Soft Tissue Massage for Shoulder Pain

Soft-tissue Massage for Shoulder Pain
Soft-tissue massage improved range of motion, reduced pain and improved function in people with shoulder pain, according to a research study.

"A trial into the effectiveness of soft tissue massage in the treatment of shoulder pain" was conducted by staff at Auburn Hospital and Concord Repatriation General Hospital in Sydney, Australia.

Twenty-nine subjects who had been referred to the Concord hospital for management of shoulder pain participated in the study. Their medical diagnoses varied, but impingement, rotator-cuff tear and unspecified shoulder pain were the most common diagnoses.

Fourteen of the participants were randomly assigned to the control group, where they were placed on a waiting list for massage and received no treatment for two weeks.

Fifteen of the participants were randomly assigned to the massage group, where they received six sessions of soft-tissue massage around the shoulder for two weeks. The massage included the lateral border of the scapula, in full shoulder flexion; posterior deltoid, at end-of-range horizontal flexion; anterior deltoid, at end-of-range hand-behind-back; and pectoralis major, in the stretch position. Each session lasted 15-20 minutes.

Active range of motion was evaluated for flexion, abduction and hand-behind-back movements before and after the study. Pain was assessed on the Short Form McGill Pain Questionnaire, and functional ability was assessed with the Patient Specific Functional Disability Measure, both before and after the study period.

Subjects in the control group showed no significant improvements from the beginning to the end of the two-week period. Subjects in the massage group showed significant improvements in all measures, with a mean improvement of 22.6 degrees in flexion; 42.2 degrees in abduction; and the ability to reach a mean of 11 centimeters further up the back. Subjects in the massage group also reported decreased pain and improved function.

"This randomized, controlled trial has shown that soft tissue massage around the shoulder in subjects with shoulder pain of local mechanical origin produces significantly greater improvements in pain, function and range of motion than does no treatment over a two-week period," state the study’s authors.

"The fact that these patients improved with such a wide range of diagnoses points to the potential generalisability of the effects of this massage in patients with shoulder pain of local mechanical origin."

- Source: Auburn Hospital and Concord Repatriation General Hospital in Sydney, Australia. Authors: Paul A. van den Dolder and David L. Roberts. Originally published in the Australian Journal of Physiotherapy 2003, Vol. 49, pp. 183-188.

Stress and Health Stress: How It Affects Your Body, and How You Can Stay Healthier

Types of Stress

Stress can be defined as any type of change that causes physical, emotional or psychological strain. However, not all types of stress are harmful or even negative. There are a few different types of stress that we encounter:

• Eustress, a type of stress that is fun and exciting, and keeps us vital (e.g. skiing down a slope or racing to meet a deadline)
• Acute Stress, a very short-term type of stress that can either be positive (eustress) or more distressing (what we normally think of when we think of ‘stress') ; this is the type of stress we most often encounter in day-to-day life (e.g. skiing down said slope or dealing with road rage)
• Episodic Acute Stress, where acute stress seems to run rampant and be a way of life, creating a life of relative chaos (e.g. the type of stress that coined the terms ‘drama queen’ and ‘absent-minded professor’)
• Chronic Stress, the type of stress that seems never-ending and inescapable, like the stress of a bad marriage or an extremely taxing job (this type of stress can lead to burnout)

The Fight or Flight Response

Stress can trigger the body’s response to perceived threat or danger, the Fight-or-Flight response. During this reaction, certain hormones like adrenalin and cortisol are released, speeding the heart rate, slowing digestion, shunting blood flow to major muscle groups, and changing various other autonomic nervous functions, giving the body a burst of energy and strength. Originally named for its ability to enable us to physically fight or run away when faced with danger, it’s now activated in situations where neither response is appropriate, like in traffic or during a stressful day at work. When the perceived threat is gone, systems are designed to return to normal function via the relaxation response, but in our times of chronic stress, this often doesn’t happen enough, causing damage to the body.

Stress and Health: Implications of Chronic Stress

When faced with chronic stress and an overactivated autonomic nervous system, people begin to see physical symptoms. The first symptoms are relatively mild, like chronic headaches and increased susceptibility to colds. With more exposure to chronic stress, however, more serious health problems may develop. These stress-influenced conditions include, but are not limited to:

• depression
• diabetes
• hair loss
• heart disease
• hyperthyroidism
• obesity
• obsessive-compulsive or anxiety disorder
• sexual dysfunction
• tooth and gum disease
• ulcers
• cancer (possibly)

In fact, most it’s been estimated that as many as 90% of doctor’s visits are for symptoms that are at least partially stress-related!

What You Can Do

To keep stress, especially chronic stress, from damaging your health, it’s important to be sure that your body does not experience excessive states of this physiological arousal. There are two important ways to do this:

• Learn Tension-Taming Techniques: Certain techniques can activate your body’s relaxation response, putting your body in a calm state. These techniques, including meditation, yoga, deep breathing exercises, journaling and positive imagery, can be learned easily and practiced when you’re under stress, helping you feel better relatively quickly.
• Prevent Excess Stress: Some acute stress is unavoidable, but much of the episodic acute stress and chronic stress--the stress that damages our health--that we experience can be avoided or minimized with the use of organization techniques, time management, relationship skills and other healthy lifestyle choices.

Seeking Professional Help

Sometimes stress becomes so great that people develop stress-related disorders or need the help of medications, herbal treatments or the aid of a professional. If you experience excessive anxiety or symptoms of depression, find yourself engaging in unhealthy or compulsive behaviors, or have a general feeling that you need help, talk to your doctor or a health care professional. There is help available, and you can be feeling better and more in control of your life soon.

Whatever your situation, stress need not damage your health. If you handle your stress now, you can quickly be on the road to a healthier, happier life.

By Elizabeth Scott, M.S.,