Over the last few months we have had several athlete’s come in with a nerve-like sensation down the arm and a feeling of weakness or pain when they lift the arm.
As with every treatment, I try to first identify what exercise caused the initial pain. Some have said they were doing power snatches others were doing handstand pushups, but a few things are common in all of the cases we have seen:
- They have trouble lifting their arms without feeling a nerve-like pain or weakness.
- There is pain when lifting the arm to the front of their body or to the side.
- They are feeling the pain is coming from the back but it is hard to pinpoint.
- The shoulder was involved in the initial injury.
In these scenarios, the first few muscles we will look at releasing will be the muscles that act on the shoulder and specifically those that adduct the arm laterally and to the front of the body. The pictures outline below show the muscles of the rotator cuff and the trigger points (tender spots in the muscle) that should be released to minimize pain.
The Sports Massage Treatment
The treatment for this condition will consider a few factors:
1. The level and type of pain
First and foremost, I will want to determine from a scale of 1-10 (10 being the most pain) how painful the situation is. Mainly I want to know if you will be able to endure a 30-60 minute session and this will also give me an idea of the severity of the condition. As with any muscular condition if it is acute (happened within the last 2-3 weeks) we will want to guage inflammatory condition as well (Is this a sprain?) Assuming that the client has a muscle strain (not swollen or inflamed) that is in the sub-acute phase (3 or more days after the initial strain) we can move on to the next step of treatment. Once we have determined your level of pain, that will be recorded and referred back to at the end of the session. We also want to make note of the type of pain/discomfort you are experiencing to be sure not to exacerbate the condition.
2. The range of motion of the shoulder joint (or lack thereof)
It is normal to conduct a few resistance style tests to determine exactly which muscles are the problem. Depending on the client, I could also test the range of motion of your shoulder and conduct a variety of PNF/MET stretches to release the tight muscles restricting your range of motion.
3. How fascially bounded the area around the muscle is (is the area stiff?)
Often times clients who are “fascially bounded” will have a hard time receiving treatments because of the stiffness surrounding the muscles in question. Fascia is like Saran Wrap or a protective barrier that limits your range of motion and keeps the muscles locked up. At this point in the treatment Traditional Chines Cupping in the form of “running cups” will be applied before performing massage therapy treatments to release the fascia.
After addressing these elements we will then move into releasing trigger points in the shoulder and slowly increasing range of motion. It is common to be sore after this type of session, but if the muscles that were affected are addressed with the right amount of stimulation, often times clients will see immediate improvements. Of course as with any sports or medical massage I will retest the shoulder and check in with the level of pain at the end of the session and then determine whether or not you will need followup appointments.