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How to manage shoulder pain after breast cancer with a treatment buddy

Annoying and persistent shoulder pain can be a daily issue for at least 50% of women after breast cancer. If you are in "the 50%" group, you could be amoung the lucky ones to experience some relief when someone massages the right spots on your upper back- it feels a little painful, but moany groany great immediately after.

I have managed my own chronic shoulder pain for many years now and know how hard it is to:

  • Reach those spots yourself without turning yourself inside out and getting RSI (repetitive strain injury) in the process.

  • Find your partner with 10 mins free everyday, and be up for it: massage of course!

  • Get them to find the knots and stay long enough at the best moany groany spots.

That's why I made my treatment buddy - it allows me to treat my own shoulder muscle tightness, whenever I want to. All I need then is a sturdy wall or the floor and 5 mins.

Ball in a sock becomes a treatment buddy when it has all the right components.

I have practiced many ways over the years and I can share with you the methods that didn't work for me:

  • a golf ball is too hard

  • a cheap tennis ball- the pressure is all wrong and then BOOM - it breaks in half!

  • the spikey balls- I tried many different kinds, and felt way too many pain spots for my liking

  • lying on the floor with the ball between you and the floor means wriggling to get the right spot, and then it is really hard to get the right pressure for the pain to go away

  • lying on the floor when there is a baby, toddler or dog in the house- as they think you are there to play.

  • standing up against a wall with the ball between you and the wall. Moving from one massage spot to the next requires a great feat of wriggling and still the ball drops to the floor.

  • pressing or rolling in one spot for too long

So what was the solution for me? Quick answer: right ball, right length sock, good technique and the need to love your treatment buddy.

Long answer

Right ball: The pressure in championship tennis balls is just right for most of the upper back muscles. Dunlop produces the Australian Open tennis balls and I like them for pressure and lastability. Dunlop generously donated 200 balls for me to share at the 2019 BCNA conference at my display table. If you received one of these treatment buddies, skip the right sock length section - go straight to good technique section and download the pdf.

There are some muscles that require smaller contact with the trigger point, like the infraspinatus on the shoulder blade. On this muscle, I start with the tennis ball and then move to the larger size superball (the one that is really bouncy and about 2inches diameter)

Right length sock: By putting the ball in a sock saves both time and frustration. No more chasing after the dropped ball when trying to stay still and focused; up against the ball and the wall. The sock needs to be long enough to hold it your hand (opposite hand to the shoulder you are working on) and still reach about bra height, at the back, or an inch or two below the shoulder blade. I like a sock about 26- 30 inches

Good technique Part 1: I will make this short and sweet; rolling and rubbing against a muscle with the ball in the sock, standing up against the wall is annoyingly painful! I prefer the trigger point release method while standing against the wall for three reasons:

1. The pain when you press on the right place tells you are in the right spot - the trigger point of the tight band of muscle.

2. The time it takes to fade away tells you that the pressure you are using is just right. Aim for enough pressure to feel "sweet pain " and then hold this until the pain fades away- this can be 20 seconds on day 1 and 5 secs after several sessions of practice.

Two common mistakes with this method are:

  • Pressing too hard, causing too much pain, and the muscle will not relax.

  • Pressing in continuously means you will not feel the pain fade away.

3. When the pain fades, you will be able to sink into the layers of muscle that have relaxed. I like to measure the amount that the ball sinks in at this point- sound evidence that the technique is working. Also it is so much easier to learn to adjust the pressure between you and the ball at this "sink in" stage. I call this the second treatment spot.

When this sweet pain spot fades- time to move on to the next treatment location. Only treating two spots at one location is really important for many reasons and will require another blog to explain.

Good technique Part 2: Trigger point enough of the muscle to make a difference. One muscle may have several parts, where the muscle fibres run in very different directions. I have a saying - one part does not talk to another.This means when I use the treatment buddy at one part of the muscle, then the relaxation I get does not extend to the other parts.

So I have used the amazing trigger point research from Travel and Simons and my own 20 year practice, to create a guide to the locations for using the treatment buddy.

I started with a treatment pattern for one area at a time, for example their four points on the shoulder blade will target the main known trigger points of infraspinatus (red spots on the pdf, page one). If you try this practice with a treatment buddy, you may find that you need to turn a little toward the wall, because of the angle of the shoulder blade at the upper back.

After treating these four spots, I would treat the muscles between the shoulder blade and the spine. This could be covered with 4-5 spots, starting from a spot about 2 inches lower than the tip of the shoulder blade (see the blue spots on page one of the pdf).

This method would take about six minutes max: nine spots, two treatments at each spot, each spot taking a maximum of 20 seconds to relax some layers.

When I got used to the trigger point locations, after several weeks of practice, I then moved to a faster method- the zig zag method. This method is really hard to write concisely- easier to see on the pdf.

The second page of the pdf is for people who have received training with me. These points require training as they are deeper than you would think to go.

Love your treatment buddy

Before you have a go with a ball or a treatment buddy, against the wall - a reminder of the important features:

  1. This is gentle pressure on the skin and muscles. If you know that your skin or muscles will not be up for it - don't do it.

  2. Only two presses in one location and then move on.

  3. Short sessions of 4-6 mins are enough for the shoulder blade and upper back muscles- don't overdo it!

  4. If the pain doesn't reduce or gets worse after using this technique - then cease trying, and get some health professional advice.

Developing an effective self- treatment method is a skill for life when there is a chronic underlying medical condition like scars, fatigue, radiotherapy and chemo.

I have trained many of my patients to use this as part of their shoulder care program. If you are ready to try using a treatment buddy, then book in a consult and I can take you through training to suit your health needs. This will work face to face, in Brisbane, or online.

My shoulder pain has been managed- I love my treatment buddy!

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