Category Archives: Musculoskeletal Health

5 things you didn’t know could be caused by muscle pain

Most massage therapists and myotherapists treat taut bands of muscle and what they call myofascial trigger points, or what you might know as ‘knots’ in the muscle. Also known as trigger points, they are described as hyperirritable spots in the fascia surrounding skeletal muscle. They are associated with palpable nodules in taut bands of muscle fibres. There is little science around what causes these trigger points, or how they can be medically diagnosed, as they cannot be seen in medical imaging. As a result, the misdiagnosis of myofascial pain is prevalent.

The misdiagnosis of pain is the most important issue taken up by Travell and Simons, the clinical physicians who coined the term, trigger point. Referred pain from trigger points mimics the symptoms of a very long list of common maladies, but physicians, in weighing all the possible causes for a given condition, rarely consider a myofascial source. The study of trigger points has not historically been part of medical education. Travell and Simons hold that most of the common everyday pain is caused by myofascial trigger points and that ignorance of that basic concept could inevitably lead to false diagnoses and the ultimate failure to deal effectively with pain. [1]

Below are just five symptoms of myofascial pain. If you’ve explored other options with your GP, with no results, consider checking with your massage therapist to see if myofascial tension could be the cause…

  1. Earaches, Ringing (Tinnitus) or Itchy ears
    These muscles in the front of the neck, jaw and face join in around the base of the ear and can lead to ear pain, feeling of itchiness or create a ringing in the ear.

Sternocleidomastoid or SCM for short, has a whole list of symptoms it can cause when it is tight and has active trigger points, including sinusitis-like symptoms, dizziness after whiplash injury, sore throat, temple or frontal headache, dry cough and nasal drip. Tension in SCM in combination with tension in the masseter and pterygoid muscles, that help you chew, can lead to ear pain.

Massage through the front of the neck and jaw can ease these symptoms.

  1. Rapid, Fluttery, Irregular Heartbeat or Heart Attack-like Pain
    Muscles in the chest, including the sternalis and pectorial major, can cause pain in the chest. While trigger points in the scalenes, at the front of the neck can cause referral pain in the chest and arm. Tension in these muscles can lead to pain that emulates heart palpitations or heart attack. However, if you are having these symptoms, please call emergency and be cleared for any heart problems first before you think about having a massage.

  2. Irritable Bowel
    Trigger points in the lateral abdominal obliques can cause dysfunction of the muscle and inhibit the function of the bowels.
    While dysfunction of the multifidi of the lumber spine can cause dysfunction of the pelvic floor muscles that control bowel and bladder movements.
    Massage to the abdomen can help get the muscles back to normal function and relieve active trigger points that may be causing pain and dysfunction.
    One way to help recruit and strengthen the lumbar multifidus muscles is by tensing the pelvic floor muscles for a few seconds “as if stopping urination midstream”.[2]
  1. Stress Incontinence or Anal/Genital/Perineal pain
    Stress incontinence is a condition (found chiefly in women) in which there is involuntary emission of urine when pressure within the abdomen increases suddenly, as in coughing or jumping.
    Stress on the adductor magnus, piriformis and pelvic floor muscles can often occur during childbirth, or exercise. These muscles are on the inside of the thigh, in the deep gluteals/hip rotators and the distal floor of the pelvis respectively.
    The pelvic floor is important in providing support for pelvic organs, such as the bladder, intestines, the uterus and in maintenance of continence as part of the urinary and anal sphincters. It facilitates birth by resisting the descent of the presenting part, causing the foetus to rotate forwards to navigate through the pelvic girdle. It helps maintain optimal intra-abdominal pressure.[3]
    Massage can be performed through the adductor magnus and piriformis. Your massage or physical therapist can teach self-massage to you for the pelvic floor, stretches and exercises to help ease tension in all of these muscles.

Easy Stretches to Relax the Pelvis – Women

  1. Menstrual or Pelvic Pain
    Similarly, the muscles around the pelvic floor, deep glutes, sacrum and abdominals can cause menstrual or pelvic pain. Some abdominal massage, self massage to the pelvic floor and stretches and exercises can aid in releasing these muscles to ease menstrual pain.

Please remember, that although muscular pain can lead to a range of symptoms, to check with your GP or health physician first to rule out any other cause.

Three things your massage therapist will always tell you

If you’ve injured yourself there are a number of things that your massage therapist will tell you to do after your massage, but there are three things they will always tell you in order to help you get better;

 

  1. Stretch

If you’ve injured yourself or you have chronic muscular pain and tension, stretching is a really great way to ease that tension and manage the pain. It will almost certainly speed up your recovery.

And you know, we can tell when you’re not doing them!

