Neck and shoulder pain from a baby sling

Gua sha is a powerful treatment tool in quickly mobilizing soft tissue (fascia) to decrease pain while improving movement.

It also has diagnostic properties that often go unnoticed. As the treatment is applied, petechiae form. Petechiae is often misinterpreted by Western medicine practitioners as bruising, but this is incorrect. Bruising results in destruction of the capillaries; gua sha increases microcirculation into the area which may overwhelm the capillaries but ultimately leaves them in tact (if performed properly).

The petechiae can be interpreted based on the amount, size and color. Pink discoloration does not indicate underlying pathology, merely an increase in circulation. Light red, dark red and purple indicate increasing levels of pathology and/or chronicity.

Another interesting area of diagnostics is the interpretation of the location and shape of the petechiae:

SUBJECTIVE:
34 year old female complaining of left neck pain with associated headaches for the past 12-18 months. She cannot recall any injury to the neck. She recently completed her Masters degree. She has 2 young daughters ages 2.5 and 4.

OBJECTIVE:
Posture: right cervical tilt with left rotation, right scapular elevation with minimal downward rotation

ASSESSMENT:
Myofascial adhesion in the right upper trapezius creating the postural deviations. The pain on the left side of the neck was from an increase in tone to try to prevent the right lateral flexion.

The predisposing factor in this case was a sling she wore around her neck to carry her second child. The deep layer of fascia thickened to try to protect the underlying structures, namely the brachial plexus.

PLAN:
Continue with soft tissue mobilization over the next few treatments until petechaie dissipate. Perform post-isometric relaxation for the right cervical flexors and scapular elevators to further lengthen them. Perform muscle energy technique in the left lateral flexion and right scapular depression patterns to correct cervical and scapular posturing.