My client came in complaining of upper back pain on the right side after long hours of serving. We tracked it down to a scar on her left thumb. Whhhhaaaat?! Yup.
Scars can entrap nerves
The median nerve supplied motor and sensory information to the thumb and is supplied by nerve roots at C6-T1. Nerves don’t like to be stretched and as this nerve was entrapped at the thumb and connects up into the brachial plexus on the L side, it was affecting the motor control of the whole of the L arm and shoulder girdle.
Nerve entrapment affects motor control
Most importantly it was affecting the functioning of the lower fibers of serratus anterior. Serratus anterior stabilizes the scapula and interdigitates with the external abdominal oblique — making it the major connection of the core musculature into the arm. We could establish this connection using Neurokinetic Therapy. She holds her tray with the left hand which requires a good steady functioning of this muscle, and since it wasn’t working she was overusing the upper back muscles on her right side to try to stabilize her spine while she held this load for long hours on her left side.
Scar Release Requires Patience
We tractioned the scar and the nerve entrapment site for almost 20 minutes while she occasionally nodded her head to floss the nerve. Scar release can take a long time and requires patience and a lot of attentiveness to the subtle changes in the quality of the tissue. After the release she felt a return of warmth to the area. When finished we retested the patency of her scapulo-thoracic joint and found it had returned to functioning smoothly. At the end of the session her left arm was stable. What about the complaint she had come in with though?
The site of pain is rarely where the problem is
We had only worked on the releasing the peripheral nerve entrapment happening at the location of the thumb scar on her left side, however the discomfort and tension in the upper right side of her back has reduced dramatically. Why? The tension was being held there as a protective mechanism because of a failure of functioning on the left side. The site of pain is rarely where the problem is. Once the left side was working better, the right side could relax and just do it’s own job. Muscles are team players. When one is out of commission the others will step in. She will continue to release the scar for another week or so, especially before her shift starts; and she will work on her core activation. Her workdays should be a lot more comfortable.
Hand and Arm Scars can inhibit shoulder stability
I’ve had several client with arm and hand scars that are affecting their shoulder stability over the last few months. I have dealt with this issue myself pretty extensively. I have multiple scars on my wrists and arms from self harm during my adolescence. You can read more about that HERE in my blog post from Feb 2018. If you have scars on your hands or arms and are dealing with shoulder stability issues or shoulder pain, consider booking an integrative movement therapy session to have their affect on your motor control assessed.