Massage & Bodywork

January/February 2010

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MYOFASCIAL TECHNIQUES rotator cuff surgery for pain and restriction in his left shoulder (probably related to weight lifting), about two years before coming for myofascial work. His range-of-motion limitation and pain had continued after surgery, but improved substantially after receiving myofascial work. His range of motion continued to improve after the photos were taken, and several years later, he is quite active physically and pain-free, and continues to come to me for less frequent maintenance sessions. While, of course, not all clients respond as dramatically as this example, this amount of improvement is not unusual. You'll fi nd that the concepts and techniques described in these two articles will benefi t a large number of your clients who experience shoulder restriction and pain. is a member of the Advanced-Trainings.com faculty, which off ers continuing education seminars throughout the United States and abroad. He is a Certifi ed Advanced Rolfer and a Rolf Institute faculty member. Til Luchau (info@advanced-trainings.com) NOTES 1. While limited motion at the glenohumeral joint is the focus of these two articles, the term frozen shoulder is most often used in physical medicine to refer to the specifi c infl ammatory condition of adhesive capsulitis (see Part I for references). Informally, you' ll hear frozen shoulder used by practitioners and non- practitioners alike to describe any restriction that substantially limits arm abduction. Because of its lack of specifi city (and the less-than-optimal metaphorical connotations of being frozen), we tend to not use the term in our Advanced Myofascial trainings. 2. Although not the focus of this article, I should describe what a dominance of internal or external arm rotation looks like. In the case of more internal rotation at the GHJ, which is often associated with the rounded posture of shoulder protraction, the elbow of the hanging arm points out to the side, and the arm will resist passive external humeral rotation. In contrast, chronic external rotation of the humerus is most often associated with the pulled-back posture of shoulder retraction, and the elbow points more posteriorly, or even slightly medially. You' ll see clients who have more internal humeral rotation on one side, and more external rotation on the other side, especially when there is a larger asymmetrical pattern, such as a spinal scoliosis. A client with rotator cuff pain and restriction shows improved abduction as a result of increased inferior glide of the humerus. These photos were taken before (Image 6) and after (Image 7) two sessions of myofascial work, employing the techniques described here. connect with your colleagues on massageprofessionals.com 113

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