CASE OF THE MONTH
This Case of the Month is submitted by Melissa Reynolds, LMT, CMMP from Texas. Melissa recently graduated from our Medical Massage Certification program and is fully engaged in building her practice while helping patients who are suffering from various pain syndromes, sometimes for years.
This clinical case that Melissa recently finished is a great example of how a simple protocol when it is applied and executed correctly becomes a life changing experience for patients.
Dr. Ross Turchaninov, Editor in Chief
MEDICAL MASSAGE VS DELTOID MUSCLE SYNDROME
By Melissa Reynolds, LMT, CMMP
History of Present Illness
In June I had a new patient – a 53-year-old female with pain in the right arm ranging between 8-10. The pain was concentrated in the middle deltoid area and it radiated to the arm. The patient has suffered with this pain for the last 17 years. She has seen her family doctor, chiropractors, physical therapists on numerous occasions and had X-rays and an MRI with no signs of trauma or inflammation to the area.
Initial Assessment June 2017
After questioning the client and evaluating her daily activities, I learned that she feels the worse pain when she is driving, or working long hours on a computer. Sometimes the pain becomes so intense she is only able to work on the computer for an hour then has to take a 3-hour break before she can approach the computer again. After examining ergonomics at her desk, it was determined that she holds her arms out in front of her with no support when typing. Ironically, the patient had full ROM in the shoulder, but it was accompanied by pain. Also, she couldn’t hold her arm in static abduction and flexion for an extended period of time.
During manual assessment and testing using Jump’s Test and Compass Techniques I determined that the patient has very active trigger points in the middle portion of the deltoid muscle and active periostal trigger point at the insertion of the deltoid muscle into the deltoid tuberosity of the humerus. It was obvious to me that the client was suffering from Deltoid Muscle Syndrome.
I used Medical Massage protocol for Deltoid Muscle Syndrome from SOMI’s Video Library as a main treatment option. I started on the posterior neck addressing the origin of the deltoid muscle’s innervation and after that work layer by layer reducing tension in the fascia and each portion of the deltoid muscle. The final target of the session was periostal trigger point at the insertion of the deltoid muscle into the deltoid tuberosity of the humerus.
After 3 sessions the client reported a significant decrease in the intensity of pain and discomfort in her shoulder. She was able to work longer on the computer before she felt any discomfort. Finally, by session 6 the pain in the shoulder completely disappeared, function was restored, and the client didn’t feel any referred pain to her arm and forearm.
Considering the long history of my client’s chronic pain I decided to give her 3 more sessions to additionally reinforce the clinical effect and prevent reoccurrence of the tension. The client was diligent and cooperative with her homework, doing all necessary stretching and ergonomic and postural changes while at home and especially while she worked on the computer.
The patient has resumed all daily activities with no pain at any time for the last three months. She works on the computer only with support for her forearms. She is extremely happy since the pain she experienced for 17 years is finally gone.
Hi, I am Melissa Reynolds and I am so thankful to have found Dr. Ross and SOMI. I have always been interested in the workings of the human body. I originally wanted to become a Physical Therapist and with all of the twists and turns of life I did not head down that path. Although I have had many different careers, I still felt I was missing something.
After completing my Associates of Science program I decided I wanted something different for myself and pursued a degree to become a Physical Therapist Assistant. Due to some unforeseen test anxiety I was not able to take the boards for this degree program. The program director suggested I get licensed in another field and then come back and re-try the program. I left the program feeling completely defeated and stumbled into a Massage Therapy program.
Everything worked in my favor from timing, financing and the detail of the different modalities taught in this program. I began the program and discovered that there was much more to massage then I could ever imagine. Then one of my Instructors suggested I look into Medical Massage after graduation through SOMI with Dr. Ross. So after I found my love with massage in school, I looked into SOMI and Medical Massage. After I went to the first seminar I was hooked and I continued through the summer to complete the CMMP certification.
The knowledge I have gained through this program along with my knowledge from school has made me beyond confident in my ability to help others. I have been using the knowledge from Medical Massage to help my clients who have many different types of issues. The knowledge I am able to provide my clients to prevent further injuries and maintain the health of their bodies for years to come fills the void that I had for years. All I ever wanted was to have the ability to help people have a better quality of life and with the information I have been taught through SOMI I have the ability to provide all those with pain and discomfort relief and hope that a less painful life is in sight.
Category: Case Studies
Tags: 2017 Issue #4