In this short article I will discuss shoulder pain, the anatomy, common conditions and specific massage techniques used to treat them. If, like me, you suffer from shoulder pain, read on and discover how massage can help.

Shoulder pain is a common problem that most of us will suffer from. Sometimes transiently, but often as a long term chronic condition. The majorative presenting complaint of clients at Mindful Touch Massage is shoulder pain and this is generally the area they ask me to focus their treatment on.

It's hardly surprising most us are suffering from shoulder pain when you consider our modern lifestyle. Many of us have long stressful journeys to work, then sit for prolonged periods on computers. Others, like myself, have physical jobs and these always involve elements of repetitive arm movements, often at awkward angles or carrying heavy loads. At the end of the day I, like many others, enjoy a facebook catchup, hunched on my elbows whilst lying in bed, an absolute shoulder killer.

Before considering how massage can ease this tight and tired shoulders it's useful to think about the complex anatomy of these amazing limbs. Whilst The shoulder joint is relatively straightforward consisting of a ball and socket, with the head of the humerus fitting loosely into the glenoid cavity of the flat triangular scapula bone. However the scapula has no significant bony connection to the rest of the torso and this where the complex musculature and connective tissue becomes important.

The shoulder joint has a variety of latticed muscles, tendons and connective tissue. A significant number of these pull the ball tightly into the socket and this can cause its own problems. To further complicate the situation a large number of the muscles attach to our neck or spine both of these are delicate structures that are largely supplied with nerves. When the muscles of the shoulders become shortened with excessive, stress or injury use they put pressure onto the adjoining structures leading to neck and headaches.

Our muscles are bound by a non stretchy connective tissue called fascia If you can imagine a thickened sheet of cling film wrapped tightly around the muscles tying them all together. This is what the fascia can become like during times of stress or injuries such as whiplash or chronic hunching of the shoulders.

Next I am going to consider some of the specific conditions that affect our shoulders and discuss what causes them and how massage can be helpful.

Tendonitis
The tendons are the strong non stretchy bands of tissue that connect the muscles to the bones. During times of excessive muscle use the tendons can become inflamed, especially where they pass through other structures or against bones. Massage can increase blood flow to the tendon helping recovery. Some techniques can help lengthen the tendon, however the most benefit is achieved by relaxing and stretching the attached muscle. At Mindful Touch Massage I use various techniques to reduce the pressure on tendons and increase the space for their movement thus reducing pain. This diagram demonstrates the complexity of tendons around the shoulder joint.

Osteoarthritis
This condition of the shoulder joint occurs most commonly due to wear and tear. The cartilage is no longer smooth and slippery and the surrounding tissues become inflamed. As you can see from this diagram lots of the muscles of the shoulder actually pull the head of the humerus into the glenoid cavity. If this joint is sore and inflamed and the muscles are shortened it has to be painful. Here again, massage can help relax this muscle allowing more space in the joint with the warming effect of massage facilitating pain relief. Incidentally massage should be avoided in arthritis during the initial acute inflammatory phase.

Impingement
This is caused by repeated action especially where the hand is raised overhead for prolonged periods, for example painting a ceiling. The knobbly end of the scapula called the actromipon rubs on the shoulder joint and prevents normal function. Massaging the shoulder can lengthen and relax these muscles allowing for normal function to return. It's important to remember this will not be a quick fix and a course of massages are still required, moreover, myofascial involvement is inevitable. Fortunately, the Mindful Touch Shoulder Massage includes some wonderful myofascial release techniques to counter this problem.

Rotator Cuff Injury
The supraspinatus, infraspinatus, subscapularis, teres minor muscles and their associated tendons work together to hold the head of the humerus into the socket of the shoulder. If any of these muscles become tense and shortened the additional pressure will lead to pain. Rotator cuff injury is common injury incurred by those with repitional work. A combination of stretching the muscles during massage, alongside myofascial release techniques can alleviate the pressure.

Bursitis
We have fluid filled sacs called bursa between our bones and muscles. The function of the bursa is to cushion the muscle from the underlying bone during movement. Unfortunately when the muscles are used constantly they enlarge and additional pressure can result on the bursa causing them to become inflamed and swollen. Massage can alleviate some of the pain of bursitis by releasing the muscles and tendons in the joint that are causing pressure and inflammation. Localised trigger point techniques might also be used to relax the muscle and reduce its tense tone.

Although the conditions above are often seen at Mindful Touch Massage, the most common problem is generalized muscle tension, trigger points and those stress aches that can take the sparkle out of your day. As we discussed at the start of this article, modern life seems to conspire against our shoulders. We tense them up raising them by our ears instead of the relaxed easy going natural state of things.

When we adopt this tense posture for a prolonged period our muscles become shortened and our myofascial connective tissue bandages itself around them limiting their ability to relax again. At a cellular level the muscles fibers can become persistently contracted, causing trigger points.

Trigger point are small areas of contracted muscle that are usually painful to the touch and often refer their pain to other parts of the shoulder when pressure is applied. Through a combination of experience, careful palpation and communication with the client I am usually able to isolate these trigger points. With localised sustained pressure they release, resulting in almost immediate relaxation and pain relief.

The thorough back, neck and shoulder massage you will receive at Mindful Touch Massage uses a unique combination of techniques developed to maximise benefit. Swedish massage gently warms and stretches your tissues in a variety of novel directions. Deep tissue techniques ensure all the layers of muscle and tissue are engaged. Trigger point therapy is employed to release small areas of contracted muscle and myofascial release stretch this connective tissue allowing the underlying structures to move more easily again.

The result is a deeply relaxing massage that releases pressure on the underlying nerves leaving you feeling light, relaxed and ache free. Moreover Mindful Touch Massage aims to help your body mind connection, by increasing your awareness of activities causing the muscle tightness. Increased awareness allows you the option of altering your posture and breaking the habitual practices that result in tense, tired and aching shoulders.

If you suffer from shoulder tightness and pain, please do not just put up with it, visit www.mindfultouchmassage.co.uk, browse the website and book an appointment. A 45 minute comprehensive full back, shoulder and neck massage costs £40.

If you have any questions just give Ross a call on 07864 980812.