. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. assistants to be very cautiouswith massage because of the danger of overstimulating thenewly formed callus and the injured periosteum (see p. 189). 112 APPLIED MASSAGE Shoulder-joint and Its Bursse.—The shoulder-joint propercan be reached only through other structures; the deltoidand other muscles and in most places the bursse covering it,especially the subdeltoid bursa. In many lesions of theshoulder, however, these bursse are more or less involved,and will need treatment together with t
. A manual of therapeutic exercise and massage, designed for the use of physicians, students and masseurs. assistants to be very cautiouswith massage because of the danger of overstimulating thenewly formed callus and the injured periosteum (see p. 189). 112 APPLIED MASSAGE Shoulder-joint and Its Bursse.—The shoulder-joint propercan be reached only through other structures; the deltoidand other muscles and in most places the bursse covering it,especially the subdeltoid bursa. In many lesions of theshoulder, however, these bursse are more or less involved,and will need treatment together with the joint. They willbe considered later. We approach the shoulder-joint fromthe front, from behind, and from the axilla. Only the upperpart of the joint cannot be reached, as it is covered by theacromion. In the axilla we locate the joint by palpating. Fig. 44.—Thumb friction over the elbow. along the inner margin of the scapula up to the glenoid processwhich is distinctly felt. Effleurage and friction are done inthe usual way and need no special description. A form ofmassage which is very useful in fresh injuries is a kind ofkneading between both hands whereby an excellent supportis given to the joint and its neighboring structuxes. Agreat deal of pressure on the joint can thus be producedwithout pain or harm (see p; 171). In a similar mannerpressing and kneading can be applied from underneath tothe front or the back of the joint. SHOULDER-JOINT AND ITS BURSA 113 A word must be said about the position in which mas-sage of the shoulder-joint can best be done. We preferhaving the patient supine with the arm shghtly abductedand elevated, the elbow resting on a pillow or on theoperators knee. Thus the muscles are fully relaxed andthe fingers can push tow^ard the joint more easily. Thekneading between two hands can also be done with t
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