hi everybody and welcome i'm here with Rob we're absolutely working with a physical
therapist on the shoulders and they found a couple trigger point areas there
are two of them right along his trapezius on both sides and a trigger
point is just a balled up muscle we're going to inject those often times you
can work those out with a massage but rarely you need to inject them with a
little bit of medication to help it out so that's what we're gonna do today and
kind of feel it roll under the skin there so right there
you feel it yes and then on this side about the same place huh
yeah this one's not as noticeable but it is it right about t here yes it is so what
I'm gonna do is I'll mark those before I do any injections I'll kind of find the
most tender areas and typically we'll do what we'll do is inject it and then kind of
splay it out to kind of get all of that area both sides okay so we are going to
draw up the medication that we use so we use a little bit of lidocaine and a
little bit of Bupivacane or marcaine so the lidocaine is a short-acting one
this lasts about four to six hours but it has a quick onset so within 15
minutes you're having a full relief but it wears off four to six hours marcaine
or Bupivacaine longer time to start acting but acts longer so eight to 12 hours
both these combined together we get a quick onset and then a longer action so
that's going to give time for the muscle to reset and hopefully go away so see
because it's the area over the shoulder here that's a pretty big muscle but that
overlies an area where there is an opening and right where the lung is so
I'm not gonna use a really long needle I'm actually gonna just use a one
inch needle not a one and a half inch so I'll have you relax as best you can try
to relax those muscles while I feel for the area you can this one is so easy to
find right there is that where it's most tender that's it now if I push around it
it's not as tender no yep right there what I'm gonna do is
mark right in the middle of it and one more time alright and then I forgot a 4 x 4 not a 4x4
not a 4x4 a piece of wood no no I remember once that that and somebody
said is that to hit me over the head with all right so this is just a cold
spray to kind of numb up the skin okay
so you may feel that really cold there sorry as I and then we'll poke now i'm going to feel for
some grittiness you doing okay oh yeah yep found it yeah and usually you'll let
me know so draw back make sure we're not in any
vessel we'll do about two cc's in that area and then we'll kind of go
around and try to break it up oh there we go
find an area where it's tight we'll put in a little more doing okay yeah yeah
right there
little more in that area
we're just gonna do a little over on this side
and when you place the needle in I'm gonna oftentimes feel like a grittiness
against the tip of the needle and then you know you're there that that that's
that muscle that is kind of contracted so we'll just place a little bandaid on
there then we'll do the other side so we're halfway done how was that that
wasn't too bad I'm just gonna take a second kind of massage that in and get
that medicine Yeah right there is right there yeah that finger that's what I
feel like it is yeah is it more up here or here one or two that hurts right there
maybe a little higher okay maybe I'll air okay and then I'm pushing around not
as much as I push around that's it get all right sorry about that's alright
mark it with the pen there into a driver and clean it off with some alcohol here
and once more so I'm gonna spray it with this freezeing stuff again okay so cold
spray you doing all right there oh yeah I know that's cold see it kinda and then little poke and then ooh man
there it is a little medicine in there
we'll kinda go around
see if I feel anymore of that gritty
ooh there we go yeah
doing all right doing good
yeah right there we got some
you got it you feel that oh yeah
yeah right there
it feels like it's breaking up there put a little more in that area and the last cc
we'll put right in the middle here
alright
alright so I'll let you kind of shrug your shoulders move those muscles around
see how you feel feel good feel good i'm gonna push on those areas that you work pretty
tender on alright so we'll see ooh yeah if he already feels like it's gone down yeah I can
still feel the you know spasm there but that should be so these right this
medication reaches maximum effect about 15 minutes but that's not hurting you're
not jumping like excellent how about this side nothing good excellent
so that'll wear off and the hope is that when it wears off the muscle
will have reset and you don't have that that up you don't have that spasm
anymore all right so in the meantime what you can do is just some gentle
exercises and gentle stretches so so for the trapezius here I'll have you
back up and turn around so I can show you what to do here just gentle head
rolls or what you want to do so you can't kind of you can even if you want
take weights and kind of pull your arms down your shoulders down and then just
do gentle head rolls so head to chest and then slowly taking about 30 seconds
to go all the way around do your head rolls and that'll you'll
feel it on that side when you stretch it this way and then you slowly go over and
out get to the other side you'll feel it on the other side of me against the side
take about 30 seconds to go all the way around and just make sure your're
relaxed butt i'll yeah yeah all right can I still ice it oh yeah absolutely
yeah yeah yeah ice is perfectly fine you can even try some heat if you feel like
it's starting to spasm up again heat sometimes is better for muscles
thanks muscles like heat to relax alright so so we'll up sign out here so thanks
for joining us come on in here that's alright
thanks for watching this video and thank you to rob for letting us a video this
so hope you enjoyed this pass this on to your friends we'll see you next time