Move Better, Feel Better: A Movement Based Approach to Soft Tissue Mobilization for the Upper Body: Summary 41
UPPER QUARTER TREATMENT
Cervical/Upper Thoracic
Body Region
Shoulder/Upper Arm Elbow/Forearm
Locations
Upper trap, levator scapula, paraspinals
Anterior and posterior line Static without patient movement Static with patient movement (pin and stretch) TDM without patient movement (clocking, long strokes) TDM with movement (post shoulder during horizontal abduction/ internal rotation/ external rotation or triceps with overhead movement)
Epicondyles, wrist flexors, wrist extensors
Treatment Techniques Static cupping with and without patient movement (pin and stretch) TDM with and without
Static without movement (epicondyles)
Static with movement (over wrist extensors during wrist flexion) TDM over flexors/ extensors TDM with movement (proximal → distal or distal → proximal)
patient movement (cervical flexion or side bending) Move in different directions
CASE STUDY
John is a 45-year-old male with neck pain that is worse with forward bending of his neck. At work he does a lot of reaching, which sometimes causes referred pain in his right upper arm. John has relief with IASTM but feels he needs something more “intense” to break up his pain. Would you do cupping and if so, what type? Answer: • Add TDM over the upper trap/levator area as well as along the paraspinals of cervical/thoracic junction • Could progress to adding side bending for upper trap and cervical flexion for paraspinals • Use static cups over the affected area and do active stretching of the cervical spine
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