“Shovel” Technique

Science of Medical Massage

During one of SOMI’s Medical Massage Seminars, our new student at the time, RJ Schmit, LMT, shared the technique of shoulder decompression that she had developed and called the ‘Shovel’ Technique. All skepticism was gone when RJ demonstrated the application of this technique. Every day, we observe the high clinical effectiveness of the Shovel Technique on patients in our clinic. From that day on, we have included RJ’s technique of shoulder decompression as part of the Medical Massage protocols that address shoulder dysfunctions. Thank you, RJ!

By Dr. Ross Turchaninov
JMS’s Editor in Chief

‘Shovel’ Technique

By RJ Schmit, RN, LMT, MMT

This shoulder-opening technique was developed over time. I was unable to get the results I wanted by using conventional massage techniques. I was looking for a technique that would relieve pain and increase the range of motion, flexibility, and mobility of the shoulder joint in a single application.

I called this shoulder joint mobilization technique the “shovel” technique because it resembles digging. This technique’s great advantage is its ability to mobilize all major players that support the shoulder joint’s function during one short application. While applying the ‘shovel’ technique, the practitioner can address the pectoral muscle group, the rotator cuff muscle group, and even the middle back muscles (the rhomboids and the lower portion of the trapezius muscle) at the same time.

The ‘shovel’ technique can be part of a therapeutic or stress-reduction massage session or of medical massage protocols that target abnormalities in the shoulder joint. In any scenario, this technique should be performed as the final part of the shoulder’s treatment.

Step 1

I always precede the ‘shovel’ technique by preparing the joint using basic massage techniques. The practitioner decides what techniques to use.

Step 2

The next step is to prepare the shoulder joint using several passive stretches conducted during the client’s prolonged exhalation. The client’s upper extremity and shoulder must be completely relaxed.

First, grasp the client’s upper extremity and place it in internal rotation at the shoulder joint. While the upper extremity is in internal rotation, slowly pull it along its axis during the client’s exhalation. Be sure that the stretch is conducted by the hand placed above the elbow joint (the left hand in the video).

Ask the client to show you any signs of discomfort on his or her face during the passive stretch and closely watch for these signs. The passive stretch must be conducted carefully without activating the pain-analyzing system.

The next part of Step 2 is passive stretching of the shoulder joint from a new position, in which the upper extremity is abducted and laterally rotated at the shoulder joint. Notice that now the other hand (the right hand in the video) is placed above the elbow joint. Again, perform the stretch only within the client’s comfort zone.

Finish Step 2 by passively stretching the shoulder joint using the back-and-forth motions shown in the video.

Step 3

There are two variants of the Shovel Technique (ST). The first variant addresses the shoulder joint only, while the second addresses the shoulder joint and the scapula. Usually, they are performed together in the following order:

First variant of the ST

The patient should be positioned on his or her back on the table so that the body lies obliquely, with the pelvis close to the table edge and the shoulder off the table. The patient’s scapula should be ON the edge of the table. At the beginning of the video, an upward camera angle shows the position of the scapula on the edge of the table.

The application of the ST is identical to the movements of digging. Grasp the patient’s arm with both hands and imagine that his or her arm is the shaft of a shovel. Now push the patient’s arm downwards (i.e., groundwards) like a shovel being pushed into the ground. When the arm cannot go down any further, elevate the shoulder using your right hand while your left hand pushes the lower arm and the elbow downwards (i.e., groundwards). This movement is similar to scooping the ground while digging. Repeat this technique 3 to 4 times before moving to the second variant of the ST.

Second variant of the ST

The application of this variant of the ST is similar to the first variant. The only difference is the initial position of the patient’s arm and shoulder on the edge of the table. Notice this difference in the video, where the scapula is entirely off the table. The dashed line in the video indicates the medial edge of the scapula, which should be entirely off the table.

During the application of the first variant of the ST, the patient’s arm was going down due only to the elasticity of the soft tissue in the shoulder joint. As you recall, the scapula on the table’s edge restricts its vertical movement. Thus, the same move of the arm and shoulder downward during the application of the second variant produces more vertical movement because the practitioner pushes down both the shoulder and the scapula.

Step 4

The final step of the shovel technique requires passive stretching of the shoulder joint while the arm is in maximum extension. Always be sure to work within the client’s comfort zone.

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Category: Medical Massage

Tags: JMS 2009 Issue #1