torn muscle - ripped muscle - muscle tear ??

Vanessa M

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Hey guys. I did a search, but oddly couldn't find anything. In fact, I scoured all my books at home and still oddly could not find anything on a torn muscle.

I have a client who is presenting pain in his deltoid, superior (proximal) to the deltoid attachment on the humerus, roughly on the medial (to anterior) aspect of the deltoid. He also has sensitive trigger points pretty much everywhere in his upper back/shoulders area. He's been injured many times (serious car accident, roping steers, etc). He re-injured this recently when lifting weights.

He is going to get an MRI soon, but not before I work on him next and he thinks "his muscle is torn" also "it's not rrrtatercuff", his doctor told him. lol. Love doctors and their view of muscles. His doctor also told him that his erector spinae was his "tenderloin." uhhhmmmmm. yeah. (hello psoas!)

Anyway, I'm interested in any ideas on treating this, but mainly I'm wondering that if it IS torn, is it contraindicated to work the area (that he thinks is torn)? Obviously the whole muscle is not torn, just possibly a portion of it. He feels the pain mainly when he reaches his arm straight forward, perpendicular to the ground.

I've worked trigger points and did fascial meltling in all the major nearby areas including subscap, pec minor, supraspinatus, traps, rhomboids, pec major, both teres, and more. I have not addressed much of biceps, or brachioradialis. This helped the pain for a day or so, and then it came back. Then he did more roping and then it got a lot worse. He has promised no roping and we are planning 3 sessions within the next week paired with his self care to hopefully start to take care of it. He is very self motivated and has an ultrasonic machine at home that he just started using.

Any comments welcome. But mainly I'm wondering about the torn muscle thing. Would it make it work to do deep work over an area of muscle that is torn? Or are tears relatively normal and cause pain but benefit from deep work? Also, if you know where they mention it in a book that would be very helpful as I am completely freaked out that I can't find what seems to be the most basic think in any of my extensive massage book collection. (or maybe it's not extensive?) :) Thanks.
 
torn muscle - ripped muscle - muscle tear ??

shivashiva said:
I have a client who is presenting pain in his deltoid, superior (proximal) to the deltoid attachment on the humerus, roughly on the medial (to anterior) aspect of the deltoid.

Anyway, I'm interested in any ideas on treating this, but mainly I'm wondering that if it IS torn, is it contraindicated to work the area (that he thinks is torn)? Obviously the whole muscle is not torn, just possibly a portion of it. He feels the pain mainly when he reaches his arm straight forward, perpendicular to the ground.

But mainly I'm wondering about the torn muscle thing. Would it make it work to do deep work over an area of muscle that is torn? Or are tears relatively normal and cause pain but benefit from deep work? Also, if you know where they mention it in a book that would be very helpful as I am completely freaked out that I can't find what seems to be the most basic think in any of my extensive massage book collection. (or maybe it's not extensive?) :) Thanks.

hi shiva. actually, massage is indicated for muscle tear. this info comes out of a MTs guide to pathology. hope it helps.

Strains
Defintion: What are they?
Strains are a subject of semantic debate. Some people say that the word strain applies only to tendon tears; others insist it refers only to muscle tears. In this text, the word strain will refer to an injury to the muscle-tendon unit, with an emphasis on muscles.

Is massage indicated or contraindicated?
Muscle strains indicate massage, which can powerfully influence the production of useful scar tissue, reduce adhesions and edema, and reestablish range of motion. Once a thrapist has a clear picture of what structure or structures have been injured, various kinds of lymphatic drainage techniques can help to limit edema. Cross-fiber and linear friction can influence the way old scar tissue matures and new scar tissue lays down. Passive stretches of healing muscles can also influence the correct alignment of collagen.
pg. 82-85 third edition
 


Definitely work on it... your main goal is to make sure that the blood flow is maintained in the area. Increasing the flow is the best thing for it... as is teaching him how to cross fiber friction the area that is in pain, so that it promotes the muscle fibers healing and not forming adhesions where he doesn't want them... also ice and heat to comfort level... and probably some arnica on the area...
 


another thing,

i was looking at my nmt book, and checking the trigger point zones.

of course the anterior fibers of deltiod should be investigated. scalenes can even refer strongly to that part of the shoulder. so does supraspinatus, which might tie in with pain with shoulder flexion. besides pec major, biceps brachii has strong referal in the area you describe, as well as coracobrachialis (roping steer???) and brachialis had a more mild referral to that area.

