As a follow up to "Leveling the Landscape", a previous post that I made, I want to present an analogy for scapular region pain. A situation presented itself again today that brought this to mind.
“Knots” in the rhomboid and scapular region seem to get all sorts of interventions. Massage, trigger point therapy, injections, stretching, heat, ice, etc are all common. My least favorite thing to hear is that a patient’s physical therapist is trying to strengthen this area, as if weakness is the cause of pain. With any of these interventions, the pain will lessen or go away, but usually not for long.
What happens when you get a pebble in your shoe? The answer should be pretty obvious; remove the pebble or the pain will continue. What happens if something under the shoulder blade rises to irritate the soft tissue? Spasm and pain will result. That something is usually a rib(s). Cause of such an occurrence can vary, and can be acute or chronic in nature. In my experience, unless you intervene to change the landscape of the ribcage/spine, the pebble will continue to irritate.
In my Foundations in Myofascial Release I Seminar, I introduce techniques to “Level the Landscape” of the ribcage. Myofascial Release holds a wealth of potential for making permanent changes to the thorax and beyond. Check out my upcoming Foundations I Seminar in Rochester, NY on my website. Integrating soft tissue release to the myofascial elements of the trunk are only part of the solution. The therapist must go deeper into engaging the ribs and spine. The gentle, sustained pressures allow the holding of the muscle and fascia to lengthen and the ribs to return to position and to their normal flexibility. Usually, far reaching treatment must be done at the pelvis and elsewhere.
The pebble in the shoe is an annoyance. You only need learn how to remove it.

