting change.
7. The client can also work on these areas of adhesion in between treatment sessions.
One last thing I want to point out is that the client does not have to have a specific injury in one arm to create this pattern. This is a common pattern that follows repetitive motion syndromes and heavy use of the hands, forearms and arms.
This issue is something I see occur frequently with massage therapists as their career progresses because repetition creates the same kind of healing cycles as an injury and pain can show up in the levator scapula, shoulder and elbow opposite of a dominant hand. This technique can be a great tool to add to your skill set, not only with your clients but as a self-help technique as well.
About the Author
Amy Bradley Radford, LMT, BCTMB, has been a massage therapist and educator for more than 30 years. She is the owner of Massage Business Methods and the developer of PPS (Pain Patterns and Solutions) Seminars CE courses and an NCBTMB Approved CE Provider.