"The patient is a 60-year old woman with a progressive increase in shoulder pain that started as a mild aching. Over a three seek period she develops pain with overhead motions and has progressively worsening pain in her shoulder. By the end of 6 weeks she is having difficulty sleeping because she cannot lie on the side of her painful shoulder. She attributes her pain to sitting for prolonged periods working at her computer, during which she leans on her forearm. She also positions her elbow posteriorly to her shoulder, which places stress on the top and front of her shoulder. She also believes that her shoulder problem is exaggerated by the stress on her shoulder that occurs when she walks her dog, who frequently pulls at the leash in a sudden and forcible manner".

"Five months after the onset of pain, she has made little progress in range of motion but is sleeping most of the night and does not have aching in her shoulder while at rest. She notes that if she repeats her exercises often, her shoulder becomes more painful; unfortunately performing the exercises does not lead to improvement in range of motion. Her primary exercise is passive shoulder flexion, and she attempts to use her arm as much as possible doing daily activities. She has developed a skin irritation in the axilla from the limited motion, which she treats with Keri Lotion [Note: could that skin irritation be due to referred inflammation from a trigger point? - I have experienced the similar skin irritation in my own body]. Six months after the onset of the shoulder pain, the pain is only present at the end of the range of motion and she can tolerate more consistent performance of her exercise program…."

Trigger Point Case Study (6): Frozen Shoulder treated by Trigger Point Massage. Bernie, age forty-eight, had endured pain in his left shoulder for several months. The problem had begun when he tripped and fell while picking up broken branches after a storm.. The shoulder ached all the time and woke him repeatedly at night. He'd stopped even trying to raise his arm and dreaded putting on his shirt in the morning. He hated the idea of going to the doctor, but the problem wasn't getting any better. Bernie's wife gave him a gift certificate for a massage and to her great surprise, he went. The therapist worked on and extremely painful place under his arm and then showed him how to massage the spot himself. His shoulder was better right away, which encourage him to continue working on it on his own…. Three months later, he tested [his shoulder by raising] his arm all the way up. "I'd forgotten about it," he said. "I don't even think about it any more".