Technique ostéopathique myotendineuse sur le sous scapulaire dans une lésion sans rupture du tendon

This simple technique is often the most overlooked, as it is performed under the armpit (a location that puts off some practitioners). What’s more, it’s difficult to grasp the muscle and tendon concerned (you have to work your way under the pectoralis major). 

The patient is in decubitus position, with the arm in ABD at 90° and in external rotation (RE) = arm cocked. The practitioner is seated on the side of the lesion to be treated. With one hand, he supports and maintains the shoulder in ABD 90° and RE, so that the patient is as relaxed as possible, and with the other, he applies his thumb by the pulp to three trigger points: 

– The first: along its insertion on the lower abutment. 

– The second: along the top of the abutment. 

– The last: on the tendon insertion point.

Moderate pressure is maintained on the point until the patient feels the pain diminish, and/or the practitioner feels a relaxation under his finger in the treated area. In a second step, the practitioner closes the ABD by 15° and the RE, in order to put support on a more relaxed tendon. Once pressure has been applied, the compression zone can be palpated and rolled to release infiltrates. Eccentric and concentric contraction of the subscapularis is described by Janet Travel as a complement to this pressure, but I don’t use it myself, as I haven’t noticed any benefit. 

Click here to read the full article on this technique in the Echos de l’AFBO February 2021.

Author : Stéphane Beulay