When Your Shoulder Still Won't Go Overhead or Your Knee Won't Bend Fully
Key Takeaways
- Joint mobilization research shows specific joint techniques restore lost range of motion by addressing capsular tightness that develops after injury, which massage cannot access because it only works on muscles
- Targeted soft tissue work breaks down fascial restrictions and scar tissue that limit movement, reducing pain and improving function in athletes with chronic joint problems
- Neural mobilization studies demonstrate these techniques resolve nerve-related symptoms like numbness, tingling, and radiating pain by freeing up trapped nerves rather than just rubbing the muscles around them
You've been getting massage for months. Your muscles feel better temporarily, but your shoulder still won't go overhead for a snatch. Your knee still won't bend deep enough for a squat. Or nerve pain shoots down your leg every time you sprint.
Massage helps muscles relax. But if your problem is a stiff joint capsule, stuck fascia, or a trapped nerve, massage won't fix it. Our manual therapy program identifies what's actually limiting your movement and targets that specific structure.
When Your Joint Won't Move Through Full Range
Your shoulder won't go overhead. Not because the muscle is weak, but because the joint capsule tightened after your injury. Stretching and massage haven't helped because you can't stretch a joint capsule from the outside.
Joint mobilization puts specific pressure directly on your joint, gradually stretching the tight capsule. Research shows this restores range because you're targeting the actual stuck structure. Different intensities work for different situations: gentle movements for painful joints, more aggressive techniques for stiff-but-not-painful restrictions.
What it feels like: the therapist stabilizes one part of your joint and moves the other in specific directions. You feel pressure at your range limit, maybe mild discomfort. Your range improves immediately after the session.
Our orthopedic physical therapy specialists test which directions are stuck, then target those specific restrictions instead of generally stretching everything.
When Scar Tissue Limits Performance
You sprained your ankle six months ago. It doesn't hurt, but you still can't push off as hard during sprints. Or that healed hamstring strain still feels thick and restricted when you stretch.
That's scar tissue and fascial restriction. When tissue heals, it lays down messy collagen patterns rather than organized lines. Massage loosens it temporarily but doesn't break down those restrictions.
Instrument-assisted soft tissue work uses metal tools that concentrate force, breaking down adhesions hands can't affect. The tool catches on restrictions as it runs along your tissue. You feel scraping and discomfort when they hit restricted areas. The area looks red after treatment. That's normal and fades within a day.
Studies show this reduces pain and improves function because it changes tissue structure, not just provides temporary relief. That restricted feeling disappears. Your ankle pushes off harder. Our therapists at Timonium combine this with movement retraining so your body uses the new range properly.
When Nerve Symptoms Won't Go Away
Numbness in your fingers gets worse in certain positions. Burning sensation down your arm during overhead pressing. Sciatic pain shoots down your leg when you touch your toes. Your massage therapist has worked your muscles for weeks, but nerve symptoms don't change.
The problem isn't your muscles. Your nerve is trapped somewhere along its path. Nerves need to slide as you move. When they get stuck, they send pain, numbness, or tingling signals.
Neural mobilization moves the nerve itself. The therapist positions you to tension the nerve, then moves you through sequences that floss it through surrounding tissue. Feels like pulling or stretching along the nerve path, maybe tingling.
A review of 40 studies found these techniques improve pain and function for nerve problems because you're targeting actual nerve mechanics. After a few sessions, tingling reduces, numbness improves, and triggering positions don't bother you anymore. Works for carpal tunnel, sciatica, and thoracic outlet syndrome that massage keeps missing.
How to Know If You Need This
Get massage for: muscle soreness, tightness, general recovery.
Get manual therapy for:
- Lost range of motion after injury that stretching hasn't restored
- Joints that won't move fully (shoulder overhead, deep knee bend, ankle dorsiflexion)
- Thick, restricted areas unchanged with regular soft tissue work
- Nerve symptoms (numbness, tingling, shooting pain) down arms or legs
- Same treatment for weeks without improvement
True Sports assesses what structure is causing your problem, then fixes that structure. Whether you're at Bethesda or Timonium, same assessment-driven approach.
Schedule your assessment and find out what's limiting your movement.
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Frequently Asked Questions
I've been getting massage for months. Will manual therapy be different?
If massage temporarily helps but your problem returns, you're treating the wrong structure. Manual therapy targets joints, fascia, and nerves massage can't reach. You should see measurable improvement in 2-3 sessions if we're addressing the right issue.
Does this hurt?
It's not relaxing. You'll feel pressure, stretching, sometimes discomfort on restricted areas. Nothing sharp or intolerable. Most athletes call it "good pain" that leads to immediate improvements.
My shoulder won't go overhead. How many sessions?
Recent injuries with capsular tightness: 4-6 sessions. Chronic restrictions that have been there months: 8-12 sessions. You'll know after session one if we're on track because you'll gain range immediately.
Can this help my sciatica?
If your sciatica is from trapped nerve, neural mobilization often resolves it. If it's from disc herniation or structural issue, we can reduce symptoms but might not eliminate them. Assessment determines what's realistic.
Do I need a doctor referral?
No. Maryland, Delaware, and Pennsylvania allow direct access to PT. Schedule directly with us. We'll determine if manual therapy is appropriate or if you need imaging first.
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