August 2008

Metamorphic Massage Newletter

Shoulder pain

Rotator Cuff

It's summer - a great time to swim, play tennis, play baseball, paddle a canoe and do work around the house.

It's summer 2008
* Michael Phelps just won the EIGHTH gold medal in swimming in the Beijing Olympic Games!
* Hundreds of women swam in Seattle's Danskin triathlon.
* You want to swim for relaxation and exercise and you want to paint the ceiling in your bedroom- But, you neither swim nor paint because your shoulder is painful, weak and tender. What causes those symptoms?
* Swimmers, tennis players and baseball players, as well as people doing manual labor such as raking leaves, painting, housework, do a lot of repetitive overhead movement.
Watching the Olympics gives a great opportunity to see the detailed overhead movements in swimming baseball, tennis, and paddling; and, to realize that shoulder injuries could occur if they are done incorrectly.

Evaluation:

Rotator Cuff injury is a challenge to evaluate because in the shoulder there is a lot of referred pain. To determine which of the 4 muscles, (SSIT: supraspinatus, Subscapularis, Infraspinatus and Teres minor), that make up the rotator cuff, is actually injured, the focus of the evaluation needs to be on what actions cause the pain instead of where the pain is located. Five of the most common shoulder injuries all hurt in the middle of the upper arm. The more severe the pain, the further the pain is referred toward the wrist. Most rotator cuff tears happen as a progressive dysfunction over time.

The Supraspinatus is the most commonly strained muscle.
- It lies on top of the shoulder just behind the clavicle. The muscle is often compressed under the acromion (bony tissue) and there is limited vascularity, both of which can lead to muscle tearing.
- The injury usually occurs out of the blue with a sudden very strenuous activity. Activities that can cause it are some swimming strokes, scrubbing a pot, mopping a floor, carrying a heavy suitcase, or falling on an outstretched hand.

Subscapularis

- It lies under the scapula ( shoulder bone),
- often injured with overhead activities such as swimming the crawl, forehand and serving strokes in tennis, throwing a baseball.

Infraspinatus and Teres minor

- both located on the posterior portion of the shoulder, -injuries occur when doing back hand motions in racquet sports or when reaching behind for an object in the back seat of a car.

Treatment:

- Various massage techniques including cross fiber friction, pin and stretch, deep effleurage may all be beneficial
- Ice packs may help relieve pain
- Resting the shoulder facilitates healing
- Strengthening exercises can help rehabilitate the muscles, after the damaged muscles fibers have healed some.
If the above conservative treatments don't resolve the problem, then injections of corticosteroids and even surgery may be necessary.

Recovery times vary with the degree of injury.
One can return to their sport or activity after the injured shoulder has:
1. full range of motion without pain
2. regained normal strength compared to the uninjured shoulder.
3. resolved any tenderness to the touch
Re-entry to the sport needs to occur gradually, esp for throwing sports.

Endorsement:

From one who does a lot of repetitive overhead movements, Jordan R Malloch, 2000 & 2004 US Olympic Canoeing Team, presenlty a realtor at Windermere, (jordan.malloch@windermere.com), had this to say about Nikki's massage treatments.

Nikki Nichols, who has provided massages for athletes at 3 Olympic Games, has been crucial in helping me to achieve excellence in my athletic career. Without her massage expertise, I would not have been able to race at the highest International level. Her ability to soothe my sore muscles and help me recover was instrumental in helping me to make two US Olympic Teams in Canoeing.

Metamorphic Massage
"where injuries are transformed into wellness"
Specializing in athletes with injuries

Nikki LMP -- provider of massage at 3 Olympic Games
WA Sports Massage Team - active member for 12 years

Hope to hear from you soon.
Nikki Nichols LMP, RN, BSN
Metamorphic Massage
206-499-4281
Nikki@metamorphicmassage.biz