Confused about a nerve impingement

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I have a regular client, late 60's male, who has been complaining of tingling and numbness in the arms and hands (little finger, ring finger) and sharp pain at and above 90 degree abduction. I have been an MT for almost 10 months and have been dealing sucessfully with nerve impingements of this sort, but this one seems to involve more muscles and I'm a bit confused on the best approach.

So far I have had two sessions focused on this, and went about checking for a response from the common problem sites - scalenes, pec minor, ant. deltoid. They were tight as he has a protracted posture, but didn't elicit the response. When I went to work on his usual complaint site - upper back, his levator scapula, particularly at the origin, set it off. That coincides well with the limited abduction beyond 90degrees.

But, I found during that and our last session that supraspinatus and infraspinatus sets it off as well. He has no history of shoulder injury, but he does have a history of recreational baseball and his chief complaint is that he can't throw a baseball with his grandson.

I also notice that his head is always inclined to flex to his right when he is supine on the table.

I don't see the connection between levator scapula, and the rotator cuff muscles involved. Is it possible for infraspinatus to cause to refer pain down the arm to the hand?
 
Confused about a nerve impingement

Well, to build upon this...I found a muscle I don't think about often - Serratus Posterior Superior. It refers pain down the arm into the pinky and ring fingers. And it is deep to the superior angle of the scapula which is why the origin on levator was suspect, as well as supraspinatus at it's origin as well. And it can be felt at teres minor which is close enough to infraspinatus. But that doesn't explain why it is triggered at and above 90 degree abduction
 
Confused about a nerve impingement

Great detective work! :)

Maybe I can shed some light on this... (?)

Thought #1 - I'm willing to bet that there's a history of an MVA or a work injury somewhere along the line.
Thought #2 - If this is happening, and especially on both sides, it's most likely a problem with the position of the vertebrae. I say this because of:
  • The presentation of the levator scap symptoms, especially at their origin, which is C1-C4
  • The presence of not only pain (which would fit well with the trigger point idea) but also neurological symptoms (the numbness and tingling) - this suggests the nerve impingement involved commonly at the nerve roots, and almost always due to vertebral misalignments - the distribution described is roughly C8 - I would then also check for forearm flexor muscle issues and finger muscle extensor and side-to-side movement issues (T1) (basically the neighboring nerve roots to C8).
  • The bilateral nature of the symptoms - also suggestive of a more central root cause (i.e. spinal/vertebral) versus a peripheral one
Thought #3 - I also don't rule out brachial plexus, so you're spot-on to check scalenes (the first site of muscular impingement, and check the pec and axillary areas as well as pronator teres. Check for this on both sides. I wouldn't be surprised to find it on both sides, but secondary to something more central, such as vertebrae malposition.

Hope that helps! If you need a good chiro doc referral, lemme know and I'll do my best. I'm both a DC and an LMT so I know some trusted, talented people :)
 
Confused about a nerve impingement

Interesting information, jyoti.

I will ask him next time if there is a history of MVA or work injury.

I don't know if you read my post about Serratus Posterior Superior, but this muscle can cause the specific nerve pain referals that my client experiences. It explains also why the pain is felt around the superior angle of the scapula. It doesn't directly explain the pain at and above 90degree abduction, but your information on levator scapula's role makes sense, and it can tie into serratus in that the cervicle vertabrae are an attachment site as well as the ribs.
 
Confused about a nerve impingement

Well, when you find out for sure can you let us know.
I recently had an EMG done because of sharp, constant back pain.
I have my own theories and an orthopedic appointment as well.
I also was very symptomatic of right carpal tunnel which was confirmed
with the EMG. Now, within the past three weeks, my left arm started up.
I had cubital tunnel/ulnar nerve operation and it seems to have come back
like gangbusters. I thought it could be that I was maybe overcompensating
with the left arm because of the right, or possibly some diabetic neuropathy
but well, I'm a newbie returning after years of being out of work due to all my
medical *stuff*. But if you can give this person relief, please let us know.

I've heard of cubital tunnel returning but I do have a stitch in my shoulder ever
since this happened.
 
