Muscle News Vol I.26:  Serratus Posterior Superior  
 
Pain in the Shoulder Blade, Elbow & Hand  That Nothing Relieves?
Happy Spring! 

This issue of Muscle News covers an aggravating pain in the shoulder, hand and arm that nothing seems to relieve.  We will show you The Secret technique to treating one of the most frequently missed and mistreated trigger points in the human body - the Serratus Posterior Superior!

One of the critical aspects that makes Myofascial Trigger Point Therapy uniquely effective is using the proper technique!  Anyone can press on a muscle - It is knowing how, when and where to press that separates successful trigger point therapy from the pack. The Serratus Posterior Superior illustrates just how important the right technique is.

Too many people suffer needlessly from a deep steady ache in the shoulder blade that runs down the arm to the tip of the elbow and into the pinky.  This referred pain is sometimes misdiagnosed as Thoracic Outlet Syndrome.

Look at the referred pain pattern to the left of the Serratus Posterior Superior.  This simple trigger point causes deep achy pain beneath the shoulder blade (the front of the chest, as well) and runs down the arm to the tip of the elbow and into the little finger of the hand.  Because the Serratus Posterior Superior doesn't move any limbs (instead it's an accessory breathing muscle), you can't find a relieving position no matter where you place your shoulder, arm, neck or hand.  The pain is steady and won't go away no matter what you do!  This trigger point can practically drive you crazy and has evaded relief because of a simple step that is often missed or overlooked in the treatment technique. 

Let's take a look at why this muscle is often not treated properly:

As shown, the Serratus Posterior Superior originates along the spine of upper back and then reaches out and down to grab onto the second through fifth ribs.  It is a deep muscle whose purpose is to elevate the ribs when breathing deeply.

The problem is that its most common trigger point (shown by the yellow X's) lies beneath the shoulder blade where you can't reach it!  Because of its hard to reach trigger point, this muscle is rarely treated properly, which is unfortunate because the symptoms can be very aggravating.

The goods news is that there is a secret to treating this trigger point, which we will now show you.  If you or someone you know suffers from these symptoms, have them try this technique below!

*The information in this article is not intended to diagnose or treat any medical condition and does not substitute for a thorough evaluation by a medical professional.  Please consult your physician to determine whether these self-care tips are appropriate for you.


The Secret to Treating TP's in the Serratus Posterior Superior:

Key #1:  Get the Shoulder Blade Out of the Way











Because the trigger point is buried beneath the shoulder blade, the first key is to move the shoulder blade out of the way.  This is accomplished by bringing the arm all the way across the chest, holding and supporting the elbow with the opposite hand.  In the picture above, you can see how the right Serratus Posterior Superior trigger point is now exposed and accessible with the arm across the chest, whereas the left side is still hidden beneath the shoulder blade.


Key #2:  Ball Against the Wall

Because you will not have any hands free while holding your arm across your chest, the second key is to perform the trigger point compression standing with a self-care tool (tennis ball shown here) between you and the wall. 

Search for tender spots and lean into the ball to compress them.  Compress to a tolerable level of discomfort 8 - 10 seconds per tender spot or approximately 2-3 full breaths in and out.

 

Stretching:  Breathe and Let Your Shoulders Drop

Because the Serratus Posterior Superior doesn't move any limbs, there aren't too many ways to stretch or move it through its range of motion.  The best exercise is simply some good full breathing a few times throughout the day. 

Another thing you can do is avoid having your arms elevated for long periods, such as working at a high desk or overhead.

Most importantly, when you feel that deep ache in your shoulder blade, arm or hand, perform the compression with the ball on the wall and the arm across the chest.  You could save yourself a lot of pain and aggravation.  Please pass this information on!
  
  
Sincerely,
  
Your Friends at The Pressure Positive Co.
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Link Highlights:

NAMTPT LOGO National Association  of Myofascial Trigger Point Therapists

________________
The Trigger Point Therapy Workbook: Your Self Treatment Guide For Pain Relief. 3rd Edition
by Clair Davies NCTMB (Author), Amber Davies CMTPT LMT (Author), David G. Simons MD (Foreword)
This book addresses the problem of myofascial trigger points-tiny contraction knots that develop in a muscle when it is injured or overworked. Restricted circulation and lack of oxygen in these points cause referred pain. Massage of the trigger is the safest, most natural, and most effective form of pain therapy. Trigger points create pain throughout the body in predictable patterns characteristic to each muscle, producing discomfort ranging from mild to severe. Trigger point massage increases circulation and oxygenation in the area and often produces instant relief.
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Our goal is to help people manage muscle discomfort by providing useful, safe, simple, and inexpensive massage tools to help facilitate trigger point and myofascial release.

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