Annie (her alias) is a Texan grandmother in her late 60s. She started working with me years ago. She has some real problems with degenerative discs in her neck. We’ve been through a lot. I’ve worked on her, literally, from head to toe.
Last winter, she came to me with troubling news. They had found a spot of cancer in her breast. She wanted to take a trip overseas before her surgery. We worked on her neck, shoulder, and hip so that she could enjoy her travel. The process moved along and, last July, she had a double mastectomy with reconstruction.
She called me weeks after the surgery. Her shoulder was bothering her and she needed some help. I referred her to therapists who specialized in post-reconstruction massage for breast cancer survivors. I told her that she should see one of those for lymphatic work. That approach can be magical in the restoration of movement and relief of pain. She started working with a group that specialized in those bodywork therapies.
She appeared on my schedule in the beginning of October. Her shoulder was in bad shape. The physical therapists and massage therapists seemed to be helping with lymphedema but couldn’t get her shoulder working.
So, I did what I always do. I asked lots of questions. I needed to understand the playing field and create a successful plan.
She had a TRAM-flap procedure. I’m not a reconstruction specialist but I’m fairly familiar with these. Carl Hartramph devoleped the procedure. I worked with Hartramph’s daughter back in the late 80s. My mother, who lost her battle with cancer in 99, had this procedure in the mid-90s. Also, in the late 90s, I did myofascial work with women who had pain and discomfort after reconstruction. We talked about the specifics of Annie’s procedure and did a little research on the web.
Then, I did my usual trigger point assessment. When and how does it bother you? All the time. OK. When is it the worst? What happens when you do this? How far can you move that before you have pain? Where is that pain? Got it.
She couldn’t lift her elbow to shoulder level. When she lifted her shoulder, she had a sharp pain in her upper neck. That’s usually trapezius. I ran some more tests to assess the suspected trigger points. I ferreted out several other problems in her rotator cuff and, of course, her pecs. I was okay with working on her fully clothed but she brought a tank top.
Then, I worked my plan. It started with some cranial work. She tried moving her arm. Cranial had helped. Then I worked some problems in her neck. That helped too. And then her rib-cage around her spine. Then shoulder joints. Ongoing assessment led me from one place to another until we were eventually treating those rotator cuff muscles. After each release, I would have her move her arm to see if we were getting results. The work is often subtle with lingering releases so we chat, usually, about our kids, travel, bourbon and the news.
By the end of the session, she and I were very pleased with her progress. She could lift her elbow above her shoulder and reach back toward a throwing position. It was not perfect. There were still significant problems but she could do a lot more with her arm. We both had big smiles.
She came back to see me a couple of weeks later. Her physical therapist and massage therapist were surprised at the progress in her shoulder. They asked her what I had done. The usual responses are: I don’t know. He pushes on things. He works on my head a lot. It isn’t really “massage.” Sometimes it’s a little tender. I’m better when he’s finished. You should probably just look at his website.
She still had most of the range of motion that she had when she left but her complaints had changed a bit. I was happy about that. She complained about a spot in the back of her shoulder that hurts when she reaches up or forward. Trigger point assessment told me where to start.
Again, I tested and pushed on things while we talked about our kids for about an hour and a half. She got up and had more range of motion and, again, a big smile.
Her shoulder is improving nicely. She has grandkids to hold. She has suitcases to carry. She has bourbon to drink. She has flowers that need to be planted. She is doing more than surviving. She is getting back her quality of life.
This site is undergoing changes. Starting in early 2020, we began improving the format. We are also adding more extensive self-care, illustrations, therapist notes, anatomy, and protocols. We appreciate your input and feedback. You will see us adding posts and updating older posts as time permits.
Tony Preston has a practice in Atlanta, Georgia where he sees clients. He has written and taught about anatomy, trigger points, and cranial therapies since the mid-90s.
*This site is undergoing major changes. We are reformatting and expanding the posts to make it easier to read. The result will also be more accessible and will include more patterns with better self-care. In the meanwhile, there may be inconsistency in formatting, content presentation, and readability. Until we get older posts updated, please excuse our mess.