Confused about a nerve impingement

I've just continued to address Serratus Posterior Superior, levator scapulae, and to a lesser extent rhoms, SITS, scalenes. He seemed to respond strongly to Serratus and lev scap an every two weeks i see him he can raise his arm higher and higher and reviews improvement. no mva or work accidents.
 
Confused about a nerve impingement

Good clinical reasoning so far! It sounds like you are on the right track. :)

Massagynist said:
I've just continued to address Serratus Posterior Superior, levator scapulae, and to a lesser extent rhoms, SITS, scalenes. He seemed to respond strongly to Serratus and lev scap an every two weeks i see him he can raise his arm higher and higher and reviews improvement. no mva or work accidents.

Continue to address serratus anterior and pecs as well, particularly pectoralis minor. If you know how, use AIS or PNF stretching, or Muscle Energy Technique (MET) to stretch those anterior muscles, and also to strengthen the posterior shoulder muscles you are working with. If he doesn't gently strengthen those tissues, he will remain at increased risk of reinjury when he returns to throwing baseballs.

I also recommend that you check PASSIVE (client relaxed, not helping nor resisting) internal and/or external rotation. If the client's shoulder presents a "hard" or "bone-on-bone" type end feel, he probably also has some form of capsular adhesion restricting normal function of the glenohumeral joint. If so, you need to address that too, sooner rather than later.
 
Confused about a nerve impingement

Nerve root syndromes are those that produce symptoms of nerve impingement (a nerve is directly irritated), often due to a herniation (or bulging) of the disc between the lower back bones. Sciatica is an example of nerve root impingement. Impingement pain tends to be sharp, affecting a specific area, and associated with numbness in the area of the leg that the affected nerve supplies.
 
Confused about a nerve impingement

I have a client with a similar issue. I originally thought it was TOS (Thoracic Outlet Syndrome), he has upper-crossed posture, but the tests were negative. I checked the joint play of the Cx and things seemed ok. Eventually I found that a lot of his pain/tingling was caused by Subscap, but not all of it. So we've been working on correcting his posture with corrective exercises, massage, and MET's and he's coming a long well. If you can't figure out the exact cause do some postural observation and correct what is needed. If the Client is balanced out the pain usually goes away... usually.

Also, what someone said above, take him through the passive ROM to rule out jnt involvement.

:D
 
Confused about a nerve impingement

Jason, thanks for the tips. You will be interested in the lastest development.

TrP, cool name and your post also comes about at great timing.

This guy is a real onging project because he comes every 2 weeks so he keeps me on my toes. Every visit he can lift it higher, but the cause seems to shift with this new ROM.

It started out as Serr. Post-Sup being the main trigger (believe I didn't learn that one in school!), and then levator, RC lat rots. I WANTED the cause to be pecs and scalenes because they are so unbelievably tight...but they weren't his main complaints, and they didn't elicit a response in the arm and hand. This went on for a few sessions.

One time I see him I was amazed at how "soft" the muscles of his upper back felt, not to mention his middle and low back. I had also worked on (possibly) spinalis and iliocostialis throacis knots that I figured were from a life of desk work. Whether or not that is related - the back seemed softer and the upper back muscles were still eliciting a response, but way less intensely.

Then the weirdest thing happened last week...

He came in and his main complaint with the shoulder wasn't abduction, but rotation - especially when arm is at full extension. Back muscles still felt soft, but lat rotators (teres, infraspinatus) were moderately tender. I decided I could afford to spend more time on the neck and chest and I pounded away at scalenes for a bit and wondered if his neck didn't seem to be as laterally flexed as usual. Then I get to pecs and it's a bit of a new area so I do some pretty general palpation and massage scanning for points and he (a man of little words so i take what i can get) says "Yeah, I think that;s the spot". this after I worked all his usual spots. I asked him whether the sensation was stronger or weaker than the back and he said stronger. I tested lat and med rotation and both were pretty limited.


Anyway, hour was up and he seemed pleased with the immediate results.


I'm wondering what your guys' take is on this. He is my most consistent client and its not of a strong monetary interest that I am posting my treatment - it is wanting to really see what can be accomplished.

TrPAssasin,

I have suspected subscap here and there for some reason, even though I do not work on it often because I am relecutant to dive into my clients' axillae. Any thoughts on the new info I posted in relation to your experience?

