Once you have evaluated your client from the lateral (side) view you will need to start evaluating the client from the anterior (front) view. We will start by analyzing the two most common anterior distortions: Uneven Shoulders

For this course, we are going to keep these as simple as possible to allow you to treat the muscles involved without getting caught up in diagnosis. You can really make an enormous difference for a client if you can address the short/tight muscles in the body.

What is going on with an Uneven Shoulder(s)?

There are several reasons a client could have one shoulder elevated over the other.

• Structural or neural issues – An uneven shoulder height could be because of structural imbalances such as scoliosis (unnatural curve of the spine), a titled pelvis or having one leg longer than the other. In addition, neural issues such as a neck injury from the past could result in one shoulder raising.

• Uneven Hips – If you have hips that are not level, in that one hip is higher than the other, this can cause the shoulders to appear uneven. This hip imbalance is known as a lateral pelvic tilt. In a lateral pelvic tilt the side with the higher hip will have have the shoulder that is lower down.

• Flat foot – Having flat feet, or more specifically having a foot with one arch that is more collapsed than the other, can cause one hip to be raised higher than the other, which in turn can cause uneven shoulders.

• Muscular imbalance – Muscles around the elevated shoulder are not the correct length due to overuse or tightness.

So how do you start addressing this issue?

Treatments

Correcting for an elevated shoulder means you will have to first properly assess the condition. You will want to first assess for scoliosis, lateral pelvic tilts and flat feet. Once you have assessed and you are determined that this is simply a muscular imbalance, then you can proceed to address the neck and shoulder muscles involved.

Remember, as a massage therapist you should never diagnose, however visually assessing for short & tight muscles is in my opinion YOUR JOB. In future lessons we will have a video demonstrating a full assessment. You should also correct the four contributing factors:

Muscles that are tight/short:

Levator Scapula

Scalenes, SCM

Upper Traps

1. Massage & Stretch the the tight Levator Scapula, Upper Traps on the effected side. Use Deep Tissue Massage, Myofascial Release Techniques or PNF Stretching.

In the event that a client has overactive upper traps that are causing this situation to reoccur, it will benefit the client to strengthen the Lower Traps. Activating and strengthening the lower traps, will counteract the chronic upward pull of the upper traps.