Frozen shoulder massage

Original text.

Shoulder, Arm & Mid-Back Myofascial Pain Syndrome

By Dr. Greg Fors
Restore your shoulder flexibility and strength while eliminating the pain with FENIX self-care trigger point therapy products.
After low back pain, shoulder pain is the second most common cause of occupational injury claims, and shoulder pain is also a major complaint for individuals seeking healthcare.
It is easy to see why this is the case once we understand the shoulder joint. The shoulder is the most unstable joint in the human body. This is because our shoulder joint is designed to allow for maximum range of movement. In fact the only major bone to bone anchor to the body, of the shoulder joint complex, is the collar bone (clavical) joining to the breast bone (sternum). This sternoclavicular joint is no bigger then the tip of your thumb. The rest of your shoulder basically floats in space held together by muscle, this allows for optimal range of motion. Four major shoulder muscles known as the rotator cuff, hold the shoulder together.
Because of the shoulder's unique anatomy, it is easily over stressed or injured through acute or repetitive over activity. The shoulder is made vulnerable to injury by any existing underlying muscle imbalances especially in the four rotator cuff muscles. These muscle imbalances are primarily weakness and shortening caused by myofascial trigger points, (hyperirritable tissue in muscles). Most of the time these myofascial trigger points in these four rotator cuff muscles only cause a minor ache or restricted movement that can be ignored, until you over stress your shoulder.
Once you experience a shoulder injury, whether acute or repetitive, your body begins to lay down adhesive fibers between the muscles to protect the injured tissues. However, these adhesions between the muscles and fascia further the restriction of shoulder motion started by early muscle imbalance. The preexisting myofascial trigger points along with secondary myofascial adhesions continue to further decrease the strength and restrict function of your shoulder. Through this process the problem can snowball leading to pain and dysfunction spreading to the arm, neck, and mid-back, and even cause a "frozen shoulder."
According to many researchers, 95% of all shoulder pain cases are attributed to the tendons of the rotator cuff muscles becoming pinched between two bones the humerus and acromion when we raise our arm. These "impingement syndromes" of the shoulder are the most common type of shoulder problem causing pain.
Self-care trigger point therapy products are ideal for those suffering from myofascial pain syndrome of the rotator cuff.
Basic FENIX Technique:
As previously described, what generally makes your shoulder prone to this "impingement syndrome" and chronic pain are the underlying myofascial trigger points. These myofascial trigger points also tend to make your shoulder pain more chronic and more difficult to resolve until they are removed. It is possible to deactivate these pain-causing myofascial trigger points and adhesions by utilizing the FENIX Rehab System. You can learn how to do this by clicking here to see the Basic FENIX Treatment information. Here you will be shown how to apply the FENIX Rehab System step-by-step. To find your treatment points go to see "How to Find a Trigger Point" to get step-by-step instructions. Go to Upper body pain-causing trigger points Shoulder/Arm pain section and examine the second model with lines D through H. You can also learn from the text and pictures included in this article.

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The "Shoulder Joint Pain" Muscle - Infraspinatus: Using the FENIX Rehab System or your own index finger search along the length and slightly above and below line F in the middle of your shoulder blade. This is the infraspinatus muscle the major cause of shoulder arm pain. The most common and primary trigger point for most shoulder problems is found in the middle of line F in the middle of the shoulder blade about 1" below the boney ridge of the shoulder blade. This myofascial trigger point in the middle of the "shoulder blade" muscle sends severe deep aching pain into the front of the shoulder and down the front and back of your arm down to the hand. See pain drawing for referral pattern; also examine pictures of model for infraspinatus location and position of trigger point therapy. Always stretch the infraspinatus muscle after myofascial trigger point release as in the picture for about 60 seconds. Go slow and easy only stretch as much as you can without causing pain. These myofascial trigger points in the Infraspinatus can also referral pain into the mid-back along the shoulder blade, and is many times a source of chronic mid-back pain that won't go away. When the restrictions of the infraspinatus trigger points are released the next-tightest muscle to show up will be the teres minor.

X marks Infraspinatus trigger point - middle of shoulder blade Infraspinatus Trigger Point

Location of the infraspinatus muscle trigger point in the middle of the "shoulder blade."	Trigger point therapy position for deactivation of infraspinatus muscle.	Stretch for the infraspinatus muscle

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The "Posterior Bursitis Pretender" Muscle - Terres Minor:
At the outer 2/3 of line F is the tendon of the infraspinatus and slightly below line F is the teres minor muscle below, both vital aspects of the rotator cuff. Underneath these soft-tissues are the ligaments of the shoulder joint capsule, which can also form adhesions. These tendons and ligamentous soft-tissue adhesions restrict shoulder mobility and create pain and inflammation. You can treat these joint and muscle adhesions with the FENIX Rehab System by viewing the "Myofascial Release Technique" page and follow instruction #3 or #4 depending on what works best for you after a little experimenting.
At the very end of line F is the posterior deltoid and around the front the anterior deltoid, (see pain pattern drawings). This muscle creates a dull ache right over the "cap" of the shoulder. See pictures for the deltoid muscle location and deactivation position.