Jason and others, any input would be very welcome as well.

Also Jason, I am not familiar with capsular adhesions.
 
Confused about a nerve impingement

I think Jason may be on to something, could be Adhesive Capsulitis (Frozen Shoulder) if so, what you are doing is good because no matter what kind of intervention is usually takes around a year to recover from.

Also, how is the quality of movement and is there any pain on active/resisted isometric int/ext rot of the shoulder or any part of ROM? On passive how does the shoulder feel and does the mvt elicit pain? If so then it may be a jnt or jnt capsule/ligament issue.

And thanks about the name :D
 
Confused about a nerve impingement

Like I mentioned he experiences pain during isotonic and isometric ext and int rotation of the shoulder.

I haven't assessed the end-feel so much. It is not something I am too familiar with, but I;m sure I can discern a bony end-feel.

I will have to look into this capsule issue.
 
Confused about a nerve impingement

I have been having success with James Waslaski's approach to releasing the shoulder capsule, but I couldn't find a video for you. Here's an alternative method that you might find useful: http://www.youtube.com/watch?v=qf5D7BrXLAY

On that page there is also a link to an Erik Dalton technique somewhat similar to this one. He moves much faster than I would recommend, but the basic idea is similar. Hope that helps!
 
Confused about a nerve impingement

Something I've noticed when working with people with chronic/long term muscle problems is that as you get the initial tight spots and triggers to let go, often the problem spots move somewhere else. When you think about it, it makes sense. The body tries to splint and support painfull areas, and it also tries to balance itself. So, if the front is tight to splint something, the back will grow tight to balance the tension, and vice versa. If the lower body is tight for some reason, the upper body will tighten up to balance. So it is not surprising that when you get good release in one area, you will find that the opposing areas now feel overly tight. And the longer the problem has been in place, the more of the body will be involved. Don't be afraid to assess and treat muscles outside the original problem area, the body has strange and wonderfull ways to cope. You may find that the opposite lumbar or hip is involved, or the other side of the neck, or the other shoulder. Or, you may hit a plateau where nothing you can do further improves things, and the client needs x-rays or an MRI to find underlying causes like spurs or tears. I usually recommend clients see a chiropractor first if massage is not noticeably improving the kind of ROM/tingling problems you describe. From personal experience, I know that subluxations can cause many subtle, hard to describe problems as well as the classic, acute stuff like sciatica. A question: in your state, can you reccommend exercises to your clients? Some homework in the form of ROM and strengthening exercises might just be helpful. :altsmile:
 
Confused about a nerve impingement

jyoti said:
Great detective work! :)

Maybe I can shed some light on this... (?)

Thought #1 - I'm willing to bet that there's a history of an MVA or a work injury somewhere along the line.
Thought #2 - If this is happening, and especially on both sides, it's most likely a problem with the position of the vertebrae. I say this because of:
  • The presentation of the levator scap symptoms, especially at their origin, which is C1-C4
  • The presence of not only pain (which would fit well with the trigger point idea) but also neurological symptoms (the numbness and tingling) - this suggests the nerve impingement involved commonly at the nerve roots, and almost always due to vertebral misalignments - the distribution described is roughly C8 - I would then also check for forearm flexor muscle issues and finger muscle extensor and side-to-side movement issues (T1) (basically the neighboring nerve roots to C8).
  • The bilateral nature of the symptoms - also suggestive of a more central root cause (i.e. spinal/vertebral) versus a peripheral one
Thought #3 - I also don't rule out brachial plexus, so you're spot-on to check scalenes (the first site of muscular impingement, and check the pec and axillary areas as well as pronator teres. Check for this on both sides. I wouldn't be surprised to find it on both sides, but secondary to something more central, such as vertebrae malposition.

