From YouTube in Video
Hi I’m dr. David Russ chiropractor and neuromuscular therapist in Portland Oregon. Today we’re, going to demonstrate a neck and upper-back treatment on Matt Matt has some symptoms of stiffness and mild pain in his neck and upper back and a history of right shoulder injury and dislocation.
I like to start often with the patient’s seated. It gives me a chance to feel how their spine bears weight when they’re sitting, and I’m just going to feel each vertebra one by one feel it through its range of motion and see where any restrictions or fixations might Be at the same time, I’m feeling the musculature for trigger points, irritable areas, scar, tissue, tight, short muscles or areas that might be weak from overuse.
You sensitive here right here, oversee right here that’s, tender mm-hmm. We have three vertebrae in a row that are stuck together. We call that a fixation they’re, not moving in relationship to each other.
So a part of the goals of our treatment today are going to be to get that get that fixation moving and when she’s. Laying on his back, I’ll, get a better sense of exactly which one of these vertebrae needs to be adjusted, but one of them right here in the upper left so come lay facedown, please, with him face down.
I’m. Taking a survey of all of his muscles and his upper back and neck, it’s. A nice trigger point right here and I’m just going to compress and hold that for about a minute. Some nice deep breaths here good feel it loosening up already.
Does that referring thing anywhere in that or is it just right there? It was just right there and there’s. Another one right here. You feel a nice long top band in the muscle. It has a little nodule right in the center of it right there.
We’re, just gonna get that little nodule moving get the blood flow through it restore circulation and the trigger point will resolve usually in a day or two. The latissimus dorsi runs from here starts on this big thick fascial band, called the thoracolumbar fossa up to here and then rolls out tucks underneath his armpit here.
His lower trapezius starts on his 12 thoracic and runs up diagonally. This way, taking up this whole space and it’s, going to attach to his shoulder blade here and we’re. The two muscles cross right here.
You can see it’s, chunky it’s very common. This is a really common sight for trigger points to form right here where the lower trapezius muscle comes up and the latissimus dorsi muscle comes around these two muscles get stuck together and that creates a decrease in circulation to the muscle tissue muscle, tissue, gets compromised and Trigger points form in order to treat that you have to get those two muscles moving in relation to each other.
So let’s. Get some movement in here, Matt, okay, you’re gonna bring your elbow down, and then you’re gonna bring your elbow up just like this. I want you to do that five or six times so as he does that I’m, holding the lower trapezius up off of the latissimus and getting them to move in relation to each other free up.
A lot of movement in the shoulder in the neck one more time, good, let it rest just like that. I’m gonna lower you down, not sure if my mic is gonna pick up a crack. If I adjust this back, but I just put a towel here, somebody has don’t slide.
Okay, take some breaths in and out good bring it out. These are adjustments for the fixation I found when he was sitting up. We’re gonna look at this right, shoulder a little more okay, I didn’t, feel some referral to my left scales like you were, having the position and adjusted okay.
How’s? The spot right here? Okay, is that referring anywhere no just right there? Okay, so if your shoulder feels uncomfortable or vulnerable in any of these positions, just let me know. Okay, I’m feeling a little guarded towards the top okay.
Thank you. How’s this? It’s just like that. That’s better. This is his infraspinatus muscle and Terry’s minor two, really important muscles in the rotator cuff that I’ve stuck together and that’s, really restricting movement of his shoulder.
So today I would just want to start the process of getting these moving in relation to each other. You can’t. Do it all in one treatment, so just six or eight passes right through that little stuck area while encouraging and coaxing a little more movement out of his shoulder joint and that’s.
All we would want to do at once, so we can see his right shoulder is rolled forward and in a little bit indicating some tightness and shortness of his pectoral muscle, and that might be the original cause of the injury.
It might just be part of his body’s, way of compensating and guarding for a problem elsewhere, but either way we can’t. Let his shoulder just adapt that posture and stay there, because that’s going to create problems in his neck and upper back.
We can see a trigger point here in his pectoral muscle. Can you see it snapping a little bit there on the camera right there and that’s very characteristic of a trigger point or a little hyper contracted area of the muscle? In a trigger point, you get a few muscle fibers that are more contracted than the ones around it and that pulls on the connective tissue and blocks off circulation can create pain, changes.
The range of motion and the posture of the muscle and just creates all kinds of problems they’re very easy to treat if you can find them. It’s, just compression a little traction and get that little group of muscle, fibers.
Moving usually just about a half a minute to a minute of treatment and it’ll clear up in a couple of days, we’re gonna add a little movement to this treatment. Here again, I’m gonna move your arm. I want you to tell me if it feels uncomfortable, unstable, okay, so, as his pectoral muscle is rolling the shoulder in and forward, I want to just coax that muscle up and back a little bit just getting a few degrees right here, working that muscle that pectoral Muscle in that trigger point against the movement, getting some lengthening and opening in the connective tissue lengthening and opening in the shoulder restoring circulation in the end, it’s, the circulation and the movement that heals the tissue.
So that’s. Really the goal of most soft tissue therapy restore movement, restore circulation and the muscle will get better. This is a lot easier on a male, not a female. We have to do this with them, laying on their side and, of course, everybody’s always covered when they’re in here right here we have a vertebra that needs to be adjusted here.
It’s. The fourth cervical and it has shifted to the left and back so we’re, going to set it up with a little tension. Moving forward into the right make sure his head stays as close to neutral as we can and just give it a push so that’s, a demonstration of a cervical upper back and shoulder treatment.
Everybody needs something a little different, depending on their condition and their needs, but this is what a lot of our treatments here look like. Thank you, Matt really appreciate it.