Scaleni and Rhomboidus

[bernard]

Hi Somasimplers,

Sometimes with shoulders problems, we encounter scaleni and rhomboidus contractures. They are hard to relieve?
I tried that one with very good results.

Patient is sitting and we demand an active, focused movement of painful shoulder frontward and in direction to the opposite shoulder. The movement is made against resistance. The movement is released with the same muscles.

So there is two phases;
1/ frontward with pectoralis, SCM..
2/ backward with the same ones but the resistance diminishes and the strength, too!

The movement is pain free.

[emad]

Hi Bernard ;

do u mean retraction and protraction.


cheers
emad

[bernard]

Emad,

I do not think so.

The movement is done with the shoulder in a horizontal plan (i.e. for L shoulder). The shoulder goes frontward and to the right (a kind of diagonal). The arm stays along trunk.

They are the same muscles that are doing the job, in a direction and the opposite. It breaks the agonist/antagonist couple and restores a balance in functional movements.

[nari]

Bernard

Horizontal adduction, which I think you are describing, is a test for a number of nerves as well. Supraclavicular, etc, but the nerve supply to Rhomboids is buried in the scalenes, too. Remember you are stretching and activating muscles, but also doing neural mobilisation as well.
Muscles do not, I understand, get 'tight' by themselves unless underlying neural function is poor.


Nari

[Nacho]

Hi. I think that the best for rhomboidus contractures is the scapular movilization in diferents patterns like elevation, abducction and external rotaion and depression, abduction and internal rotation. First only movilization and then with resistence of the abduction.
After this you can do, in supine, both arms gos to the opposite hips. Bilateral patterns of Kabat (extension, aduction and rot int).
And I´m agree that the nerve wich suply the rhomboidus is buried in the scalenes so I do a deep massage in the scalenes with the patient in lateral position.

Nacho

[Diane]

Hi Nacho, welcome to the board. I've not heard of Kabat exercises.. Will you or Bernard please say more? Any link?
Thanks,
Diane

[bernard]

Diane,

Herman KABAT was one of the fathers of Proprioceptive Neuromuscular Facilitation

http://homepages.ulb.ac.be/~jduchat/files/Guissard%20&%20Duchateau%20(2004).pdf

http://nsca.allenpress.com/nscaonline/?request=get-abstract&doi=10.1519/1533-4287(1999)013<0193:TIOVRA>2.0.CO;2

All his techniques are used in post-strokes problems. Internet is poor about his works :cry: .

[bernard]

Diane,

That one seems better =>
http://www.sharpman.com/Article.asp?ArticleID=637

I think the works of Dr JANDA is also relevant since they are based upon Kabat ones.

[Diane]

Thanks Bernard. I know all about PNF, didn't know Kabat was founder. The PNF I learned many decades ago was large limb diagonal movements that included rotation with either flexion or extension of kees/elbows, and were carried out against therapist's resistance (either mild or maximal.) This page presents a bit differently, sounds more like what I learned as contract relax.
Cheers,
Diane

[bernard]

Diane,

As I said, I use only the diagonal and rotation scheme but limited here to shoulder. In fact, it becomes a very short diagonal movement! :wink: And the stretch is not done.

[Nacho]

Hi !! Thanks for de welcome!

Sorry Kabat is the same that PNF.
PNF have a lots of movments, not only the clasical diagonals and rotations of the arms and legs. The scapular has 4 diagonals wich participated in the whole limb movment. Or, like I sais, you can use this scapular diagonals alone with the patient in lateral position working only the scapula.
There are neck patterns wich are very helpfull for the scalenes, to descompress this zones doing movilization and contracting the antagonists.

Nacho