Massage Therapy Journal Summer 2024

24 • Massage Therapy Journal

effects of this change. One of the many fabulous things about estrogen is that it keeps our tissues hydrated and supple. Frozen shoulder is an extreme example of this challenge, appearing most often in peri- and post-menopause. Here, we’ll focus on the shoulders, and, in particular, the roll-and-glide mechanics of a ball and socket joint, as well as the impact of scapular mobility and placement on issues in the shoulder.

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Roll and Glide: Movement Basics The hips and shoulders are ball and socket joints. Think of them being shaped like a mortar and pestle. When you lift your arm, your humeral head rolls up toward the edge of the socket. But unless it also glides back toward the center of the joint, the humeral head ends up pressing against the front structures of the shoulder, and this area is where almost all injuries of the shoulder begin. Reminder: Whichever way the end of the bone (the elbow) moves, the humeral head must glide in an equal and opposite way to maintain a healthy joint. For example, elbow up, humeral head down. Problems in the shoulder or hip almost always involve disruption of the glide function. So, what muscles create the gliding action? The internal and external rotators. In the shoulder, that’s the rotator cuff. That’s why almost all shoulder problems involve trigger points, functional weakness and mechanical disadvantage of the rotator cuff. I’ve always thought that the rotator cuff should be renamed the “stability cuff.”

Photo by Mark Hanson

You don’t need me to tell you that massaging the shoulder muscles—from the biceps to the spine—helps immensely with any shoulder problem. ... As a massage therapist, you are already working on all of this.

labral tears, supraspinatus fraying and rupture, acromial impingement, bursitis, arthritis—these are all injuries that have separate features, but what they have in common is a loss of glide in the shoulder joint and the resultant limitations to healthy movement. Additionally, the fascia dehydrates and becomes stiffer as we age. Its capacity to absorb stress decreases and the cells that rebuild injured tissue become fewer. If you’ve gone through menopause—and all of the problems of middle age it can cause—you probably experienced the

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