Rotator cuff help!!!!!

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I have a client tonight that has had surgery on rotator cuff 7 weeks ago. She has P.T. 3 x week but is still in lots of pain. Does anyone have any good tecniques? stretches? dr. recommends deep tissue.The appoint is tonight! HELP!
 
Rotator cuff help!!!!!

Okay, guys, tell me who else here has been tempted to help this person, but has thought better of it?I have written & erased (before posting) twice on this.In fact, I have just done it again... erased a whole paragraph...I am torn between trying to write out some helpful ideas, strategies & minding my alarm buttons that say to tell you to refer this appt out. Get with a mentor or take a course in rotator cuff/shoulder girdle work & then offer your services to the client. Its not that you couldn't do any of the right things, but you could inadvertently do some harm if you are not familiar with this kind of work. I have been a massage therapist for a while & just recently went to a rotator cuff class (CEU). I appalled myself when I found out what I didn't know!In a class, or with a mentor, you can easily & safely learn a great RC protocol. Reading descriptions & helpful hints here before a session tonight will not give you enough to go on.If you read this before your appointment tonight, call the client to refer them out, or at least postpone the appointment until you can work with someone who can show you & let you practice what to do.Jill/sagetherapist
 
Rotator cuff help!!!!!

Funny to know that I wasn't the only one who hesitated on this one. :)
 
Rotator cuff help!!!!!

Update....i went ahead to the appoint because she is a friend of my neighbor, and I knew of her daughter in high school...anyway...her daughter is a PT so I spoke to her on the phone as to exactly what she wanted me to do. I felt pretty confident in just trying to get some blood flow to the area before it freezes. After the session she did her own stretching.thanks for all the comments!
 
Thanks for posting back about this.  I am glad to hear that you did consult with someone and all worked out well. :)
 
Yes Jill, I was nervous too.   To me... 7 weeks post-op seemed awfully fast for deep tissue work as well. There's just so much that can go wrong if the practioner and client aren't on the "same page" so to speak.As for describing techniques and things... some things just don't translate well in writing... and I found myself  searching for the words to describe what I'd been taught for rotator cuffs in school for quite awhile before I just gave up. (I was actually taught how to massage the rotator cuff way before massage therapy school because my Mom had injured her rotator cuff and Sheila (our MT) taught me how to massage my Mom's shoulder daily from our very first visit to her.  We used a special anti-inflammatory cream that the chiropractor recommended to do it containing Boswellia Serata and Capsicum. So, I think it's fair to say, rotator cuffs are a special interest of mine. LOL)polorolo, I would suggest that you give a little more information (if it's known) the next time you post a thread.  We'd love to help you out, and we are generally a very helpful lot,  but we can't give you a good answer without more complete information. Glad everything worked out well though! Be sure to keep us updated on how she progresses, regular massage can make a big difference in healing rotator cuff injuries, I've seen it in my own family.And... welcome to the board!
 
Reading the responses made me wonder who I would have consulted if I were given the same situation.  I don't have a source for advice on a matter I'm not comfortable with.  I believe I need to create a referal list.  I definitely would have been unwilling to do any "deep tissue".   Kudos to you on handling the matter with smarts!Medicineman ;)
 
Rotator cuff help!!!!!

The appoint went great. She is a very bubbly person. I mostly treated the muscles and tendons around the cuff, however had a hard time with subscapularis because she is not able to lay on her side. She is a trooper and was able to tolerate a lot. any suggestions on getting to subscap?
 
Rotator cuff help!!!!!

You can access subscap with the client supine. It gets a little tricky because you have to reach along the side of the body below the axilla, press fingers into the space between the lateral border of the scapula and the rib cage and bring the arm into flexion and medial rotation (arm out in front of body, rotating across the chest). This motion brings the scapula around the side of the ribcage, and over your fingers. It has a tendency to be painful, particularly if there is a lot of tension there (which there often is). The movement also has a tendency to shift the drape, possibly exposing the client, so extra care is necessary to secure the drape.
 
Rotator cuff help!!!!!

I'll try it; however, I don't know if she has that kind of ROM yet.thanks for the tip!
 
The June/July issue of "Massage & Bodywork" has a very good article about cervical injuries.  Quite informative and the article talks about alleviating the pain from rotator cuff injuries.  Check it out, I think it may help.Jeff Baskett (Sombraman)
 
Since the client is unable to lay on her side, you may want to try to find a modification of your own (work with what you know about mechanics) with her sitting, to work that sub-scap region.  Even if you can't get all of it, just a little may begin to be helpful.  :)
 
Rotator cuff help!!!!!

Try a connective tissue approach with very minute lengthing...
 
Rotator cuff help!!!!!

Try a connective tissue approach with very minute lengthing...

Would you be willing to clarify what you mean by a connective tissue approach and provide some sources of getting that type of education for the good of the forum?  Thanks!  :)
 
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