Case Study: “Harold” – Part One

Client is an 81-year old man who woke up in the middle of the night with chest pains. After the doctors determined that he was not having a cardiac episode, they prescribed a bunch of pain meds and muscle relaxants. The meds gave him bad constipation and he lost his appetite and 20 pounds, which on him was far too much weight to lose, so he was keen on finding a non-medical solution to his pain.

He experienced pain and/or limited range of motion in shoulder flexion, abduction, lateral rotation, protraction and retraction. Was unable to upwardly rotate shoulder. Extension, adduction, medial rotation, retraction were within normal limits. After assessing his range of motion, we began the session.

Working on the elderly requires a very deft and gentle touch. Their skin is very fragile and easily torn, and it is important to work to create a comfortable group of positions for them to recline, as their joints are often painful and makes difficult prone or supine positions for very long.

This particular man required trigger point work in his subscapularis and serratus anterior muscles, which have insertions on the anterior surface of his scapula, which means going in through his axilla to access the muscles. Also, his infraspinatus, supraspinatus, levator scapula were all very tight and required work as well. Using very slow, gentle pressure, I was able to get the subscapularus trigger points released, as well as relaxing the posterior rotator cuff muscles and levator scapula.

Recommended a weekly appointment for the next four weeks to continue making progress.