obviously once he has the mri done, you will know more about which muscle(s) have injury and which are compensating.

on a side note, i am working with a pregnant client. she has a diagnosed tear of the biceps brachii long head. she won't be able to get the needed surgical repair until after the baby is born and at least old enough that she doesn't always need both arms. she gets a lot of tension head aches from holding her arm in medial rotation to protect it. she has a history of subluxation of both shoulders, and was a competitive swimmer and now teaches (coaches) swimming. (her workouts have prevented her from having torn rotator cuff muscles.) she appreciates cervical and scalp work, as well as all the work around her shoulder girdle, she particularly likes when i strum medially along the bicep long head tendon. maybe the massage will be so effective over the next 2 or 3 years that she won't need the surgery after all. i guess that is what we all kind of hope for.
 


Yes, the long head of the biceps helps to stabilize the glenohumeral joint so it is a very important muscle in terms of shoulder stability and function.
 


Thanks all! Now that I look back on my question and the simple answer (yes, work on it) I feel kinda silly. Of course we work on these things! And I probably have a million times. But he repeated the word "torn" several times and I started getting this image of me digging into a "torn" muscle and it made me hesitant. ccMarie, the quote from your book really helped, and realizing that I am keeping blood flow going and prohibiting scar formation are good images to have in my mind.

I will definitely address all the areas that have been mentioned, especially the biceps and close-by muscles that I hadn't given as much thought to.

and good luck with your pregnant woman, ccMarie! :)
 


shivashiva said:
and good luck with your pregnant woman, ccMarie! :)

thanks, she is actually my brother's gf, so i should become an aunt, sometime in november...

:)
 


Remember that what a client thinks they have isn't always so. If the muscle was strained, sprained or actually sustained a good tear, you should be able to palpate it. It will feel very different than healthy tissue. Do what you are doing already and then when the verdict comes in, change your work for what is needed.

Since your work helped his pain for a couple days, you are on the right track. Try not to get disheartened because the pain returned. That is completely normal--things won't resolve instantly, especially since most musculoskeletal problems have been developing over time before the client is usually really affected by them.

If the 'tear' is recent, you wouldn't want to use deep tissue work over the specific area anyway for at least two to three weeks. Generally, pain over the deltoid is usually local and not referred from another source. And this is not to say that the related areas don't need work.
 


I worked with a client once who had TORN (as in torn off the tendon) his biceps and b/c he didn't have insurance he never went in. Yeah as in to the doctor. So 2 years and medical insurance later he's at the chiro with several upper trap pain that caused major restrictions in his cervical region. (ie - "I gots this crick in my neck").

Anyway - the muscle has completely reattached and healed in a location lower down from the shoulder joint where it usually sits so it was very odd to work on. But yeah - even with major tears.....especially older or chronic injuries, massage can be VERY helpful. Releasing some of the fibrotic and super tight/restricted areas really gave him a lot of relief and restored most of his range of motion. Not sure it would ever have matched the other side but he could twirl a rope again, ride his horse again and swing a hammer to fix fence (he hadn't been able to raise his arm above the shoulder level AT ALL when he first came in.

I ALWAYS tell my clients with chronic pain like that - it is two steps forward and one step back adn that is totally normal. I usually say "It took a lot of years of abuse to get in this shape and it will take me more than one hour to help you clear it up." which helps them not get impatient.

