Trigger points and pain in the shoulder - Part 2

Trigger points and pain in the shoulder - Part 2 -

Last month, I was talking about trigger points and pain in the shoulder rotator cuff in the posterior (spinous and teres minor) and their common reference models. Another common shoulder muscle to find active trigger points is the supraspinatus. Active trigger points in this muscle may refer pain to the deltoid and down the side of the arm

See the typical trigger points and referral patterns below.

Watch the video below for a demonstration of needling dry the supraspinatus

case study:

current patient of this mine with side pain the arm 3 months duration. . Known because of injury, but a diagnosis of triceps injury / tear

Test Pretreatment

Movement assessment of functional selective (SFMA) dysfunctional patterns not painful

all models of the cervix (malfunction mobility)

R shoulder internal rotation + T9 extension (mobility dysfunction) - functional and painless (FN) in the

multi-segmental (MS), the rotation R (engine control deficit) - (FN) in L.

SFMA painful dysfunctional patterns:

lateral rotation R shoulder + flexion (bending limited to 140 degrees)

MS extension (R EU pain)

tests special:

Hawkins + on R

shoulder passive IR 20 deg

palpation .:

Tenderness to palpation of the two point supraspinatus with reference to the trigger pain down the upper side end at the wrist (pt indicates that is the pain that penetrates the upper arm)

Treatment on day 1 consisted of Functional dry Needling the supraspinatus (x2) with electrical stimulation followed by the most superficial Graston technique superior R trap, supraspinatus, thorny, small and round with light strumming the supraspinatus insertion. Corrective exercise involved 3pts. thoracic rotation (EU positioned in internal rotation - hand behind the back) with manual assistance initially to maintain / work to relax pt. was able to control the full range available

Test after-treatment

painless functional models.

R shoulder internal rotation + extension (T7)

MS rotation B

SFMA dysfunctional painless reasons:

All models of the cervix (mobility )

SFMA painful dysfunctional patterns:

lateral rotation R shoulder + flexion (improved flexion to 0 degrees)

MS extension (R EU pain)

*** both are still painful, although the intensity has decreased while the movement grew ***

special tests:

Hawkins + on R but much less intense

IR 50 deg passive shoulder

Bottom Line.

trigger points with active reference models should be treated immediately, especially when they recreate the patient's pain. In this case, the patient's pain subsided immediately with a significant improvement in the range of shoulder movement. This simply confirms that this will be a critical area for further process.

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Joe Heiler PT, CSCS

Joe Heiler MSPT is the owner and content manager SportsRehabExpert.com, a site dedicated to the advancement of education rehabilitation and performance professionals. The site focuses on orthopedic and sports physical therapy subjects through webinars, audio interviews, articles, manual therapy and exercise videos, and more.

Joe is also the owner of Elite Performance Physiotherapy and Sports in Traverse City, MI specializes in orthopedics and sports medicine, as well as training of athletic performance. It is Graston Technique (GT) and a certified instructor GT SFMA FMS and trained, and is passionate about a number of soft tissue and manual techniques, including Trigger Point Dry Needling and manipulation.

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