Rotator cuff surgery/post op massage?

[Craven]

Hi, I have a client who is 4 weeks post op rotator cuff surgery via scope procedure. This is her second cuff surgery on same arm. Client tripped and fell on shoulder. She's currently seeing PT with limited success. She asked to have massage and  my first eval. finds her extremely tender in deltoid as well as entire scapula area. I can only do very light strokes. She has difficulty laying on stomach, back and side for any length of time.

She has some range of motion but cannot abbduct her arm at all. This was an eval. of many things including pain tolerance, comfort with position, how touch was tolerated. She almost seems hypersensitive to touch.

Anyone encounter this with a client? Any tips?

:-/


???

 

[Pompal 09.]

Sounds to me as if one of the problems is the area has been traumatized.  First the fall, then the surgeries.  Part of the problem could be the fact she is hypersensative to your touch because she is protecting.  Trying to mentally protect it from additional pain. If she were my client I would have her mentally focus in on the area you are working.  Tell her to just let the pain run its course.  Describe the pain to you as she feels it setting in and then backing off.  As she is doing this do not massage.  Either remove hands or simply set them on her shoulder or back.  When a trauma like hers occures, the brain doesn't complete the process of riding out the pain.  (Kind of like when you rack your shin into a coffee table-Ouch!)You just have to ride it out.Help her to do this and maybe your progress will then be able to move along a little smoother.Let me know if this helps.Good Luck,Email me if you would like,Jenny, LMT

 

[Teh]

4 weeks post-op is really very recent for any kind of surgery.  When I see clients who have had surgeries as new as this one, I usually work very gently and almost energetically to enhance the healing process in the area.  I would make sure I did a little cross fiber friction on the tendons involved at each sesssion however.  Any range of motion work would be very limited, and I would take my cues from the PT.  In general, my goal would be to enhance the healing process with deep relaxation.  In 4 more weeks I would look at doing some deeper work in increments.  I get the impression from your post that the client is looking for a fully functional shoulder as soon as possible (if I'm wrong please correct me).  The best thing you can do for this client is to help her understand that healing is truly a multilayered process.  It can be encouraged with the right amount of nurturing and skill, but never rushed.My $.02.  Hope it helps.Cassandra

 

[Sue C]

Rotator cuff surgery/post op massage?

Thanks Cassandra and Jenny: I had another session and decided to do light lymphatic on her deltoid/scapular areas, while I massaged the right side of her entire back. She left that session completely relaxed and rested. We agree that this is how we'll procede and if she needs more sessions, she'll get approval. I see her twice a week. I'll keep you posted.

 

[How dry a yam]

Rotator cuff surgery/post op massage?

Another link on our forum regarding Rotator Cuff:

Rotator cuff help!!!!! http://www.massageplanet.com/forum/viewtopic.php?t=2448

 

[raised by chimpz!!!]

That area of her shoulder has been traumatized and I bet the myofascial tissue around that area has hunkered down on it tight and is not letting it move.  Maybe try a connective tissue approach with very minute stretching to try gradually increase the range of motion.