PERFECT! Thank you for clearing up very eloquently, where I would need to work exactly. I was looking for some advice on that same issue. I don't run in to too many clients with impinged nerves through their neck and arm...it is more so with the Sciatic nerve and that's a breeze to correct. This ,on the other hand is doable, but I just needed a little extra advice on where else to massage and if it truly could be a vertebral thing. Thank you once again for your advice :)
-Malena
 
Confused about a nerve impingement

Sciatica is a breeze to correct??? Please enlighten me as to how to do that. I've suffered from recurrent sciatica for most of my life, due to an inherent looseness in the apparatus that holds the vertebrae in place, and a bunch of injuries. I've pretty much resigned myself to the fact that one side or the other of my low back, glutes, and legs is going to hurt all the time. I can throw my illiosacral joint out just turning over in bed! Right now the back of my right thigh is burning and tingling so much it is painful to sit. Yesterday, it was the left one, and I went to my chiro to get fixed, and now it is the right side. I'm overweight and getting older, that doesn't help, but this has been a life-long problem. If there is a way to fix, prevent, or even lessen the constant pain, I and my clients would be very gratefull!!
 
Confused about a nerve impingement

At least to find and work on...is what I really meant (about the sciatica). Compared to the nerve impingement around the brachial plexus area, that is.

As far as your injuries go, I do not specialize in medical massage, so I only say that for the clientel that I have recieved and worked on, which vary in size, health,etc..but I am no physical therapist. I am sorry that you are going through so much pain. The only thing that has worked for me and my clients is the more consistent you are about stretching,getting exercise and ,of course, massage, would greatly increase the ability for your muscles to be re-trained into their anatomically correct position. I have had sciatica as well, and it is no fun at all. I have lost about 20 lbs. since then and I don't have it as much or often. I stretch everyday now. I want to be a good example to my clients and not tell them to do things that I don't even practice myself. I take one 10-15 minute hot bath every day to every other day- or I just soak in a hot tub at my gym if I can help it, and that helps substantially with my tight muscles. I only drink water (on occasion a mineral water or soda) and whenever I feel that tingly or strained feeling in my glutes, which is a signal that if I don't take care of that problem, it will turn into sciatica,and I don't want to even go there, so I get my therapist to use his elbow or fist and stretch my glutes out. The tightness is gone, and then I can go about my usual body maintainence routine. I have about a medium muscle tightness...some people have more loose muscles and they have muscles that feel like jello :) but mine, even if I stretch,etc...still get tight...so you just have to stay on top of it and do what you have to do to prevent any further problems. Every body is different and I just found out what works for me and actually took my own,and other therapists advice. A foam roller is your friend and you should consider purchasing one ( I got mine for $20 at Academy- Sports and Outdoors, and it has been a life saver :) )A tennis ball or for even more direct pressure,a golf ball would do. The foam roller would be less abrasive but even the tennis ball, if sat on( along the piriformis area) and rolled around, would loosen up your muscles. I have even used a broom stick handle(it was rounded) and just leaned on it and swirled it around...but that is if you don't have anything. There is going to be pain involved when tending to these issues, but you will feel a release when and if properly worked on. I hope this clears things up for you :) Have a good day.

