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 she developed and called ‘Shoverl Technique.  All skepticism was gone when RJ demonstrated the application of this technique. We daily observe the high clinical effectiveness of Shovel Techniques on patients in our clinic. From that day, we included RJ’s technique of shoulder decompression as a part of the Medical Massage protocols that address shoulder dysfunctions. Thank you, RJ!

Dr. Ross Turchaninov, Editor in Chief

‘Shovel’ Technique

          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, rotator cuff muscle group, and even middle back muscles (rhomboids and 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 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 apply 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 the inner rotation in the shoulder joint. While the upper extremity in the inner rotation slowly pull it along its axis during the client’s exhalation. Be sure that stretch is conducted by the hand placed above the elbow joint (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 this sign. 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 the new position when the upper extremity is abducted and laterally rotated in 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 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 the back of 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 your 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 the scooping of 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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Tags: 60 Variations of 7 Basic Techniques, Journal of Massage Science 2009 #1, Science of Medical Massage