A recent patient came in with a shoulder injury. While addressing the joint movement and palpating the region including the shoulder musculature, the bicep and tricep and all other area one region felt much different than the rest. The tricep muscle didn’t have the feel of being a healthy tissue. It felt leathery and bumpy, even to the point that this patient could notice a difference.

From the work of Dr. Michael Leahy we learned that soft tissues can become hypoxic, meaning a lack of oxygen received to the area. This hypoxic event is can lead to different palpable changes to the tissue itself. 

A soft tissue injury can be resolved rather quickly if the correct intervention is used. For this certain patient our goal was to improve both blood flow and improved length to the tricep region. 

Using a combination of dry needling for the active trigger points with low level electrical stimulation for 2 minutes followed by myofascial release improved the blood flow to the region. 

As treatment continues we continue to assess the tissue and the surrounding region. We know that muscles work in coordination with each other, and that there must be that coordination to function properly. Continued treatment involves modalities that improve both blood flow to the tissue while improving the joint health of the shoulder. Using Controlled Articular Rotations (CARs) will help with both the joint health and increasing a muscular swelling with focused and controlled movements. Check out this video showing CARs for the shoulder. 



I am confident in a treatment plan that involves a mixture of both passive treatments when pain modulation is required, along with improving motor control patterns using active treatment visits. More on that in our next blog, stay tuned for that. 

Dr. Steven Bird