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technique with scapulae

Hello all,

I've got a question about technique with shoulder blades. There might be several groups that could help me with this questions, but I'll start by being a student and asking here.

Placing the client's hand low on their back while lifting the shoulder often allows the scapula to lift up, off the ribcage. However, I see several 60+ yr old women whose shoulder blades don't lift up. What types of strokes should I work with and how in which areas to help free that up?

Thanks!
O.

Replies to This Discussion

Permalink Reply by Cindy L. Williams on November 10, 2010 at 5:15pm

It is very common to see a client, regardless of age, whose scapula is adhered to the ribcage via the soft tissue that lies between and around these structures. There can be a variety of culprits. Among them are the subscapularis, serratus anterior, mid and upper trapezius, and rhomboids. These are only a few. I recommend reviewing the anatomy of the entire shoulder girdle (including the anterior body, such as the pectorals) in order to understand where the muscles attach, as well as the way in which these muscles work together, so that you can knowledgeably treat these areas. Warm up with effleurage, then sink in slowly as the muscles allow. You can then work the superficial and deeper layers, as well as the attachment sites, with friction and cross fiber strokes which are great for breaking up adhesions. Remember to honor the body and only go as far and as deep as it allows. Forcing is never an option, but finessing is. Connective tissue molds to the strains placed upon it, so incorporating regular movement can greatly reduce strain and adhesions, as well as bring more blood and lymph flow to the area. I recommend referring your client to a PT or movement therapist to assist them with exercises that might complement the soft tissue work that you do, creating more lasting results.

Permalink Reply by Olga Chwascinska on November 13, 2010 at 2:05am

Thank you, Cindy - these are well phrased words. I took your advice and poked in the anatomy books some more and feel more confident with the area and therefore the work that follows. Some good results have already ensued. Thanks again! O.

Permalink Reply by Olga Chwascinska on November 17, 2010 at 2:44am

Thank you Erin, indeed Cindy's comments are just above yours. I'll look forward to digging around the link you've shared. Best, O.

Permalink Reply by Gary W Addis, LMT on November 21, 2010 at 11:11pm

Olga Chwascinska said:

Thank you Erin, indeed Cindy's comments are just above yours. I'll look forward to digging around the link you've shared. Best, O.

I too am a student, but if I'm not being presumptuous, I'll pass on a technique I've learned. With the client prone, bring the arm across the back, cup the shoulder with your supporting arm and lift and pull it back also; this should lift the scapula, allowing you to get beneath it with your fingertips. Or I could be dead wrong. :) There is so much to learn!

Permalink Reply by Olga Chwascinska on November 24, 2010 at 9:54am

Hi Gary - you are right on with your technique, trust your wisdom! My question is what to do when what you suggest does not work, meaning when the scapulae are actually adhered to the ribcage and do not lift. If you are curious, I've started a similar discussion on the 'deep tissue' group and got some really nice acupressure pointers, among others. Good luck with your studies! Best, O.