Unlocking Computer Shoulder

1
Unlocking Computer Shoulder

• Eric Stephenson, LMT, NCTMB
• Director, Massage Education, imassage, Inc.

2
Bring imassage to your state convention
Katherine Warner, AMTA KY President
says.... "Last March imassage taught at our AMTA
KY Chapter conference with amazing evaluations. 
Our chapter has offered 37 continuing education
classes in the past two years and Eric has had
the highest evaluations of any speaker, scoring a
perfect 5.  We brought imassage back to teach at
our next summer session." We Invite You to Stay
in Touch Website www.imassageinc.com Youtube
videos Keyword imassageinc Join us on
Facebook http//groups.to/imassageinc/
3
Tracking Muscles of the Shoulder Girdle
4
Lengthening to the Pectoralis Major

• Technique Description
• Hook your fingertips of your inside hand off the
  sternal attachments and continue lateral towards
  the head of the humerus
• As you move lateral, make contact with the entire
  hand, continuing to hook into the connective
  tissue
• Call for active movement of pecs
• Continue across the bicepital groove onto the
  anterior deltoid as you bring the clients arm
  into external rotation with your outside arm

• Focus on Self-Care
• Begin in a shortened Horizontal stance facing the
  head of the table at the clients side
• Bring your bodyweight up onto your flexed toes
  and sink back to the floor, keeping your back
  straight
• Bring your head up out of the work to align your
  spine
• Keep your chest open and your head at the horizon
  as you melt into the clients tissue

5
Opening the Anterior Fascial Cylinder and SCM

• Technique Description
• Begin by standing beside your supine client and
  place your inferior open fist along the SCM on
  one side of the clients neck, with your fingers
  pointing posteriorly
• Slowly engage the tissue back, around the neck
  toward the back, not into the neck
• As you begin the stroke, have the client move
  into a true rotation of their head, away from you
• The direction of your pressure is crucial do not
  push into the neck!

• Focus on Self-Care
• Begin in a short horizontal stance, at the nook
  of the tables head, facing directly into the
  clients head
• Find your landmark of the SCM and line your
  extended arm directly over the muscle
• Come onto your flexed toes if need be and let
  your arm melt easily into the tissue, not to
  occlude the carotid artery or jugular vein
• After the stroke begins, bring your head up out
  of the work into extension

6
Biceps Brachii Slot Machine Opening

• Technique Description
• Begin by flexing the clients elbow and abducting
  the arm to 90. Engage the heel of your hand
  between the muscle belly and the periosteum.
• Hook in and drag the tissue superiorly with your
  inside hand, while drawing the forearm slowly to
  the table with your outside hand
• Focus on self-care
• Begin in a horizontal stance, facing the abducted
  arm
• Extend your arm in front of you as you move from
  center to engage the tissue
• Bring your head to the horizon

Anterior Deltoid Reverse Slot Machine

• Technique Description
• Begin by flexing the clients elbow and abducting
  the arm to 90.
• In a horizontal stance, turn and face towards the
  feet, at the head of the table
• Hook your open fist or heel of your inside hand
  into the fibers of the anterior deltoid and call
  for passive or active internal rotation
• Slowly pull the tissue inferiorly while
  internally rotating the clients arm with your
  outside hand, bring their arm all the way to the
  table

• Focus on self-care
• Keep your arm fully extended out in front of you
  as you enter the stroke
• Bring your head to the horizon as you move
  superiorly

7
Lengthening to Serratus Anterior

• Technique Description
• Client is in a supine position, their arm is
  externally rotated to rest on the table at a 45
  degree angle
• Hook the three fingers of your outside hand
  gently into the tissue of the muscle at the 9th
  rib
• Slowly head in a superior direction as the client
  slowly brings their arm into overhead extension
• Taper away from the axilla and up the lateral
  edge of the scapula

• Focus on Self-Care
• Begin in a kneeling or seated position at the
  clients hip
• Extend your outside arm to contact the tissue at
  the 9th rib
• Keep your arm extended as you move from your
  center through the stroke
• Keep your head from looking down into forward
  flexion
• Focus on Ethics
• A womans breast tissue will displace laterally
  when she lies in a supine position. Be sure to
  check in with your client to ensure that the
  drape feels secure and comfortable. They may
  secure the drape further after exposing the side
  seam by supporting with the hand of their other
  arm.

