As a follow up to a previous post that I made, I want to present an analogy for scapular region pain. A situation presented itself again today that brought this to mind.
“Knots” in the rhomboid and scapular region seem to get all sorts of interventions. Massage, trigger point therapy, injections, stretching, heat, ice, etc are all common. My least favorite thing to hear is that a patient’s physical therapist is trying to strengthen this area, as if weakness is the cause of pain. With any of these interventions, the pain will lessen or go away, but usually not for long.
What happens when you get a pebble in your shoe? The answer should be pretty obvious; remove the pebble or the pain will continue. What happens if something under the shoulder blade rises to irritate the soft tissue? Spasm and pain will result. That something is usually a rib(s). Cause of such an occurrence can vary, and can be acute or chronic in nature. In my experience, unless you intervene to change the landscape of the ribcage/spine, the pebble will continue to irritate.
In my Foundations in Myofascial Release I Seminar, I introduce techniques to “Level the Landscape” of the ribcage. Myofascial Release holds a wealth of potential for making permanent changes to the thorax and beyond. Check out my upcoming Foundations I Seminar in Rochester, NY on my website.
Walt, what do you think some of the cause are of unilateral ribcage differences seen when a patient is lying prone?
Janet,
Cause could come from an asymmetrical pelvis, which translates a rotation through the spine. Spinal rotation forces a deformation of the rib cage in response. Working strictly at the ribcage would provide temporary relief/change only, as the initial cause still exists. That being sad, when you are viewing a person who has had pelvic and rib asymmetries for years or decades, full resolution may not be possible or practical. Treating from the symptoms can create a huge change in the person’s level of pain and function.
That is what I have found. Release the pelvis first then work on the symptom. Gradually the the proper adaptation takes place reducing the frequency and severaty of the pain return.
I agree! Pelvic balancing is very often the starting point. Starting from the symptom will seldom lead to lasting changes. But don’t ignore the fact that cause does not always start at the pelvis. Thanks for your response.
You are so right in balancing the pelvis, but look further to the hips, legs and feet which support the whole kinetic chain. Look at your clients, in standing and walking. You will see the imbalances, and treat accordingly, you will help your clients flourish.
Michelle,
I fully agree. Anyone who starts a sentence with “Everything begins at the …..” is missing the larger picture.
Fundamental law: Every action has an equal and opposing reaction. To stand on two feet and walk from place to place requires myriads of nervous system reflexes to program these apposing reactions. Any failure sets off a reprogramming to try to make a successful reaction. These reprogramming perpetuate other failures causing a cascade effect.
It takes persistence and experience to trace them back to the original pebble in the shoe.