Angela
 
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  37. Golden Sunshine Spa:
    โœจClick on our Username and FOLLOW US for updates and special services ! โœ… Click Here Today๐ŸŒธSamy๐ŸŒธPriya๐ŸŒธLynda๐ŸŒธAletta๐ŸŒธIsabella๐ŸŒธIvy Call us โ˜Ž 905 - 265 - 2158โ˜Ž๏ธ Your ultimate service awaits! โœจ
  38. DareDevil:
    366 ARIA WELLNESS โ™ฅ๏ธโ™ฅ๏ธADDRESS: 360 HWY 7, UNIT #6, RICHMOND HILL,647-222-5683 โ™ฅ๏ธโ™ฅ๏ธ(PHONES CALL ONLY, NO TEXT'N AVAILABLE) โ™ฅ๏ธTODAY'S Schedule!โ™ฅ๏ธ Loaded lineup with Beautiful Girls : New young RMT student Helen, Fun girl Apple, Magical Mia and Work out๐Ÿ‹๐Ÿšด๐Ÿ’ช Babe Amy! SPECIAL PROMO 30 MINS 2 GIRLS $70 ๐ŸŒน๐ŸŒน**TODAY'S PICKS OF THE DAY ARE ๐Ÿฌ๐Ÿญ APPLE AND HELEN๐Ÿฌ๐Ÿญ**
  39. Soul Relax Spa:
    โœจ Looking for a relaxing escape? โœ… Click Here Meet๐ŸŒธCarly๐ŸŒธBrandy๐ŸŒธKellyCall us today for the best treatment and service experience. Click on our Username and FOLLOW US for updates ! Call now โ˜Ž 289 - 298 - 5662โ˜Ž๏ธ Your ultimate relaxation awaits! โœจ
  40. Spa in Markham:
    GOLDEN FS โ€“ 8380 Kennedy Rd ๐Ÿ“ž 905-258-0777 / 416-688-6886 ๐Ÿ‡ญ๐Ÿ‡บ VANESSA, ๐Ÿ‡ป๐Ÿ‡ณ JULIE (2PM), ๐Ÿ‡จ๐Ÿ‡ด MEGAN (8PM), ๐Ÿ‡ป๐Ÿ‡ณ KELLY, ๐Ÿ‡ฎ๐Ÿ‡ณ SONIA (8PM), ๐Ÿ‡ป๐Ÿ‡ณ JESSIE ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookinggoldenlove
  41. FLOWER Spa - BLUEXADO | Thornhill | VAUGHAN:
    BLUEXADO FS โ€“ #06-1102 Centre St ๐Ÿ“ž 416-357-9797 / 416-678-8668 ๐Ÿ‡ป๐Ÿ‡ณ CICI, ๐Ÿ‡ป๐Ÿ‡ณ AMY, ๐Ÿ‡ป๐Ÿ‡ณ SHERRY ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookingbluexadolove
  42. FLOWER Spa โ€“ PINK | Scarborough | TORONTO:
    PINK FS โ€“ 3300 McNicoll Ave ๐Ÿ“ž 416-299-5515 / 416-817-3839 ๐Ÿ‡ฎ๐Ÿ‡ท ELINA, ๐Ÿ‡ต๐Ÿ‡ญ MADY, ๐Ÿ‡ธ๐Ÿ‡ฌ CANDY, ๐Ÿ‡ป๐Ÿ‡ณ NANCY ๐Ÿ”Ž View Schedule: bit.ly/flowers_schedule ๐Ÿ›Ž๏ธ Booking Now: bit.ly/bookingpinklove
  43. SpringGreen.:
    Today we have 5 girls on downtown Toronto 72 gerrard st west๏ผš๐Ÿ’‹๐Ÿ’‹ New girl Hitti very young๐Ÿ’‹๐Ÿ’‹Lisa- Tanned Spanish beauty with large melons and a fun booty too minica- exotic goddess with a gymnasts body and corresponding flexibility Jennifer- Exotic beauty with... Call and text 647 891 0699 ask question :heart4 :heart4 :heart4
  44. Jennyโ€™s Spa:
    ๐ŸŽ‰๐Ÿ’JENNYโ€™S SPA๐ŸŽ‰๐Ÿ’ โœ…5170 DUNDAS STREET WESTโœ… ๐Ÿ‘ŒETOBICOKE ONTARIO M9A 1C4๐Ÿ‘Œ โ˜Ž๏ธ( 647-893-5196)โ˜Ž๏ธCall or Text โ˜Ž๏ธ( 437-888-3759)โ˜Ž๏ธCall Only (ETOBICOKE) OPEN 10am to 9pm MONDAY to SUNDAY ๐Ÿ”ฅโœ…GRAND OPENING๐Ÿ’ฏNEW GIRLS EVERYDAY๐Ÿ”ฅEXCELLENT MASSAGE + SERVICE QUEENS NOW AVAILABLE AT JENNYโ€™S SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS๐Ÿ”ฅ๐Ÿ’ฏ๐Ÿ˜˜๐Ÿ”ฅโค๏ธ๐Ÿ‘Œ ๐Ÿ”ฅTWO BEAUTIFUL NEW YOUNG ASIAN GIRLS EVERYDAY๐Ÿ”ฅ ๐Ÿ’ฏREAL PICTURES OF ATTENDANTS๐Ÿ’ฏ ๐Ÿ”ฅ๐Ÿ’‹Limited Time Special Promotion๐Ÿ”ฅ๐Ÿ’‹ โœ…๐Ÿ’ฆ30 Minutes Nude Mass
