I found a similar pattern described by Travell and Simons in the Serratus Posterior Superior muscle, which lies deep to the Rhomboids – the third layer of muscle tissue down, beneath the Trapezius and the Rhomboids.  The muscle originates on the spinous processes of the vertebrae, out to the cranial surface of ribs 2 through 5.  It assists in breathing by drawing the ribs superiorly and posteriorly.  When it refers pain, it commonly refers into the anterior surface of the deltoid, and down into the forearm extensors.

So, I place my client prone and place the scapula bone abducted, away from the spine.  This exposes the likeliest location of the SPS’ trigger point, the attachment spot at the second rib insertion.  Stretching the trapezius and rhomboid lengthen and thin out their tissues, allowing me to access the deeper layers of muscle with less effort and more accuracy.

That’s one reason I love my robot table so much; it lets me put my clients into comfortable, fully supported positions that allow me to more effeciently and effectively access tissues that are much more difficult to do on an ordinary flat table.

When I palpated the client’s insertion on the second rib, the referred pain pattern in his forearm and front of the deltoid was elicited, and I felt a moment of relief, happy that I had correctly found the source of the pain.  Since the muscle is so deep, feeling its tissues becomes easier when one moves the scapula out of the way, and lengthens the shallower muscles.

Using a vaulted hand, I applied ischemic compression into the trigger point, which slowly shrank away.  I think part of what is happening is that the ribs are being pulled enough to impinge upon the pathway of the brachial plexus, compressing the nodes that ennervate the anterior deltoid, and forearm extensors.

The client reported the absence of numbness at the conclusion of the session.  The client’s physician had thought that it would take a good massage therapist to be able to access this layer of tissue, and that an injection would probably have been necessary to alleviate the pain.  I am hopeful that that the more invasive approach will not be necessary.  My next steps will probably involve the application of ice for 20 minutes to the area before attempting a shiatsu compression with the client’s breath to stretch the muscle.  I can modify my table to provide excellent side-lying support by changing out the head cushion and using the U-shaped chest cushion.  I love my table!

Anyway, the challenges and satisfaction at being able to find touch-related pain relief for people is very gratifying for me.  It’s fun and rewarding to help other people.

I’ll be there with my massage chair, doing massage for donations to Team Bear. Also, I’ll be raffling off a two-hour massage gift certificate (not a one-hour like it says). Sister Mary Juanita High will be blessing the riders and roadies, too, and we’ll have music – lots of music! Ejector and DJ Agent Adam will both be providing music.

B-Unit is located at 2111 Franklin Street in Oakland at the Bench N Bar.

If you can’t make it, you can donate here.

We started talking about how my work isn’t just about me trying to make money from my clients, but about helping them know themselves on a deeper level, and about knowing that the work that I do ripples out from me into the world, making the world a better place. I told her that a one of the biggest parts of connecting with clients is in turning off my own ego during the work sessions, and communicating that to my clients so that they know that my sole focus is them and the work we are doing together.

But how do I communicate that to my clients, she asked. I told her that it all starts with the very first moment that the client comes into my presence. I look at them in the eye, smile, breathe fully, welcome them to my studio. I listen to them, ask questions of them that show I have been listening, yet I keep control of the session so that they feel safe and have confidence in me. I move and speak slowly, calmly, not rushing, to let them know that they can do the same, to relinquish their burdens for a time. The first touch is performed calmly, but confidently, slowly, with gentle strength, to let them know that my touch is completely controlled and intentional. I will often spend a few moments palpating their body, feeling the places where they are holding, guarding, or are in pain or injured. This communicates to them that I am giving thought to their needs and planning out how I want to work with them. In short, I told her, I make it all about them, and not about me.

I give them an experience of knowing. Of knowing that they are utterly safe and cared for. Of knowing that they have nothing to do but simply be. Of knowing that they are worthwhile and dignified creatures, respected and loved. Of knowing themselves on a more deep level than before.

Finally, I said to her that service to others was the highest form of living, and through serving others we find transcendence and inner peace. Service to others is what creates a loving and more peaceful world, and is something we should all strive for in our small corners of that world.