At a recent conference, it was stated that the Infraspinatus muscle was key to all pain in the upper quadrant. He advised rolling a lacrosse ball back and forth it over it. You either sit or stand against a wall or lie down and roll it. Now a study on elderly with nonspecific shoulder pain shows it is involved.
J Geriatr Phys Ther. 2018 Jan/Mar;41(1):1-13.
Dry Needling on the Infraspinatus Latent and Active Myofascial Trigger Points in Older Adults With Nonspecific Shoulder Pain: A Randomized Clinical Trial.
Calvo-Lobo C. et al
- Sixty-six patients aged 65 years and older with trigger points in the ipsilateral infraspinatus of the painful shoulder
- Nonspecific shoulder pain was diagnosed if nothing else found on testing
- Technique: – “Hong’s fast-in and fast-out technique with multiple rapid
-lie down with bad side up
– “A headless 0.32 × 40-mm needle (Stainless steel, Agupunt A1041P, 158 Caspe, Barcelona, Spain 08013) was fi xed between the fi ngers of the nondominant hand and inserted perpendicular to the scapula toward theMTrP.”
– “By means of metacarpophalangeal fl exion extension of the fi rst to second fingers of the dominant hand, the area was probed in different directions until presence of 1-LTR, a pain response and, usually, the referred pain pattern of the MTrP were obtained”
– multiple insertions over 1-2 minutes were done “until reaching LTR exhaustion.”
– press on spot 1 minute to stop bleeding
My technique is different –
- I find a good spot
- I needle area until I get a good trigger response, then electrically stimulate with pulses from a pointer plus for the count of 120 times.(80 times will sometimes do it but 120 times consistently gets relief) – stimulation should be enough to move the muscle but not painful
- Then move on to other satellites.
- Infraspinatus triggers tend to be closer to scapular spine and closer to shoulder.
- Afterwards I work out all the remaining knots manually:
– If you engageg infraspinatus transversely with your thumb either pushing cephalad (up towards head) or towards feet, you can quickly massage through it by thumping your thumb with a chripractic activator. Patient will complain it burns but it will be a good burn ( works well for upper trap and levator cscap too but that is another story)
then rub the muscle 120 times and repeat sequence until muscle painfree.
I would have them hit those triggers by rolling a lacrosse ball (A Canadian sport if you must know…) – Tennis ball may be too soft.
They talked about satellite triggers in Anterior Deltoid and Exensor carpi radialis brevis. I find triggers in the anterior deltoid are manually tough to get out but with the activator can gradually be relieved – needling would make it easy though. pandora charms uk pandora charms uk