-Malena
 
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    Phoenix Blossom Spa 🌹🌹🌹3 girls 🔥🔥🔥5124 Dundas St W Etobicoke☎️416-817-3366👍 nice girl Luna and Ivy big boobs 36DD 😘😘😘😘Hot and sexy body, super body slide, very provocative service😘😘😘, professional super Suki deep tissue massage, has therapeutic effect to loosen bones and relieve muscle pressure and will bring you unexpected service effects, she will bring you a little surprise😍😍😍😍❤️You are welcome to make an appointment at any time or walk in the back door with plenty of parking spaces
  24. すみません:
    **Anniversary Celebration Alert!** 🎉 To celebrate our aniversary, we’re thrilled to announce a **2-Week Promotion** Starting from october 15th to 31st ! Every day, we’ll be selecting a lucky winner daily who will receive a **FREE room fee!** 🏨✨ How to enter: 1.The lucky person will have the chance to pick a lucky envelope that contains their free room fee prize. 🎁 Join us in the celebration, and don’t miss out on your chance to win! Good luck to everyone! 🍀
  25. laluna1857:
    Nu spring spa @ Spanish / Japanese/ Korean girls in Markham 416-669-8508 call getting more info
  26. hiyamickey:
    Reinella wellness have 7 girls working: Jenny, Cici, Hatti, Lulu, Pinky, Ella, Queenie @6262 Hwy7 until #1 Vaughan ☎️:905-851-4888
  27. Jenny’s Spa:
    🎉🍒JENNY’S SPA🎉🍒 ✅5170 DUNDAS STREET WEST✅ 👌ETOBICOKE ONTARIO M9A 1C4👌 ☎️( 647-893-5196)☎️Call or Text ☎️( 437-888-3759)☎️Call Only (ETOBICOKE) OPEN 10am to 9pm MONDAY to SUNDAY 🔥✅GRAND OPENING💯NEW GIRLS EVERYDAY🔥EXCELLENT MASSAGE + SERVICE QUEENS NOW AVAILABLE AT JENNY’S SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS🔥💯😘🔥❤️👌 🔥TWO BEAUTIFUL NEW YOUNG ASIAN GIRLS EVERYDAY🔥 💯REAL PICTURES OF ATTENDANTS💯 🔥TODAY’s ROSTER INCLUDES: Anna😘- A stunning sexy girl from Hong Kon
  28. Sparkling Spa:
    ⚡🌟SPARKLING SPA⚡🌟 ✅50 Lockridge Ave Unit 8✅ 👌Markham, ON L3R 8X4👌 ☎️ (905) 604-8186 Spa Land Line☎️ ☎️ (437) 446-6688 NEW Spa Cell Phone☎️ (West of Warden & 16th Ave) OPEN 10am to 9pm MONDAY to SUNDAY 🔥✅NEW MANAGEMENT💯NEW GIRLS🔥SUPERSTAR SERVICE QUEENS AVAILABLE AT SPARKLING SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS🔥💯😘🔥❤️👌 🔥SEXY NEW YOUNG GIRLS ALWAYS WORKING - Today’s Schedule is…🔥 Zoe - 🔥Stunning Tall Taiwanese Service Queen with Endless Passion and Sensuality who
  29. Sparkling Spa:
    ⚡🌟SPARKLING SPA⚡🌟 ✅50 Lockridge Ave Unit 8✅ 👌Markham, ON L3R 8X4👌 ☎️ (905) 604-8186 Spa Land Line☎️ ☎️ (437) 446-6688 NEW Spa Cell Phone☎️ (West of Warden & 16th Ave) OPEN 10am to 9pm MONDAY to SUNDAY 🔥✅NEW MANAGEMENT💯NEW GIRLS🔥SUPERSTAR SERVICE QUEENS AVAILABLE AT SPARKLING SPA FOR ALL YOUR MASSAGE AND SPECIAL EXTRA NEEDS🔥💯😘🔥❤️👌 🔥SEXY NEW YOUNG GIRLS ALWAYS WORKING - Today’s Schedule is…🔥 Zoe - 🔥Stunning Tall Taiwanese Service Queen with Endless Passion and Sensuality who
  30. lotushubspa:
    Dear customers, Lotus Spa is located at 10737 Yonge St unit13. The girl who works today is named Anna💋Tiffany💋Amy💋. We have massages from Taiwan, China and Korea for you. First-class service. Come and try it quickly👍💋Please contact 9052375885💋 or SMS 4163565876💋
  31. SunriseRH:
