Case Study - Shoulder Injury - Symptoms and Treatment - Sagewood Wellness CenterIn an ongoing series of articles, I’ll be documenting my Neuromuscular Therapy process for treating various clients’ injuries at Sagewood Wellness Center. I’ll be breaking down the causes and symptoms of these injuries, and my subsequent treatment of them. While not all injuries and treatments will be exactly the same and results will vary, these case studies will provide examples of how I assist clients in healing and living pain free lives.



In this case study we will be looking at a client who came to me with debilitating chronic shoulder pain, resulting in limited range of motion and weakness. This condition had been initially caused by a sports injury in the gym during a workout session years prior. He was complaining of pain in his shoulder, neck, back and upper chest. He was often unable to lift heavy objects over his head and would get headaches at times for no apparent reason. The client had a career in which he spent a significant amount of time sitting at a desk and working on a computer. While working, he felt increased pain as well as numbness and tingling in his arm and hand.



Shoulder Injury Case Study - Sagewood Wellness Center

Shoulder Injury Case Study – Sagewood Wellness Center

During this client’s initial evaluation we made several key determinations. First, we discussed the nature of the injury. We identified that it had occurred many years prior during a weight lifting session, specifically during bench press. Since then his symptoms had gotten progressively worse. This can be common in untreated injuries of this type.

Next, we discussed how he sat at his desk and looked at the fact that the injury was in his left shoulder, which was his non-dominant side. He spoke about how he had the unconscious tendency to lean his arm on the armrest, which caused increased pain. I explained that this tendency had most likely exacerbated the initial injury. This led to muscle fatigue and more numbness as the prolonged sessions of sitting and working at his desk increased over time.

I also asked about other areas in his life where he might have a tendency to lean like this or use these muscle groups and he mentioned that he often felt more pain after driving. I had him sit in his car and show me his driving position and technique. While behind the wheel he tended to extend non-dominant (left) arm and held the steering wheel at about the 10 to 11 o’clock position. This put more stress on the shoulder injury and caused him additional pain and numbness.



Rotator Cuff Muscles Shoulder Injury Case Study - Sagewood Wellness Center

Shoulder Injury: Rotator Cuff Muscles – Sagewood Wellness Center

I identified adhesions and trigger points in muscles of the client’s left rotator cuff (shoulder), neck, chest and upper back. These were causing him local and referred pain. Utilizing Neuromuscular Therapy and specifically Trigger Point Therapy, I worked the areas to break down the adhesions, and release the trigger points. To further assist in his healing process, I taught him stretching exercises and provided handouts that illustrated them for use at home. These exercises helped stretch the injured muscles between Neuromuscular Therapy sessions, which helped increase range of motion over time. The client started to see a noticeable difference within the first few sessions and within about 2 months of weekly visits, the client experienced a significant increase in range of motion and a decrease in pain and numbness.

As part of the treatment plan, I provided the client with suggestions for improving sitting posture, and setting up his desk for proper ergonomics. As he had a tendency to lean to his left and put more stress on the shoulder injury, we focused on proper posture and sitting. By becoming mindful of his posture at his desk, he began sitting more upright while keeping his shoulders squared, which eliminated much of the leaning that he was doing. Also, by making sure his chair was properly adjusted and his keyboard was at the proper height, he could eliminate the need to support himself by leaning on his elbow and thus putting undue stress on his injured shoulder.

We also discussed how his driving technique was exacerbating his injury and focused on solutions. I suggested lowering his left arm and placing his hand lower on the steering wheel, which reduced strain on the injured shoulder. I also recommended that he drive with both hands on the steering wheel. This provided counterbalance support from his right hand and arm. By lowering his hand position to a more comfortable level and providing dominant-side support he would be taking most of the stress off his injured side. Within just a few weeks of utilizing these improved driving postures, he saw a significant decrease in pain and numbness while driving.



Once the client started seeing dramatic improvement in his symptoms and reduction in pain, we decreased the frequency of his sessions to twice per month. I also recommended that he continue with his stretching exercises and maintaining proper posture while sitting and driving.



Within 4 months of the onset of treatment, the client recovered from pain in his shoulder, back and neck, as well as numbness in his arm and hand. His headaches completely disappeared. Through Neuromuscular Therapy and his stretching exercises, he also experienced a dramatic increase in range of motion and strength in the injured area. His sitting posture both at his desk and in the car have improved greatly. He has since reported that he is pain-free, and as a result, has even returned to working out in the gym as a result.


I hope that this case study has provided you with a better understanding of the Neuromuscular Therapy process and how I assist in healing muscular injuries.  Often, injuries go unnoticed when they occur, or when they happen gradually over time due to repetitive motion. Many times we don’t know that we have suffered an injury, or what caused it. By focusing on symptoms that occur as a result of these injuries, I can usually trace back to the source of the injury and determine the nature of what happened. If you suffer from pain, numbness and limited range of motion, this may be an indication of a bigger problem that requires treatment.

For your own personal evaluation contact me at Sagewood Wellness Center (949) 496-2821.

Have a balanced day! ~Maria




About The Author

Maria Martos - Sagewood Wellness Center - San Juan Capistrano - Nueromuscular Therapy

Maria Martos – Owner & Founder of Sagewood Wellness Center

Maria Martos is the Executive Director and Founder of the Cancer Support and Education Program, and has been owner of Sagewood Wellness Center for 20 years. As a Certified Neuromuscular Therapist, Maria specializes in the treatment of severe, chronic or minor pain, as well as injury rehabilitation and prevention. She holds a certification in Sports Massage providing her with expertise to evaluate and address athletic injuries and to help professional and recreational athletes improve their athletic performance. Maria is also Board Certified by the National Certification Board for Therapeutic Massage and Bodywork.  She holds a Master of Science in Counseling Psychology, and offers Holistic Counseling, focusing on Integrative Mind-Body Therapy to help individuals uncover and remove unconscious blocks that limit them from living their best lives.  She is also a Reiki Master and Teacher, and has worked in the health care field for over 25 years. Her passion and life’s calling is to help others not just survive, but thrive in the face of challenges.