Issue link: https://www.massageandbodyworkdigital.com/i/1299745
C h e c k o u t A B M P P o c k e t P a t h o l o g y a t w w w. a b m p . c o m / a b m p - p o c k e t - p a t h o l o g y - a p p . 89 soft-tissue pain in the upper back. It is most effective to work through the layers of back muscle from superficial to deep. Your deep longitudinal stripping techniques applied parallel to the muscle fibers will start in one direction as you work the most superficial tissues. They will then change direction as you focus on the next layer of muscle. It is helpful to visualize the muscle layers as you are treating them, so be well-versed in the region's anatomy. Clients often have myofascial trigger points in the upper back These trigger points refer pain or other sensations into the neck, head, or upper extremity. The small contact surface techniques (especially those that go parallel with the muscle fiber direction) allow you to identify and deactivate these tissues. Active engagement techniques encourage shoulder girdle flexibility These techniques incorporate motion during the treatment. Have the client lie in a prone position on the table so the upper arm can be brought as far as possible into horizontal abduction, swinging the arm toward the face cradle. Have the client pull the upper arm into full horizontal abduction and attempt to squeeze the scapula together. Instruct the client to slowly release the contraction and move the arm through horizontal adduction as far as possible. As they perform this movement, apply a deep stripping technique with a small contact surface to the mid trapezius and rhomboid region. Make sure to stay medial to the vertebral border of the ABMP members can take advantage of in-depth training with an exclusive discount on Whitney Lowe's 130-hour Orthopedic Massage online program. Normally $750, ABMP members pay only $650. Use this code when purchasing: ABMP PRO. scapula so you don't put uncomfortable pressure on the edge of the scapula. You can see a video of the technique applied by scanning the QR code above. HOME-CARE SUGGESTIONS Offering clients home-care options can play a helpful role in reducing the pain from soft-tissue tightness in the upper back. A curved self-massage tool is a great way to address these muscles, particularly when lying supine on the floor. However, a great substitute is two tennis balls placed between the scapula, with one on each side of the spine (placing the balls in a sock is helpful). These are also used when supine on the floor. Instruct the client to pull their knees to their chest to apply the appropriate amount of pressure to the upper back as they lie on the tennis balls. They can then move the tennis balls around and focus on the most sensitive areas, which are those likely to house myofascial trigger points. The popular phrase that "motion is lotion" is true in this region. Encourage the client to engage in upper extremity and upper back movements that help increase range of motion and decrease the chronic tightness that results from the long periods of immobilization. When you can combine simple movements with the soft-tissue treatments, it is far more effective than either one of them done alone. As long as people are sitting for long periods in front of screens, there should be no shortage of work for massage therapists. There are few treatment strategies as effective as massage for addressing most of the soft-tissue complaints in this region. Our best results come when we encourage our clients to gain greater freedom of movement while providing pain relief through our hands-on work. Notes 1. Andrew M. Briggs et al., "Thoracic Spine Pain in the General Population: Prevalence, Incidence and Associated Factors in Children, Adolescents and Adults. A Systematic Review." BMC Musculoskeletal Disorders 10, no. 1 (June 2009): 77, https://doi.org/10.1186/1471-2474-10-77. 2. Matias Noll et al., "Back Pain Prevalence and Associated Factors in Children and Adolescents: An Epidemiological Population Study," Revista de Saude Publica 50 (May 2016): 1–10, https:// doi.org/10.1590/S1518-8787.2016050006175. 3. Jules Mitchell, Yoga Biomechanics: Stretching Redefined (Pencaitland: Handspring Publishing, 2019). Whitney Lowe is the developer and instructor of one of the profession's most popular orthopedic massage training programs. His text and programs have been used by professionals and schools for almost 30 years. Learn more at www.academyofclinicalmassage.com. Frequent sedentary postures and forward-head tilt to look at monitor screens puts a significant biomechanical strain on the thoracic extensor muscles. Watch "Stripping with Active Engagement—Rhomboids"