Short Upper Arms

Often in a practice we run across individuals with similar problems in a series that can sometimes be blamed on the season or weather. Certainly clients with back issues come to us after shoveling snow or during gardening season. For what ever reason, however, lately, I am seeing several clients with short upper arm structures and resulting issues from their genetic frame. Normally, if you measure the arm or humerus in our upper extremity it expands from the glenoid fossa of the scapula superiorly to the distal end (olecranon process of the ulna) inferiorly to the waist and iliac crest. Individuals with short upper arms have humeral bones that do not measure down to the iliac crest. Usually they have no idea why they have leaned forward their entire lives or why they may not have been able to reach something on a top shelf when someone the same size can. Often these folks will have more trouble with work stations and are likely to develop carpal tunnel-like symptoms.

A medical history and a visual observation will reveal clients with short upper arms present with over pronated forearms; very hypertonic pronator teres and resulting numbness and tingling to wrist and fingers. The structure itself lends to abducted scapulae with prominent medial humeral rotation, more so on the dominant upper extremity. Add repetitive actions and non-ergonomic work areas and you have a laundry list of muscles to unravel and release entrapments and a recipe for carpal tunnel syndrome, pronator teres syndrome and possibly double crush syndrome.

A Dimensional approach begins the sequence in a supine position with techniques to release hypertonic trapezius, SCM, posterior cervical muscles and pectoralis minor and major muscles. Active engagements techniques help to pin and stretch pectoralis minor and subscapularis. Both muscles are usually very tight on these types of frames. Moving on to the upper arm, release and stretch arm muscles with elliptical movement and dual-distraction moves. Release the elbow joint with movement and techniques. Elliptically move the forearm muscles and release the pronator teres. Sidelying is next with serratus anterior as a star target. Position the client prone lastly to release the soft tissue of the back. Exercises are suggested.

There are a wide variety of techniques massage therapy uses on clients with all kinds of structural issues. The above is my approach for short upper arms and clinical issues that often present themselves to this target group. Other considerations could be hip and pelvic positions, gait, and lower extremity factors. One fact remains apparent that the structure we have contributes to a reaction to our repetitive activities. A wise massage therapist will see beyond the repetitive action!

Nancy Dail teaches courses in Dimensional Massage Therapy and is the co-author of Kinesiology for Manual Therapies published by McGraw-Hill. For more information about Dimensional Massage see other pages on this site. See her schedule for workshops in your area on this website or contact her at ndail@aol.com.

The Trapezius and the Sails of Life

We use our shoulders, arms and hands to take action. On the other hand, they are used expressively in talk, they are parts of speech. Gestures with shoulders, arms and hands reveal with connotative clarity what we really mean. We see also in writing and sign language an entirely linguistic use of shoulders, arms and hands. Massage itself meaningfully bridges these two worlds of action and language. We perform our strokes with shoulders, arms and hands and use them to convey anatomical information and non-verbal messages.
We have all seen clients whose shoulder blades virtually adhere to the ribcage. Structurally and energetically, the shoulder blades’ ability to glide freely over ribs is of enormous importance. Without that freedom, stress, instead of “rolling” off our backs, can become “impacted”, affecting the free excursion of ribs, spine, ultimately the lungs and heart.
The energies flowing vertically through the body intersect in the shoulders and upper limbs with horizontal flows reaching out to the world around us. This can be seen as an axis of love.
TRAPEZIUS
The trapezius is one of the body’s primary energetic shock absorbers, just as lower limbs are the body’s main physical shock absorbers. As stress comes and goes, trapezius’ tension increases then dissipates. However, with chronic stress or acute trauma, the body may absorb stress, rather than letting it go.
In the trapezius virtually every adult carries some residue of past life tension with a resultant diminished capacity for dissipating everyday stress. When shock absorbers start losing resilience, the effect of stress stays longer and goes deeper into the bodymind.
A primary purpose for trapezius work then is to let go of any residue of the past that no longer serves us and to initiate new habits of handling stress by letting go, rather than by absorbing it.
The freed trapezius allows the full excursion of breath underneath it. It amplifies healthy movement of upper limbs and torso. The healthy trapezius is a sail. Freed, it enables us to tack into the winds of life with optimized momentum and wastes no energy holding onto what we no longer need.

