Hi everyone, I have a 70 yo female chronic systemic patient with fibromyalgia, with pain everywhere for 40 years, surgeries on both knees, on toes on both feet, and on right rotator cuff. 1 year ago fell to the floor and damaged her shoulder)
After 4 months of EXTORE, herbal medicine and diet, all pains has gone but the shoulders. Before she couldn't move them without pain, now still have pain under minimal resistence. still difficult to do normal life.
She got an MRI with the next results:
Right Shoulder: Full-thickness tear in supraspinatus tendon with 4-5 cm tendon retraction.
Tendinopathy and partial thickness articular surface tearing in the infraspitatus tendon.
Effusion and synovitis in the glenohumeral joint
AC joint arthritis, subacromial/subdeltoid bursitis. Partial tear of subscapularis tendon. Posterior labral tear. Mild supraspinatus muscle atrophy.
Left Shoulder: partial thickness articular surface and substance tearing in the supraspinatus tendon 1 cm from its insertion onto the greater tuberosity. Effusion and sinovitis are seen in the glenohumeral joint.
Full-thickness tear in the subscapularis tendon of the lesser tuberosity with up to 3 cm of tendon retraction. Partial tearing of the long head of the head of the biceps tendon
AC joint arthritis and subacromial bursitis.
Type II SLAP tear.
Subscapularis muscle atrophy
Do you have any suggestions on how to keep treating her?
I have been doing perfusion, working on her serratus, and basically all muscles around the shoulders, and also 20 Hz on her AC joint (but this only 4 times, should I do it constant 2xweek or somehthing like that?
Thank you very. much for your help!
January’s webinar is here! This one is a favorite of mine because it includes the fascial lens when teaching the movement of the foot and ankle. It cover anatomy, fascia, and accessory motion of the foot and ankle. Definitely worth checking out.
Give this a read after you watch the video: https://pmc.ncbi.nlm.nih.gov/articles/PMC7689775/
Athletic Intensive Myofascial Release
Location: Shokunin CrossFit, Mesa, AZ
Pre-requisite: EXSTORE
Register here:
https://aseseminars.com/event/athletic-intensive-myofascial-seminar/
I am back in Hamilton, Ontario teaching Foundations of Electro-needling to Physios, Chiros, Acup’s and RMT’s June 13-14 - register here: https://aseseminars.com/event/foundations-of-electroneedling/
Only seen him 1x so far, last week. He's 27 yo and has been playing soccer (recreationally) since he was little, loves it and wants to get back ASAP. He came in for R calf pain (dull, achey, worse at end of day after being on feet all day). History of multiple gastroc tears (11/2024, re-injured 05/2025, and again at the end of 2025 but is feeling much better since the start of 2026.
He also has a history of R quad and labrum tear in 2023/2024, currently asymptomatic. He pointed out a divet in upper R thigh.
This is what I treated:
1) Motor Points: R TFL (super tight like a rock), R glute med ant, R glute min, L TVA.
2) R calf adhesions Inline(4 points) followed by guasha
For further treatment, should I add:
- Gastroc motor points?
- Achilles paratendon treatment (in ankle webinar)?
- Divet in the R upper thigh - should I address this in some way?
- Other?
Follow up case discussion: I asked about a M/55 y/o groin pain case a few weeks back. I was able to do treatment to reduce pain in the area when we discussed obturator nerve issue but it turned out to be a hernia. I had referred out the patient for assessment with his primary care and they found a hernia and they will follow up with surgery. I am unsure if the hernia might have been due to a weight loss procedure he had a few weeks before having the issue. He was having to wear a compression vest post procedure.
