Work and Shoulder Pain: A Case Study

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By Michelle Morris

Registered Massage Therapist

As an RMT, I come across a wide variety of back, neck, and shoulder pain, including those caused by physical jobs. About a year ago, a client came in to the clinic complaining of muscle pain in both shoulders, and difficulty raising his arms higher than his chest. This client is a construction worker and worked a lot with home improvement projects as well, and was just coming off a weekend of hard work.

He came in to the clinic for a 30 minute appointment, wanting to try anything to help relieve the pain and stiffness. He had gone to his doctor who had decided to give him muscle relaxants and painkillers; the client reported that these helped for the short term, but that the relief didn’t last and that he didn’t want to take medications for any length of time.

My assessment showed no nerve impingements, and no muscle tears muscle sprains. On palpation, feeling the muscles that were bothering the client, there was a lot of tension in the muscles, and those supporting the shoulders were very tight. Before treatment, I tested how much range of motion the client had, finding that the trapezius and the rotator cuff muscles were tight and restricting movement of the shoulder.

During treatment, I applied heat to the shoulders to loosen the muscles. One muscle that was more difficult to treat was one of the rotator cuff muscles, subscapularis. This muscle sits on the underside of the shoulder blade and helps initiate lifting the arm away from the body and raising the arm overhead. Working on the muscles with heat added to the treatment helped to relieve the tension in the muscles, as well as passive stretching. Passive stretching means that I manually stretched the muscles with the client on the table, without them helping me.

After the 30 minutes, the client felt some relief and was left to get dressed. Upon coming out of the treatment room, the client was lifting his arms over his head before I could even ask how his shoulders felt or if he had regained some movement in his shoulders. Reassessing the range of motion in the shoulders showed full range of motion, with just a bit of soreness left over. I left him with stretches he could do regularly for his upper back and shoulders, and he was very happy to not feel the need to take the muscle relaxants, and was eager to get back to work.

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