  45. AliceSpa:
    3 Sexy Young Girls Today at Alice Spa. Open 10am to 9pm : CLOUDIA (12pm-9pm): is Vietnamese, young, petite 5'2" & 96 Lbs, B Cup, best rim deep bbbj cim. $40 Room Fee + $80 (incl bbbj & fs). +$20 for rim/cim. Excellent open minded services. SKY (10:30am-9pm): is Part time girl from Indonesia, petite 5'2", B Cup, 100 Lbs, long black hair, new to the biz.Young, fresh/cute, pretty, submissive, slim tiny waist, fair skin. bbbj
  46. ForeverWarden:
    Monday at ๐Ÿซฆโค๏ธ๐Ÿ”ดโ™พ๏ธ๐“•๐“ž๐“ก๐“”๐“ฅ๐“”๐“ก ๐“ข๐“Ÿ๐“โ™พ๏ธ๐ŸŸฅ๐Ÿ”ดโค๏ธ๐Ÿซฆ 2190 Warden Ave, Unit 201, Scarborough ๐Ÿฐ๐Ÿญ๐Ÿฒ-๐Ÿด๐Ÿฌ๐Ÿฌ-๐Ÿณ๐Ÿด๐Ÿด๐Ÿณ: Bella, Yumi & Cindy. Bella is around 5โ€™3โ€ with a thin to medium build, C Cups, and a pleasing personality. She can offer dfk, bbbj and cfs as well as a good massage experience. Yumi is a young half Chinese / /half Korean very sexy & slim beauty, can do bbbj cim, excellent services...
  47. HolidaySpa:
    Monday at ๐ŸŒด๐Ÿ˜Ž๐ŸŒ…๐“—๐“ธ๐“ต๐“ฒ๐“ญ๐“ช๐”‚ ๐“ข๐“น๐“ช๐ŸŒ…๐Ÿ˜Ž๐ŸŒด3517 Kennedy Rd, Unit 4, Scarborough โ˜Ž๏ธ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฎ๐Ÿฐ๐Ÿณ-๐Ÿญ๐Ÿญ๐Ÿต๐Ÿตโ˜Ž๏ธ: AMY, FIONA & CINDY. AMY is an attractive young lady with larger breasts and a nice bottom. She has outstanding oral skills, and is very popular. Donโ€™t miss out on her special skills! FIONA is a slim hottie with long dark hair, great melons and ass, and nice services. CINDY is slim
  48. SugarLoveSpa:
    Monday at โค๏ธ๐Ÿ’™ ๐Ÿ’œโŽ๐—ฆ๐—จ๐—š๐—”๐—ฅ ๐—Ÿ๐—ข๐—ฉ๐—˜ ๐—ฆ๐—ฃ๐—”โŽ ๐Ÿ’–๐Ÿ’—๐Ÿ’˜: ANA, CHRISTINA, MIA, TIFFANY & VIVI. 1270 Finch Ave W (at Keele St), Unit 18. North York, ON โ˜Ž ๐Ÿฐ๐Ÿฏ๐Ÿณ-๐Ÿฏ๐Ÿฒ๐Ÿฑ-๐Ÿฎ๐Ÿฒ๐Ÿด๐Ÿด โ˜Ž ANA is a young, short and sweet lady, 5โ€™1 & 105 Lbs, very tight, with a small to medium booty. Ana is a versatile honey who provides great massage, & can accommodate your needs. CHRISTINA is Spanish, C Cups, 5'3", tall & nice curves, very open mind
  49. bnwellness_wilson:
    We have 4 young girls are working today, young pretty Lily 25โ€™s with curve body and flirty Ivy 36DD with curly body 30โ€™s open mind, young sweet popular Michelle 26โ€™s with curve body open mind and cute GFE Ella are providing deep tissue massage, pls call 4163985777 book appointment and walk in always welcome,back entrance and parking available, 350 Wilson Ave North York
  50. Annie Spa:
    Gorgeous Young Petite Girl Judy, Sweet Tiny Young College Student Luna, Stunning Korean Girl Ivy and Busty Sensual Coco today ๐Ÿ’ฏ๐Ÿ’‹โค๏ธ Call or text May to book appointment 416-891-9688 or 416-291-8879๐Ÿ”ฅ๐Ÿ’ฏโค๏ธ
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