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The unsung heroes of the rotator cuff!

bodywork clinical massage therapist training rotator cuff shoulder pain Feb 25, 2025

The infraspinatus and teres minor may not always get the spotlight, but they’re the unsung heroes of the rotator cuff!

These two little muscles do an amazing job keeping your shoulder stable. In fact, they’re the only external rotators of the shoulder joint, which means they work extra hard to balance out the stronger internal rotators like the pec major, lats, teres major, anterior deltoid, and subscapularis.

When working with these muscles, a great technique to try is called "goading." This just means using strokes from the outside (lateral) to the inside (medial) to help them shorten and become more contractible.

PS- Instead of creating more strength in the internal rotators encourage your clients to do some simple exercises which strengthen the posterior thoracic and scapular stabilizers

Palpating the slippery subscap

bodywork clinical massage therapist training rotator cuff shoulder pain Nov 16, 2024

Subscap can be a tricky muscle to palpate and is an essential skill to have in treating shoulders. Watch the video and learn a fool-proof way of finding it!

Chronic Pain and the Brain

bodywork clinical massage therapist training nervous system Aug 07, 2024

As bodyworkers we all treat people in pain and most of the time successfully. But what if your client has had pain for more than 3-6 months and is not responding to your or any other treatments?

It’s possible that it’s neuroplastic pain (also known as neural circuit pain, central sensitization, TMS (tension myoneural syndrome)

Neuroplastic pain results from the brain misinterpreting safe messages from the body as if they were dangerous. In other words, neuroplastic pain is a false alarm. Though the pain can be addressed through various practices, this does not imply that the pain is imaginary. The pain is REAL!

“The relationship between pain and the state of the tissues becomes weaker as pain persists” Dr. Lorimer Moseley

In other words the longer the pain persists the higher the chance it’s being caused by the brain and nervous system. Without the brain there is no pain.

Neuroplastic pain is caused by a brain/nervous system which has gotten stuck in sympathetic arousal – fight, ...

It’s not a strength issue is it?

bodywork clinical massage therapist training nervous system Apr 05, 2024

My client, Nancy came in the other day and was concerned about her left arm and left hand. She'd been doing bicep curls with her trainer sitting at a machine, using a 15 pound bar and she experienced pain and lack of strength in her left arm/hand.

She has a history of an ulnar nerve injury in that arm and experiences flare ups now and then.

Her personality type is one that pushes herself hard, a high achiever and sets very high standards for herself.

I just completed my Movement Specialist Certification and there were some really handy tools in there including a Movement Threat Screen Assessment.

I asked Nancy to visualize doing the exercise the same way she had just done it with her trainer and asked her if that caused her any worry, fear, or pain. She reported that it did and was amazed that a visualization could produce the same experience.

But as we all know, the brain really doesn't know the difference between past, present, or future. It's always in the now.

We then we d...

The upstream and downstream of bodywork

bodywork clinical massage therapist training Mar 04, 2024

A new client came in recently, we’ll call her Glenda. She complained of pain in her lower right rib area from a car accident about 5 years ago. “It feels as if it pops out of place” she said.

As I explored and palpated the area and verified where she felt the pain she anxiously asked, “Is there inflammation there?”

Instead of answering her directly I said “Your body is really protective of this area.”

It was beautiful to see and feel her response. She took a deep breath and said, “Yeah, that makes sense.” Here whole being relaxed and her exquisite parasympathetic system came on board.

These are the moments I treasure – I call them hallelujah moments.

Using the phrase “Your body is really protective of this area.” is a tip I got from the marvelous pain researcher Lorimer Moseley. Lorimer was a recent guest on the Thinking Practitioner podcast.

Lorimer is one of the most well respected pain researchers in the world. An Australian he is a former physiotherapist (PT to those of us i...

