seeking help again, client w/ back pain

[Jaclyn]

i have a client, and forgive me for the description, but i havent seen this before (i'm a newbie, been working for about 3 months). her scapulas are very loose (no, not winged). i can hardly get under most of my clients' scaps, but hers lift right off her back and are very mobile.
she has, forgive me here, some tissue bound up in her rhomboids, its big and moves all around, i cant get a hold on it. When i try to compress it, even super slowly, it bounces away from me. Not sure if you'd call it a TP, it doesnt refer and its so big and springy...what is it?
she has a lot of pain inbetween her shoulder blades. what would you recommend?

 

[Riley S:)]

Could be a lipoma. Difficult to work through it, so you may need to work around it or try to displace it to get at areas under it. However, this is only an educated guess and not a diagnosis. If you haven't asked her about it, this is a good time to do so. If it's a lipoma, you probably need to get at the tissues below it to give her relief.

Aside from displacing it, it's also possible to give great relief by stretching the tissues around and deep to the unidentified mass. If you aren't sure how to stretch those areas, don't attempt to do so until you have learned how.

 

[name-me]

You could also work the anterior side of the body. Tight muscles in the chest can be one cause of upper back pain.

 

[Whips&Chains]

Although it is hard to say just from reading, but it sounds as though you may be on a knot in a different muscle than the rhomboids. Knots in the inferior traps can be found above the rhomboids and can move around when trying to work on them.

Double check your location by feeling the direction of the muscle fibers. Many therapists do make the mistake of thinking pain between the shoulder blades is the rhomboids, when in fact one of the more common places is the lateral to medial spinae group.

 

[inquisitive_1]

thank you for your replies. my client is coming back in 2 weeks, but ive also seen one more person since then with this same thing. I'll check to see if its the lower traps, I didnt think to feel for fiber direction, i was trying more, unsuccessfully, just to get it pinned down. should i do something different if it's the lower traps vs. the rhomboids?

 

[benjamin a]

The fiber directions of those muscle groups run crosswise to one another. Knowing the fiber direction and layer you are addressing will help you release the layers from superficial to deep more effectively. If you don't have a copy of "The Trail Guide to the Body" - this is a great time to pick it up! Refreshing my knowledge of anatomy often provides inspiration for different approaches to treating problem areas.