I have a client with chronic pain in her right wrist. She has been wearing a brace at night to cope. She went to the doctor. Believing it to be soft tissue, they sent her to physical therapy where they focused on the wrist. This is understandable in that her wrist feels tight and the diagnosis codes given were all about the wrist.
I haven’t seen her in about 7 weeks. Her story about physical therapy and how it had effected her pain 0%, as she said, told me that the issue was elsewhere. She has extreme tension at the anterior aspect of the middle of the radius, where flexor pollicis longus, pronator teres, and flexor digitorum superficialis all attach. The radius is immobile and shifted into an anterior plane.
It would be easy to get stuck right at this area, but having worked this before without results and knowing the physical therapist did not get results by focusing on the wrist, I went to the shoulder. Tension in serratus anterior can be a cause of wrist pain and instability.
The second digitation of her right serratus anterior was adhered to subscapularis. Her right scapula was in protraction and moved toward an anterior plane. This position had pulled the humerus into medial rotation, which was effecting the humeroradial joint and the position of the radius. This not only added to and possibly caused the issue with the middle of the radius mentioned earlier, but it effected the distal end of the radius and the radiocarpal joint.
The area in her axilla where serratus anterior and subscapularis were adhered was very painful. Luckily, SMRT allows me to remove this adhesion without pressure and without direct contact. It took about three minutes to remove this adhesion. Her shoulder fell back toward the table and the tension her forearm and wrist decreased dramatically.
Join me in Ft Worth, TX from March 9-11, 2018 for this SMRT: Shoulder, Axilla, Ribcage, & Upper Back course. 10% early registration discount ends February 9, 2018. Register now!