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108 m a s s a g e & b o d y w o r k m a y / j u n e 2 0 1 4 MYOSKELE TAL ALIGNMENT TECHNIQUES Opening the Front Line. As the client internally and externally rotates her entire arm, the therapist's soft forearm hooks the pectoral fascia near the sternum and drags the tissue laterally all the way down the biceps. ©erikdalton.com. Deltoid Shear Release. The therapist's left hand grasps the client's wrist and pulls the humerus inferiorly, while his right forearm hooks and traverses up the lateral deltoid fascia. ©erikdalton.com. to stretch or mobilize. You must first explain why mobility is limited or compromised. Look closely and you will often find that a tight muscle is limiting a movement pattern where motor control or stability is poor." Stewart McGill, PhD, countered, "The spine must first be stable before movements and forces are produced to enhance performance." Of course, both men are right. Ground-up core stability is paramount for optimal joint centration and shoulder function. The saying, "You can't shoot a cannon from a canoe," sums up the importance of spinal stability in all upper (and lower) extremity movements. As I mentioned in my last Massage & Bodywork column ("Finding the Weak Key Link," March/April 2014, page 107) the thoracic spine and ribs must be mobile and the scapular muscles stable. In today's desk-occupied, sedentary lifestyle, function is often reversed as the thoracic spine stiffens and the scapulae flare, leaving an unstable anchor for the GHJ. The decentrated joint predisposes the rotator cuff to injury, particularly in those who participate in activities requiring the use of overhead arm positions such as painters, tennis players, and gym-junkies. Images 3, 4, and 5 are examples of techniques I've found helpful in addressing upper-crossed syndromes, deltoid shears, and rotator cuff injuries. Once proper glenohumeral mobility is restored, home retraining advice should include exercises for core stability, scapular stabilization, and rotator cuff strengthening. SECURING THE WOBBLY WHEEL Remember: mobility first. Refrain from advising muscle-strengthening exercises for joints that are not moving freely. This can lead to cartilage degradation and ultimately capsulitis or osteoarthritis. When massage and movement therapists successfully restore length- strength myoskeletal balance, tissue lubrication improves and the transmission of nerve impulses becomes more efficient. Better proprioceptive neural feedback enhances motor control and reduces injury in clients with the "wobbly wheel" syndrome. Erik Dalton is the executive director of the Freedom from Pain Institute. Educated in massage, osteopathy, and Rolfing, Dalton has maintained a practice in Oklahoma City, Oklahoma, for more than three decades. For more information, visit www.erikdalton.com. Humeral Head Drop. The therapist's right webbed hand softly cups the humeral head, and the left hand brings the client's arm into 90 degrees of abduction. The client is asked to gently pull her elbow toward her right hip (against isometric resistance) to a count of five and relax. A gentle counterforce stretches the deltoid fascia and drops the humerus into the bottom part of the glenoid fossa. Repeat three times if client is pain free. ©erikdalton.com. 5 4 3