8
Subscapularis Release

• Technique Description
• Begin with clients arm flexed overhead
• Locate the lateral border of the scapula
• Swim your fingertips to the anterior, lateral
  scapula
• Engage the clients tissue and add active
  internal/external rotation
• Work along the entire lateral border

• Focus on Self-Care
• Begin at the head of the table in standing or a
  seated position
• Extend your arm long and sink into the clients
  tissue, moving from your center
• Keep your thumb straight through the radial side
  of your arm
• Focus on Ethics
• Work within your clients comfort and range of
  motion when flexing the arm
• Secure the drape to protect breast tissue while
  exposing the lateral border of the scapula

9
Trigger Point Release Pectoralis Minor

• Technique Description
• Begin with the client in a supine position, arms
  resting at their side
• Mindfully apply a breast drape to the client and
  ask permission to roll the outer edge up to
  expose the side seam
• In a seated position, position your center
  directly in front of the clients breast tissue
• Bring your inferior hand underneath their arm to
  the lateral border of the clients breast tissue
  and your superior hand stabilizes their shoulder
  girdle
• Take one stone in your inferior hand and enter
  their tissue slowly while moving anteriorly on
  the ribcage
• Angle up toward the attachments on ribs 3, 4 and
  5
• Slightly depress the shoulder to create slack in
  the attachment
• Ask client to breathe into trigger points

• Focus on Self-Care
• Begin in a seated position, both feet anchored to
  the ground
• With both of your palms facing away from you,
  compress into the clients body using the weight
  from your center (much like playing an accordion)
• Maintain the alignment of your spine as you move
  into the stroke
• Focus on Ethics
• A womans breast tissue will displace laterally
  when she lies in a supine position. Be sure to
  check in with your client to ensure that the
  drape feels secure and comfortable. They may
  secure the drape further after exposing the side
  seam by supporting with the hand of their other
  arm.

10
Good working positions

• To understand the best way to set up a computer
  workstation, it is helpful to understand the
  concept of neutral body positioning. This is a
  comfortable working posture in which your joints
  are naturally aligned. Working with the body in a
  neutral position reduces stress and strain on the
  muscles, tendons, and skeletal system and reduces
  your risk of developing a musculoskeletal
  disorder (MSD). The following are important
  considerations when attempting to maintain
  neutral body postures while working at the
  computer workstation
• Hands, wrists, and forearms are straight, in-line
  and roughly parallel to the floor.
• Head is level, or bent slightly forward, forward
  facing, and balanced. Generally it is in-line
  with the torso.
• Shoulders are relaxed and upper arms hang
  normally at the side of the body.
• Elbows stay in close to the body and are bent
  between 90 and 120 degrees.
• Feet are fully supported by floor or footrest.
• Back is fully supported with appropriate lumbar
  support when sitting vertical or leaning back
  slightly.
• Thighs and hips are supported by a well-padded
  seat and generally parallel to the floor.
• Knees are about the same height as the hips with
  the feet slightly forward.
• Regardless of how good your working posture is,
  working in the same posture or sitting still for
  prolonged periods is not healthy. You should
  change your working position frequently
  throughout the day in the following ways
• Make small adjustments to your chair or backrest.
• Stretch your fingers, hands, arms, and torso.
• Stand up and walk around for a few minutes
  periodically.
• These four reference postures are examples of
  body posture changes that all provide neutral
  positioning for the body.

Information acquired at http//www.osha.gov
11
Proper Ergonomic Posture
Information acquired at http//www.osha.gov
12
Visit www.imassageinc.com to download a useable
copy of this treatment plan