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Start the massage session with the patient positioned on his or her back. The deltoid muscle is located superficially. All its surfaces and margins can be easily palpated. This makes the treatment easier. As an introductory part of the session, massage the neck, shoulders, and arm on the affected side. Then turn the patient on his or her stomach and work with the upper back area, especially on the C3-C4 and C4-C5 segments of the vertebral column. The next step is to work with the posterior part of the deltoid muscle. Give special attention along line of attachment of the deltoid muscle to the spina of the scapula. To massage the anterior part of the deltoid muscle, turn the patient on his or her back again. Be very detailed along the border between the deltoid and pectoralis major muscles (i.e. area of stimulation of axillary nerve), as well as to the regions of insertion of the deltoid muscle to the clavicle and humerus. It is best to massage the lateral part of the deltoid muscle when the patient is in a sitting position facing the affected side to the practitioner. The location of the trigger points can be found in Fig. 332. The final part of the treatment involves stretching the deltoid muscle and shaking the whole arm.

If the patient has DS as a result of ANN, give special attention to the area between the anterior surface of the shoulder joint and the subclavicular region. This is an area of the projection cords and branches of the brachial plexus. Another important area to work is the axillary pit. Put the arm in the position of maximal abduction in the shoulder joint. Do not use strong pressure in this area.

b. Treatment using SRM.
The treatment of DS by the SRM method should be done on the Glezor/Dalicho's zones (see Fig. 46; 48-49).
(1). For influence on connective tissue component (CTZ), see Fig. 20-23; 24; 26;36.
(2). For influence on the skin component (dermatomes), refer to pages 63-64. The optimal direction of the massage strokes on the cervical and thoracic areas is shown in Fig. 56. We show the areas of main and supportive dermatomes on Fig. 331.

Fig. 331. Locations of main and supportive dermatomes in the case of right side DS. Dark areas - main dermatomes Shaded areas - supportive dermatomes