Physical Rehabilitation Medicine/apley scratch test pain

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Question
Brian,
     Thanks for answering this. I am always struggling to increase my  rom in my shoulders but when ever I try I end up messing up either my scapula, neck, or something else. If I perform the test with my right hand reaching up and behind my head, my fingers end up around c7 or c8 on my vertebrae. Also I feel kinking in the trapezius area. The arm that is on the bottom is relatively flexible, but when i come out of the stretch the lower dorsal part of the scapula feels crappy. I've seen exercises where you would connect your hands with a towel during the stretch, attempting to rip the towel apart using the rotator cuff muscles, relax, then move hands closer. This always kinks my neck. Any suggestions?

Answer
Stretch the pectoralis minor, then the traps.  Directly after, strengthen the scapular stabilizers such as the rhomboids, serratus anterior, and low trap.  Look up exercises for these particular muscles.  Usually it's postural and can be fixed with stretching and strengthening.

I hope that makes sense.

Physical Rehabilitation Medicine

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Brian Neville, OTR/L, CWCE

Expertise

I can answer questions about both conservative and post-operative rehabilitation for UPPER extremity injuries. These include but are not limited to: fractures, tendon repairs, tendon transfers, nerve repairs, lacerations, tenolysis procedures, TFCC injuries, repetitive motion disorders, reconstructive procedures. I have an advanced knowledge of UPPER extremity anatomy and industrial rehabilitation. I have extensive splinting skills for injuries to the upper extremity. Although not a physician or a surgeon I have worked closely with world renowned upper extremity specialists for over 10 years. I can give general information on what some of the most common upper extremity surgeries involve. I can reference those procedures as well. PLEASE DON'T ASK ME QUESTIONS ABOUT ANYTHING OTHER THAN THE NECK, SHOULDER, ARM/HAND. I'M NOT QUALIFIED AND KNOW ABSOLUTELY ZERO ABOUT BACKS/HIPS/KNEES/ANKLES/ETC. THANK YOU!!!

Experience

10+ years working closely with orthopedic and hand surgeons and their patients. I have treated patients with small lacerations to major reconstructive procedures. My knowledge base includes both conservative and post-operative rehab protocols and care for upper extremity injuries. I have treated patients all the way from day 1 post-op to return-to-work status.

Organizations
Kentucky Occupational Therapy Association American Society of Hand Therapy National Nurses in Business Association Roy Matheson and Associates

Publications
RSD article

Education/Credentials
Occupational Therapist former Certified Hand Therapist (license currently inactive) Deep Physical Agent Modalities Instructor Certified Work Capacity Evaluator

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