Patient Has 'Tight' Upper Trapezius Muscles?

My patient came in to our clinic yesterday complaining of 'tightness' in his upper trapezius muscles. He saw me two weeks ago for his R knee pain and that had settled, but now it was discomfort in his upper trapezius area. He had been using the trigger ball in his upper trapezius area and there were marks all over the area.

Other than tightness, he was complaining of a deep ache and constant discomfort there. He thinks this sometimes causes him to have headaches and neck pain as well.

Upright scapula

What gave me the most clues was looking at him from the side view. While looking at him from his left side (I'm using the picture above to keep his identity anonymous), his trunk was tilting backwards with respect to his hips. However, when I got him to straighten up you can see his left scapula tilting forward (right side of the picture below).

See how his left scapula tilts forward

Having explained to him what I saw, I then proceeded to treat him. I did not do any deep tissue massages/ or release his upper trapezius muscles (the area of his complaint). Neither did I stick any needles there to relieve the 'tight' muscle tone. I did not even treat his neck.

So what did I do? I treated his Front and Back Arm Lines. Yes, you read correctly. I treated his arms. If you look at work done by Tom Myers, he's able to dissect the "arm lines" (see picture below) from a cadaver.

In the picture on the right, the Superficial Back Arm Line has been laid over a skeleton model to show the fascia connections.

My patient was amazed, fascinated and happy that I got him better just by treating his arms. He almost couldn't believe it.
Treating the Deep Front Arm Line is key to getting his condition better because of the anterior tilting scapula. Treat the cause of the problem, not the pain.

Deep Front Arm Line