    FRIDAY at 𝗦𝗨𝗡𝗥𝗜𝗦𝗘 𝗦𝗣𝗔: NANA & NAYLA. 10 East Wilmot St, Unit 27, Richmond Hill, on ☎️ 𝟲𝟰𝟳-𝟯𝟮𝟱-𝟴𝟬𝟴𝟲 ☎️ NANA is a slim & pretty Chinese lady with liberal services. NAYLA is a tall, young, beautiful & curvy Spanish girl. Come and say hola. SUNRISE SPA, welcomes you to experience total relaxation in our comfortable, clean, cozy environment.
  32. NewOriental:
    FRIDAY at 🍏💚𝗡𝗘𝗪 𝗢𝗥𝗜𝗘𝗡𝗧𝗔𝗟 𝗦𝗣𝗔💚🍏: HAPPY & PHOENIX. 10 East Wilmot St, Unit 26, Richmond Hill, on ☎️ 𝟲𝟰𝟳-𝟯𝟴𝟭-𝟮𝟲𝟴𝟴 ☎️ HAPPY is a slim & busty Korean lady with great massage skills & lots of extra fun. PHOENIX is a gentle sweet Filipina lady, 5’4” and 105Lbs, with 34C-24-34 assets and very open minded. NEW ORIENTAL SPA
  33. Lulu_Villa_Spa:
    Jessica 💕💕 155 cm, 90Ibs Pretty Girl with amazing personality and super easy to get along 🥑 Sasa 💕 Sexy Vietnamese Body Type She is very sweet Provides Excellent Customer Service 🥑Judy💕 is a gorgeous model type Vietnamese Girl ☎️647-446-0886
  34. ASPA:
    𝗙𝗥𝗜𝗗𝗔𝗬 𝗮𝘁 𝗔 𝗦𝗣𝗔: 𝗔𝗺𝘆 & 𝗯𝗲𝘀𝘁 𝗺𝗮𝘀𝘀𝗮𝗴𝗲 𝗥𝗮𝗰𝗵𝗲𝗹 🅰️𝐀 𝐒𝐏𝐀🅰️, 28 South Unionville Ave, Unit 5, Markham. 🅰️𝗖𝗮𝗹𝗹 𝟲𝟰𝟳-𝟳𝟮𝟵-𝟲𝟲𝟬𝟲 𝗼𝗿 𝘁𝗲𝘅𝘁 𝟲𝟰𝟳-𝟴𝟯𝟵-𝟱𝟵𝟲𝟲🅰️ AMY is young and very friendly, standing 158 Cms. with 34C Cups and a very nice bum. Amy is a very popular student, young, sexy, and open minded. She is in demand for her good massage
  35. Golden Sunshine Spa:
    ✨Click On Username and FOLLOW US✅ Today 🌸Fran 🌸Isabella 🌸Alisa 🌸Aletta 🌸Selina ☎905 - 265 - 2158☎️
  36. Soul Relax Spa:
    ✨Click On Username and FOLLOW US✅ Today 🌸Emily 🌸Nina 🌸Kim ☎289 - 298 - 5662☎️
  37. ForeverWarden:
    Friday at 🫦❤️🔴🟥♾️𝓕𝓞𝓡𝓔𝓥𝓔𝓡 𝓢𝓟𝓐♾️🟥🔴❤️🫦 2190 Warden Ave, Unit 201, Scarborough 𝟰𝟭𝟲-𝟴𝟬𝟬-𝟳𝟴𝟴𝟳 : Bobo (New today), Mia & Sasa. Bobo is a small, slim and sexy lady, petite with all natural busty melons for your enjoyment. Mia is a Caribbean service queen temptress with incredible curves & very friendly attitude. She is able to bbbj like a queen, and is open to dfk and cfs.
  38. HolidaySpa:
    Friday at 🌴😎🌅𝓗𝓸𝓵𝓲𝓭𝓪𝔂 𝓢𝓹𝓪🌅😎🌴3517 Kennedy Rd, Unit 4, Scarborough ☎️𝟰𝟯𝟳-𝟮𝟰𝟳-𝟭𝟭𝟵𝟵☎️ EVA, YOYO & CINDY EVA is young, slim, innocent & demure looks, but don’t let her innocent looks deceive. She can massage & service very well. YOYO is a very beautiful slim Chinese lady, 165Cms & 116 Lbs with natural D Cups and a very sexy figure. She provides the best versatile PSE services.
  39. Annie Spa:
    🎉🍒ANNIE SPA🎉🍒 ✅7-1001 SANDHURST CIRCLE✅ 👌SCARBOROUGH ON M1V 1Z6👌 ☎️ (647) 891-9688☎️ ☎️ (416) 291-8879☎️ (FINCH & MCCOWAN) OPEN 9:30am to 9pm MONDAY to SUNDAY 🔥✅NEW MANAGEMENT💯NEW GIRLS🔥🔥 🔥GORGEOUS NEW YOUNG ASIAN GIRLS - TODAY’s ROSTER INCLUDES: 🔥 Baby😘🥰 A young, vibrant 22 year old petite spinner from Vietnam with a calm and welcoming presence. Her dark, flowing hair complements her soft, warm smile, creating an approachable and friendly atmosphere. She carries herself with
  40. Moneylee:
    All season wellness center : New Young girl big breasted beautiful buttocks charming temperament big boobs Mia ,young girl pretty face nice figure Thai deep massage Vivi,Young girl big breasted beautiful buttocks charming temperament big boobs Yoyo,Young girl Big breasted saucy naughty Ella ,Enchanting sexy petite deep massage Sherry 🏠address: #5-30 Rambler dr Brampton ,Ontario L6W 1E2☎️4376655510 👄👄🦵🦵🈵🈵👅👅