DEEP MASSAGE FULCRUM FOR THE TRAPEZIUS
Therapist: comfortably seated at head of the massage table
Client: Supine (If neck is lordotic – chin higher than forehead – put a small pillow under the head.)

Before putting your hands on, center yourself. Breathe. Position yourself so that even seated, your touch will gracefully derive from your body weight and gravity, rather than effort. Position your treatment chair or stool to allow space between your body and that of the client. Let all your joints be gently rounded, wrists aligned, elbows only slightly bent, shoulders and breath relaxed, an open space between the sides of your ribs and the insides of your arms. With hips and knees relaxed and soles of your feet on the floor, feel grounded.
Briefly review in your mind the particular life stresses the client may have revealed in the pre-session interview (and in past sessions if this is a repeat client). Realize that you are not just touching the trapezius, a muscle positioned in the client’s body/space. You are equally touching time and the accumulated content and tension from many years of life. Every touch that impacts the client’s ongoing life takes place at the intersection of space and time.
• Let your fingers rest on the clavicles. With your thumbs begin to explore the trapezius’ belly. Start near the base of the neck and work your way out in at least 4 areas each more lateral than the last, with mindful, caring touch, using light pressure. Note any associations that palpating this client here evokes for you. Some clients feel thickened; others frozen; others with overall freedom but with a few specific nuggets of tension, that seem to have been there a long time. Sometimes I feel like I’m a prospector, palpating for long-lost treasures underlying tension. Work your way out in successive points near to where the clavicle and scapula meet.
• Now return to the trapezius’ belly immediately lateral to T1. Be conscious and contact clearly with both your physical structure and your energy, mentally, emotionally, and spiritually engaged in what you’re doing. Press in with both thumbs, down toward the feet and easily rest in just lateral to T1. Give the client a moment experience this initial contact. Pause.
• Now press in further, engaging tensions found more deeply. (If you find no tension, clearly disengage and explore points more lateral.) Continue yourself to breathe and relax, sinking into the tension. Commonly at this point, you can see from the client’s breathing and facial expression that she or he is engaged. Pause.
• Rest in yourself more completely. Deepen your breathing, be patient. Lean gracefully further in, letting gravity be the therapist. Find the optimum depth for this fulcrum. Now pause again, without letting go of any vectors. It is important that you the therapist now go to a “witness” state, not moving. Allow the client time to let go, from the inside out, of successively deeper, “sedimentary” layers of tension that have developed here over the course of life.
• When you sense it’s been long enough – usually two to seven seconds will do fine – clearly disengage and move on. Then press in an inch more laterally on both sides. Repeat the steps above. Keep alive your sensitivity and patience. These tensions accumulate over a lifetime. They need the gift of time and touch to let go of the layers and years of tensions held.
• Continue working the belly of the trapezius in successively more lateral areas until you’ve given attention to four or five areas bilaterally. Even if you find more tension on one side than another, maintain conscious contact with both sides. The bilaterality of contact is important since we are looking to restore the feeling of having wings, rather than a yoke here. These wings are needed for flight!

Wonderfully, this work with the trapezius is one of the easiest fulcrums to perform. But don’t underestimate it! It has global consequences on the health of our clients’ minds and bodies. When we approach the trapezius with reverence, respect, patience, and skill we are given the opportunity to let go of lifetimes of stress and to regain the sense of the lightness of being.

David Lauterstein is Co-Director of Lauterstein-Conway Massage School in Austin, Texas, for 23 years one of the premier schools in the Southwestern U.S. He has been a bodywork teacher since 1982 and is a 2011 World Massage Therapy Hall of Fame Inductee. He is the author of Putting the Soul Back in the Body and the forthcoming Deep Massage Book from Complementary Medicine Press.