Upper X = infraspinatus tendon trigger point Lower X = terres minor muscle trigger point	Location of terres minor trigger point	Trigger Point Therapy position for deactivation of the terres minor muscle.
Posterior deltoid trigger point and shoulder joint ligaments trigger point	Anterior Deltoid trigger point	Trigger point therapy position for deactivation of deltoids

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The "Shoulder Tendonitis Muscle" - Supraspinatus: At the outer end of line G lies the supraspinatus muscle, one of the important rotator cuff muscles. This muscle lies right above the boney ridge of your shoulder blade. It produces a deep ache underneath the deltoid muscle, this is many times mistaken for shoulder bursitis or tendonitis. Trigger points in this supraspinatus muscle give you difficulty in reaching above your shoulder as in combing or brushing your hair. Trigger points here can cause difficulty sleeping especially on the affected side. It is usually associated with trigger points in the infraspinatus and can sometimes cause a snapping or clicking sound around the shoulder joint until these trigger points are removed. Examine the pictures of the models for supraspinatus muscle trigger point location and position for deactivation; a long therapeutic digit at an angle is usually easiest.

supraspinatus muscle trigger point near X Supraspinatus trigger point

Location of the supraspinatus muscle trigger point, located at the top of the "shoulder blade" above bony ridge.	Trigger point therapy position for supraspinatus	Supraspinatus Stretch if muscle to restrict; use a rolled up towel between hands.

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The "Backache and Round Shoulder" Muscle - Rhomboids: Along line E, at the inside border of your shoulder blade, you will find the rhomboid and mid trapezius muscles which connect your shoulder blade to your mid-back. The rhomboid muscle will give you a chronic nagging, aching superficial pain in the mid-back. Many times the rhomboids will "complain" on both sides of your back because of trigger points in the powerful front chest muscles of the pectoralis muscles, pulling your shoulders forward and down. Trigger points in the front pectoralis will cause shortening of the muscle pulling the shoulder forward giving you a rounded shoulder posture. For chronic nagging mid-back pain many times you need to remove the trigger points in the pectoralis muscles and stretch them out and then remove the trigger points in the rhomboids in the back of the shoulder along line E. For location of the rhomboid and pectoralis muscle trigger points and positions for deactivation, please see pictures of the model. Also, view the pain pattern drawings of the Pectoralis major muscles.

Rhomboid Muscle trigger point = upper X. Mid-Trapezius trigger point lower X. Location of rhomboid and mid-trapezius muscles, trigger points located at middle and index finger along medial shoulder blade border.

1. Trigger Point Therapy to treat outer rhomboids TP.	2. Trigger Point Therapy to treat inner rhomboids TP.	Mid-trapezius and Rhomboid Stretch

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Self-care Myofascial Release Therapy products offer you an effective way to overcome mid back pain and stiffness. The "Frozen Shoulder" Muscle - Subscapularis: Trigger points in the subscapularis muscles under each shoulder blade are very problematic causing progressive painful restrictions, especially when reaching up and backwards as when touching the back of your head. The subscapularis muscle can progress to the point of causing a "frozen shoulder," where an individual must basically keep their arm at their side as if in a sling because of the pain. This muscle is appropriately named for the subscapularis is attached to the underneath side of your shoulder blade (scapula, sub=under). This muscle connects your shoulder blade to your upper arm bone (humerus), and rotates your arm inward and down to your side, as when reaching into a back pocket. This is why trigger points in the subscapularis will restrict rotation your arm motion outward and upward, motion that is utilized in many daily activities. If you are on your way to developing a "frozen shoulder," or just losing range of movement in your shoulder, this muscle should be checked for myofascial trigger points. See picture of model for location of subscapularis muscle; an individual with trigger points in this muscle would be generally unable to perform the motion the model is demonstrating. The next picture shown is how someone positions him or herself for myofascial trigger point therapy to the subscapularis muscle, they should go slow with light pressure. These trigger points are very tender and send severe pain to the back of your shoulder and down your arm, so be gentle. After applying some form of trigger point therapy it's always important to stretch the muscle for about 60 seconds. Go slow and easy with any stretch only do as much as you can without causing pain.

Location of the Subscapularis muscle trigger point. Located under the arm against the under the shoulder blade. Trigger Point therapy position for deactivation of the Subscapularis muscle. Go easy use light pressure. Subscapularis stretch *Use a towel if you can not grab other wrist