Here we are sharing a wonderful story of our client Mr Roger aged 52 who diagnosed with muscle strain over the upper back affect his daily life activity. He works as a company manager and professional part time squash coach.  Muscle strain usually occurs as a result of fatigue, overuse, or improper use of a muscle. Causes of muscle strain are not warming up properly before physical activity, poor flexibility and fatigue.  Mr Roger visited our centre on 29/2/2019, complaints of pain over the left neck and pain running down to the back (posterior) of arm for 2 weeks. Pain scale was VAS 7/10 during neck movement, resting/ immobilised has radiating pain at posterior arm with VAS 5/10.

He started exercise at gym, carried heavy loads for past 3 months continually without doing proper warming up and cooling down exercises.  Mild pain over the left neck begin after dumbbell workout but he insists to continue until the pain became severe and disturbed his sleep when he lied on left side. He was not able to touch his middle back initially for few weeks (internal rotation of shoulder is limited).

Past history: He had a fall 2 years ago while playing squash, direct injured to the left shoulder. No rehabilitation is done except massage and rest.

We performed special test and assessment to find out the muscle that involved in injury which causes pain. He was diagnosed with muscle imbalance, causes the neck and shoulder muscles repeatedly strained. My short term goal for him was to reduce the pain, improves injured muscle elasticity and strength within 6-7 Sessions. Long term goal was return him to play squash and improve his daily activity.

He received acuphysio treatment for 1 hour in our centre.  After the 1^st session, pain over the neck reduced for only 2 days and gradually increase with VAS 6/10. After 2nd session, he got no more pain on left neck but slight pulling pain over the posterior aspect of arm VAS 4/10, immobilization of arm causing radiating pain for 1 minute, but happened less frequent. On the 4^th session the pulling pain over the posterior aspect of arm reduced to VAS 2/10.

Here I’m sharing the treatment and exercises that Mr Roger received at our centre:

1. Acupuncture: to improves the blood circulation and enhance the healing process
2. Soft Tissue Manipulation of injured area: to reduce the internal and external inflammation
3. Joint Mobilization of shoulder joint: to reduce pain and improves muscle elasticity surrounding shoulder joint
4. Deep tendon friction: release tight muscles (neck muscles, upper traps, triceps and rotator cuff)
5. Stretching of upper back and forearm muscle: to improve the flexibility of muscles
6. Strengthening exercises of weak muscles: middle and posterior deltoid
7. Kinesiology taping: to inhibit the overuse muscles and to facilitate the weak muscles.
8. Education: advised him to perform full set stretching exercise before playing squash

All the exercises and treatment are tailored to each an individual based on our understanding about pathophysiology of the condition.

“A Little Progress Each Day Adds Up To Big Results”