Issue link: https://www.massageandbodyworkdigital.com/i/68009
VISIT THE DIGITAL EDITION AT MASSAGEANDBODYWORK.COM TO VIEW A VIDEO CLIP DEMONSTRATING THIS TECHNIQUE. balance between all four rotator cuff muscles. Each must have adequate strength and flexibility to maintain the position of the humeral head, centering it within the glenoid fossa. Dysfunction of the subscapularis creates pain or weakness when performing shoulder extension and internal rotation from an overhead position. Clients may complain of pain or difficulty pulling their arm down forcefully. This may be the result of muscles impinging or becoming compressed against bony structures like the coracoid process of the scapula. Inflammation of the shoulder bursae or tendons of the rotator cuff may also result from weakness and/or lack of mobility in the subscapularis muscle. A shortened subscapularis will often result in a slightly protracted scapular posture. The humerus also appears internally rotated during standing posture or when the client is lying supine. The muscle belly of subscapularis may become adhered to the underlying serratus anterior muscle, holding the entire scapula snug up against the posterior rib cage; this can limit scapular mobility globally, creating tension and pain in the posterior neck and shoulders. It is important to address mobility of both the subscapularis and the serratus anterior muscles in this instance. PALPATING SUBSCAPULARIS Positioning (see image below): client prone with arm slightly flexed and resting on practitioner's leg 1. Palpate the lateral border of the scapula with the palmar side of the four fingers. 2. Press posteriorly and medially to the latissimus dorsi, which forms the posterior border of the axilla. 3. Use your other hand to scoop the scapula laterally, improving access to the anterior surface of the scapula, as you palpate the anterior surface. 4. Client resists shoulder internal rotation to ensure proper location. massage therapist, certified athletic trainer, and certified strength and conditioning specialist. Her private practice focuses on injury treatment, biomechanical analysis, craniosacral therapy, and massage for clients with neurological issues. She is the author of Functional Anatomy: Kinesiology and Palpation for Manual Therapists (Lippincott Williams & Wilkins, 2009), scheduled for release in October. Contact her at functionalbook@hotmail.com. Christy Cael is a nationally certified Client Homework— Stretching POSITIONING: SEATED OR STANDING 1. Sit or stand straight with trunk aligned and head centered over your shoulders. 2. Reach straight up with the arm you will be stretching. 3. Let your elbow relax and bend while you grasp it with your other hand. 4. Gently pull your elbow toward the opposite shoulder until you feel a stretch in the back of your armpit. 5. Try actively pressing your scapula (shoulder blade) down toward the floor as you continue gently stretching the arm. 6. Take several deep breaths, relaxing into the stretch. Repeat as necessary. 88 massage & bodywork july/august 2009