therapy-notes

Therapist Notes – Pain inside shoulder blade when slouching while seated

Pain between the shoulder blades is seldom rhomboids unless the client has trapped the rhomboid muscle against a hard surface or they have extremely imbalanced extrinsic back and extrinsic chest muscle. When the problem is postural, the shoulders and upper back are notably rounded or the upper back is very straight and shoulder blades are …

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Therapist Notes – Serratus Posterior Superior

Serratus posterior superior is strongly governed by the costovertebral joints of the upper thoracic spine. These fixations are almost always associated with locally displaced vertebrae, especially the shearing of C7 and the upper thoracics in Forward Head posture. Serratus posterior superior is involved in shoulder pain over 90% of the time and should be checked …

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NMT Protocols – Posterior Scapula

This protocol focuses on the rotator cuff tendons, called the SITS tendons as an acronym for the four muscles, supraspinatus, infraspinatus, teres minor, subscapularis. It works well when it follows the treatment of the sub-occipitals, lamina groove and SITS tendons. These two muscles are the primary targets of treatment in this protocol.

NMT Protocols – SITS Tendons

This post reviews the anatomy of and may be helpful before reviewing this protocol. This protocol focuses on the rotator cuff tendons, called the SITS tendons as an acronym for the four muscles, supraspinatus, infraspinatus, teres minor, subscapularis. This protocol works well when it follows the treatment of the sub-occipitals and cervical lamina.

Therapy Notes – Serratus Anterior

This muscle is often overlooked and not treated until other muscles, which produce similar pain patterns, have been treated. These patterns include scalenes, rhomboids, erectors, pectorals, and multifidi. Serratus anterior can be hard to resolve when the shoulder girdle is chronically protracted by a weight problem. The chronically protracted shoulders act as a counter-balance to …

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Therapy Notes – Scalenes

Palpation Structural anomalies are common in the scalenes. Developed palpation skills are needed to reach the proper belly for assessment and treatment. Be aware that the lateral tip of the cervical transverse process is blunt and puts significant space between the attachments of the anterior scalene on anterior tubercle and the attachment of the scalenes …

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Stretching for scalenes

Here are some specific stretches that have been recommended by many sources over the years. They were published in the self-care section on scalenes in the research of Janet Travell, the physician to two presidents. Clinical experience has proven them to be effective for helping the problematic effects of tight scalene muscles. In this post, they …

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