A Superhero saved by NKT
Not long ago the stunt man for a major motion picture superhero film came to see me for intense pain in his left rhomboid/trapezius region that was most aggravated in the mornings while drinking his coffee. The pain persisted all day but those early mornings were debilitating - which is saying something for a stuntman whose job is to basically get hurt. After 3 months of this discomfort he was limited in the stunts that he was able to perform but was able to modify his duties and coordinate stunts, however filming for a new movie was starting soon and he was the the stunt double for the lead superhero. This needed to be addressed ASAP.
He had seen multiple practitioners and had acupuncture, soft tissue release and chiropractic adjustments to the surrounding area. MRI results showed nothing of significance. He had heard about NKT and decided to give it a try since he was receiving some temporary relief with soft tissue release to the rhomboids. Maybe there was a compensation pattern in the area?
Anytime I hear that soft tissue work yielded temporary relief, I think that muscle was likely overworking and causing discomfort, but the muscles that are underworking were not being addressed. The human body can be pretty creative when it comes to compensating so I find a diligent history is foundational to understanding how the body has adapted to injury over time.
Since the injury history for this stuntman resembled an encyclopedia, I decided to focus on the 6 months prior to when the pain started. There was a left AC joint separation after a fall from an 8 foot platform that needed to be rehabbed ASAP for a role. The rehab process involved a lot of “scap setting” which essentially means he used his rhomboid/mid traps to stabilize for every exercise. Under normal circumstances this is generally an OK strategy as the glenohumeral (GH) joint appreciates a stable scapula, however in this circumstance the muscles around the AC joint needed more attention after an AC separation injury. Using the scapula to stabilize for weakness in the GH joint was not working to his advantage in this scenario.
The first NKT pattern we focused on was rhomboid facilitated for posterior deltoid. When we took away his scap setting, his posterior deltoid was very weak. If he set his scapula, it was very strong. His body relied on his rhomboid/mid trap to stabilize the GH joint. After this yielded significant improvement, we worked on the pecs facilitated for serratus anterior and after a couple sessions of this focus his pain was gone. Cautious optimism was in the air as he prepared for the film by getting thrown into walls, flung around with bungie cords, etc. Once filming started symptoms came back about 10% but continuation of his NKT exercises shortly led to the pain being completely resolved and he was able to film successfully.