  41. Moneylee:
    Full season wellness center: New Young girl big breasted beautiful buttocks charming temperament big boobs Lucky , Young girl pretty face big boobs nice figure deep massage Jessica ,Young girl Big-breasted big Big boobs big butts May, Young beautiful face sexy body and good deep massage Maggie,Enchanting sexy petite deep massage Mary . 🏠 2560 Shepard Ave Mississauga unit 1 ☎️ 4379857899 🦵🦵👄👄🈵🈵👅👅
  42. See You Health Center:
    Candy💕 She is a Vietnamese With nice Sexy Slender Body, Curves and Sweet Melons 🥑 Cici💕 Cute Skinny Sexy Vietnamese Girl With Voluptuous Huge C Melons ☎ 416-988-2950
  43. tommyboy_69:
    united states
  44. Endless Joy Spa:
    ✨✨✨✨✨[GRAND OPENING]✨✨✨✨✨ 💞Endless Joy Spa💞 🎇 (155 East Beaver Creek Rd Unit #8, Richmond Hill) 416-731-8565🎇10am-2am, Young Slim Petite Chinese Lin, Sexy Slim Chinese Kiki, Sexy Chinese Linda, Tall Slim Sexy Chinese Kelly, Young Sexy Chinese Abie
  45. Red Rose Spa:
    🌸 We have 5 hot brown girls today 🌸 KAVYA, CANDY, SALMA, MALIYA, MONIKA, SANA, PRIYA 🌸 2588 Birchmount 🌸 2 Invergordon 🌸 647-702-8800 🌸 Please visit for a great erotic massage
  46. bnwellness_wilson:
    Blue Nile Wellness Center, we have 4 beautiful young girls are working today , young sweet slime 30’s and Young fun Tina curvy body open mind, fun GFE Lina and sexy Coco are providing deep tissue and sensual massage, pls call 416-3985777 book appointment and walk in aways welcome, back entrance and parking available, 350 Wilson Ave North York
  47. Lulu1980:
    Phoenix Blossom Spa♨️♨️♨️New combination 3 girls Luna and Mia and Tina👍The caring and gentle Mia will guide you in healthy physiotherapy, and the young and beautiful Tina's diversified massage techniques will provide you with hot services. Body slide🔥The mysterious little vortex WoW attracts you💯💯You are welcome to test it at any time and make an appointment👍5124 Dundas W Etobicoke☎️416-817-3366
  48. Endless Joy Spa:
    ✨✨✨✨✨[GRAND OPENING]✨✨✨✨✨ 💞Endless Joy Spa💞 🎇 (155 East Beaver Creek Rd Unit #8, Richmond Hill) 416-731-8565🎇10am-2am, Young Slim Petite Chinese Lin, Sexy Slim Chinese Kiki, Sexy Chinese Linda, Tall Slim Sexy Chinese Kelly, Young Sexy Chinese Abie
  49. Lulu1980:
    Phoenix Blossom Spa 🌹🌹🌹3 girls 🔥🔥🔥5124 Dundas St W Etobicoke☎️416-817-3366👍 New girl Cherry and Luna 😘😘😘😘Hot and sexy body, super body slide, very provocative service😘😘😘, professional super Vicky deep tissue massage, has therapeutic effect to loosen bones and relieve muscle pressure and will bring you unexpected service effects, she will bring you a little surprise😍😍😍😍❤️You are welcome to make an appointment at any time or walk in the back door with plenty of parking spaces
  50. lotushubspa:
    Dear customers, Lotus Spa is located at 10737 Yonge St unit13. The girl who works today is named Mary💋Lisa💋Coco💋. We have massages from Taiwan, China and Korea for you. First-class service. Come and try it quickly👍💋Please contact 9052375885💋 or SMS 4163565876💋
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