Oct 2015 24

Janet's story - arm pain

By: Dave Wheeler

I've mentioned before that people with similar symptoms seem to come into my treatment room in clusters. This week I've had 2 ladies come in with similar symptoms. Here's the story of one of them - Janet.

 

My arm hurts here... here, oh and here!

pic courtesty of stockimages

 

Janet had recently taken up a high intensity cardio workout class using weights, twice a week. She came into the clinic saying that her shoulder hurt at the side near the top - when I checked, she had pain in her deltoid muscle - the big triangular shaped muscle that runs from the top of the shoulder down to about one third down the arm. She also mentioned both that the inside of her elbow hurt when she opened a door sometimes and that once in a while she seemed to lose power when doing bicep curls..

When I massaged her deltoid on the upper side of her arm, it was certainly tight, but there were no obvious signs of damage from the tests that I did. The muscle tissue seemed simply to be over-used and therefore fatiguing quickly.

The same was true of her lower arm. There's a lovely muscle that twists round from the outside (that's the thumb side) of the arm above the elbow, then joins down onto the lower arm just on the inside (the fleshy part of your forearm). It's called the brachioradialis, and again, with Janet though there were no signs of damage, it was hypertonic (that is, hyper-toned through over-use).

Obviously a big part of my job is relieving muscle aches and pains, so I made sure that I did some deep tissue work on both the deltoid and the brachioradialis to ease out the muscle tension and relieve the symptoms.

But the best part of my job, though, is trying to figure out why certain muscles cause pain, in an attempt to help the client fix the root problem.

 

The villain and victim principle

I've mentioned this a couple of times before - the idea here is that if someone gets mugged, it's not the villain that screams, it's the victim. Whilst it's not always applicable in my trade, where you've got multiple, seemingly unrelated muscle fatigue going on, it's a fair bet that something else is actually to blame.

It helps to know a bit of anatomy:

  • The deltoid's main job is to raise the arm out to the side. But it's a very big muscle that covers the front, side and back of the upper arm too. So when the muscles of the front section, when they assist the bicep in what's called flexion (typically, as bicep curl).
  • The job of brachioradialis is to flex the elbow, just like bicep.

There's an obvious connection there, which is the bicep.

When I explained this to Janet, she agree to let me take a look at her bicep, even though she said it didn't hurt at all.

That said, as soon as I ran my thumb up the length of the bicep muscle, she practically jumped off the table in pain.

What she described as a series of painful "lumps and bumps" running all the way up the muscle, was actually a series of adhesions - or scar tissue - where the muscle had been subjected to too much force, had torn slightly then repaired. The repaired muscle had then again been subjected to too much force, and ripped and repaired in the same place again. And again. And again.

Because the bicep was bascially screwed (technical term!), other muscles nearby began to help out when she was doing her bicep curls. Both the front-facing section of the deltoid and th brachioradialis in the lower arm are meant to help out bicep. But they're meant to help out the bicep, not do the whole job, so they fatigued quickly, which is why Janet noticed the pain in those 2 muscles, rather than in the bicep itself.

Once the cause is known, the root problem can be treated, not just the symptoms. In Janet's case, a bit of (painful) deep tissue work to break down the scar tissue on the bicep and an instruction to lay off the bicep curls for 7-10 days to allow the muscle to repair properly.

It was a classic case of the villain and victim principle.

As ever, if you think I can help, give me a call.