A 42 year old male professional cello player presented with a 2 year history of problems including his left arm shaking while he is playing. He has a history of falling on his left hand and forearm which resulted in a very bad sprain of the wrist.  This injury occurred approximately 5 years ago. Active ROM of his left shoulder was found to be 40% of normal in external rotation and abduction.  There was no pain associated with this deficit in motion; however there was a very hard “endfeel” to the same motion when performed passively. Active ROM also revealed limited left wrist extension and a marked decrease in strength of the left digiti minimi muscle.

Injury recall indicators were present for the wrist, elbow and shoulder.  IRT was administered to these areas and a 50% increase in active ROM was achieved immediately.  Origin-insertion IRT was also performed on previously inhibited muscles (left PMS, all divisions of his left deltoid, left latissimus dorsi, all divisions of the left trapezius, left triceps and left wrist extensors) which provided the patient with a greater ROM both actively and passively.  There was an immediate 75% reduction of the original complaint.