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30 m a s s a g e & b o d y wo r k j a n u a r y/ fe b r u a r y 2 0 2 1 "How is that connected?" she asked. "Does this muscle have something to do with my shoulder?" "Actually, yes," I replied. "Remember that this muscle, the latissimus, attaches to the anterior shoulder and therefore could possibly be a player in the pain you are feeling." My client, Dr. R., a primary care physician, smiled and shook her head with a little laugh. She seemed to possess the ideal qualities one could wish for in a doctor—an excellent listener, thoughtful, engaging, highly intelligent, and relates well to everyone she meets. She presented to me with pain in the anterior shoulder, which was diagnosed by her doctor as impingement and loss of subacromial space. When we began the session, I palpated the greater tubercle and surrounding areas related to the impingement. There was indeed notable sensitivity in the area consistent with the diagnosis. She also described referred pain into the deltoid tuberosity, which is also quite typical. I remarked to her how all these presentations fit the picture. "I think my diagnosis was probably spot on," she remarked. "But my doctor came to that decision without even touching my shoulder. You know, there is something very comforting when you put your finger right on the area that caused me such grief. That is something I will remember when I see patients as well. It feels enormously satisfying to have the provider palpate the pain." best practices | TABLE LESSONS Connecting the Dots A Key to Massage Integration in the Health-Care System By Douglas Nelson A big amen to that. Touch is something that we, as massage therapists, do so often it is easy to forget how powerful it is for the client. After exploring the subacromial area and focusing on the attachment of the supraspinatus to the greater tubercle, I moved to the coracoid process and began exploring the pectoralis minor muscle. "Wow, that's surprisingly tender," she said. "What possessed you to go there?" FABIO BRACHET/UNSPL ASH

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