The Power of Reassurance

bodywork clinical massage therapist training Jan 12, 2024

Recently I heard an interesting story from a PT (let’s call him Tom). In the clinic Tom worked in there was one PT (let’s call her Amy) who always got the best outcomes. Tom was really curious about this since they had equal skill sets and training. Tom asked to sit in on one of Amy’s sessions. Tom observed that Amy constantly reassured her patients with statements like: “You go this!” “You are improving every day!” “The body is resilient and knows how to heal” Amy also did a through intake which included addressing the the psycho-social factors such as social support, loneliness, marriage status, social disruption, bereavement, work environment, social status, and social integration.

That was a light bulb moment for Tom and since then he's incorporated his "lessons from Amy" and seen his outcomes improve.

Pain (both chronic and acute) often causes the amygdala to go on high alert, arousing sympathetic arousal.
Pain can be disabling, upsetting, and scary!
“The amygdala plays an impor...

Abducted By Aliens?!

bodywork May 12, 2023

“They come at night, mostly” my client Kim quipped, quoting the famous line from Aliens (one of my top ten movies).

She’s referring to the pains down the side of her left leg that regularly wakes her up at night.

This vicious pain pattern is ubiquitous. Gyms are full of people foam rolling their lateral thigh/ IT bands.

Trigger point referral patterns to the lateral thigh come from quite a few muscles – the main culprits are gluteus medius, minimus and tensor fascae latae. Mmm – all abductors of the hip. There’s a clue here!

These muscles fall into the phasic category and tend to be weak/inhibited. Bursitis and tendonitis of the muscles that attach to the greater trochanter is rampant. (Quadratus lumborum refers right into the greater trochanter often mimicking GT bursitis.)

Here’s a paradigm I’ve used in eliminating and/or reducing that pernicious “aBducted by aliens” painful lateral th

...

Working With The Superior Psoas

bodywork May 12, 2023

Her strategy was to approach it from above and press very hard. I tensed, my breath constricted and I felt scared.

How much easier and gentler it for both client and practitioner to approach the upper psoas laterally; slowly working your way through layers of fascia and going under the rectus abdominus.

Using rocking, deep breathing and active movement by the client allows the tissue to melt, unwind and relax organically without force.

Soften The Psoas With Thoracic Mobilizations / Bodywork, Clinical Massage Therapist Training, Education for Massage Therapists, Iliopsoas, Massage Therapy Training / By Peggy Lamb

bodywork May 12, 2023

Recently a new client came to me with a complicated pain pattern: right hip, low back, and SI joint.

Several months ago she had an ovarian cyst burst; she was in the Emergency Room for over 12 hours with 10+ pain. She was convinced she was dying – even gave all her passwords to her boyfriend. She did get her surgery and is fine now – except for the pain.

When I hear a story like that many thoughts go through my mind but the three biggies are:

Iliopsoas: (When our nervous system is in sympathetic arousal it activates the psoas muscles – as it is the psoas’ job to jump into action to curl your bodies up into a ball and freeze, flee away in fear or fight to the death.)
Tread lightly
Possible neuroplastic pain (her brain/nervous system still thinks she is in danger and hasn’t regulated yet so pain is what the brain produces to keep us safe.) The body reflects our subconscious.

I knew that creating safety for her was the most important thing I could do. When I assured Lin that he...

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Author

Peggy Lamb

Author

Peggy Lamb, LMT, BCTMB, MA is the founder of Massage Publications/The Abundant Bodyworker providing resources for massage therapists with continuing education courses, books, videos and business coaching. Her coaching and course work empower LMT’s so abundance and prosperity flows into their lives. Although a bit of a "reluctant businesswoman" she nevertheless has built multiple streams of income through her various projects. Peggy brings her eclectic and extensive background into her teaching for an interesting, enjoyable and enlightening learning experience. In addition to her extensive training in massage therapy, Peggy holds a master’s degree in Dance from American University in Washington, D.C. She has volunteered for over 10 years with “Truth be Told”, teaching creative movement and writing to incarcerated women. When she’s not working, Peggy can be found dancing, swimming in Austin’s Barton Springs, hiking or even dog sledding.

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