 

2. Rest

If you’ve injured yourself during a specific activity, particularly during sport, it’s a good idea to rest that part of the body. If you’ve injured your shoulder at the gym, then make this week, leg week. If you’re doing a repetitive task at work, ask your manager to change your duties or switch to light duties. It’s important to rest your injury, to enable it to heal, otherwise you may just be exacerbating the issue.

3. Follow up

Even if you feel better, please have your follow up within 5 to 10 days of your initial appointment. There is often still tension there, even if those trigger points have been eased. If you are still tight, and return to the activity that caused the injury, the trigger points, and pain is likely to return too.

If you have that follow up the week after, you are likely to stay pain free for longer, and that is every massage therapists goal for you!

 

Four easy exercises to ease Achilles tendonitis

What is Achilles tendonitis?
Achilles tendonitis (also known as Achilles tendonitis, Achilles tendinitis, Achilles tendon pain, Achilles tendinosis, Achilles tendinopathy) is inflammation of the Achilles tendon. The Achilles tendon is a tough band of fibrous tissue that connects the calf muscles to the heel bone (calcaneus). The Achilles tendon is also called the calcaneal tendon. The gastrocnemius and soleus muscles (calf muscles) unite into one band of tissue, which becomes the Achilles tendon at the low end of the calf. [1]

Anatomy of the heel

How do you get Achilles tendonitis?

Achilles tendonitis is an overuse injury that can occur with over training or poor biomechanics due to anatomy or poor footwear.

Common causes of Achilles tendonitis include;

  • Over-training or unaccustomed use – “too much too soon”
  • Sudden change in training surface, such as grass to bitumen
  • Flat (over-pronated) feet
  • High foot arch with tight Achilles tendon
  • Tight hamstring (back of thigh) and calf muscles
  • Toe walking (or constantly wearing high heels)
  • Poor footwear
  • Hill running
  • Poor eccentric strength [2]

Excessive high heel wearing can lead to Achilles tendonitis

What are the signs and symptoms of Achilles tendonitis?
The main signs and symptoms of Achilles tendonitis are pain in the Achilles area, particularly on walking/running and swelling around the back of the heel and Achilles tendon. Other symptoms include tight calf muscles, poor range of motion in the calf and ankle and the feeling of heat or burning in the heel.

Who gets Achilles tendonitis?
Achilles tendonitis is a very common runner injury . It can however, also affect athletes, basketballers, dancers, or people who put a lot of repeated stress on their feet.

Those with an over-pronating gait due to high foot arches can often be inflicted with chronic Achilles tendonitis and have to manage the injury for life.

How is Achilles tendonitis treated?
Most cases of Achilles tendonitis can be treated at home before it gets too severe.

Use the RICER formula:

  • RestDon’t exercise for a few days, or try an exercise that doesn’t stress your feet, such as swimming.
  • IceApply an ice pack wrapped in a towel or a cold compress to your tendon for 10 minutes or more after you exercise or if you feel pain in the tendon.
  • CompressUse tape or an athletic wrap to keep swelling down and help support and immobilise the tendon.
  • ElevateLie down and raise your foot above the level of your heart, and if possible, try to sleep with your foot elevated. This will help keep the swelling to a minimum.
  • Refer: See a physical therapist, such as a podiatrist and a massage therapist for treatment
  • Take anti-inflammatory medications. Pain relievers like ibuprofen can help ease pain and reduce swelling in the short term.
  • Stretch and exercise your ankles and calf muscles while you recover. Keeping your muscles, tendons, and ligaments strong and flexible will aid in your recovery and help you keep from re-injuring your Achilles tendon. A physical therapist can help you come up with a good exercise program.
  • Prescription orthotics. Orthotics can be helpful if you have poor biomechanics. Talk to your GP or a podiatrist to find out if they might work for you.
  • Massage. Remedial massage can help manage the muscle tension in the hamstrings and calves and help reduce swelling around the Achilles tendon [3]

What stretches should I do for Achilles tendonitis?

Calf Stretch: Place your hands on a wall with one leg straight and the heel to the ground. Place the other leg, with the knee bent, in front of the straight leg and push your hips toward the wall. Stretch your calf to the point where you feel a strong pull but no pain. Do not let your heels come off the ground. Hold the position for 20-30 seconds, and then relax. Repeat 3 times on each foot in a slow controlled manner.

The same stretch can be repeated, with both front and back knees bent.

Straight Leg Calf Stretch

Seated Heel Raises: Sit on a chair and raise your toes up as high as you can without pain. Slowly lower your heels. Do 5 repetitions, 4 times a day. You can gradually increase the intensity, as you get stronger by holding a weight on your thighs.

Seated Calf Raise

Following are some other exercises you can do, but they should be done under the supervision of a physical therapist, at least initially, because they could damage the Achilles tendon if they’re not done correctly:

Bilateral Heel Drop:  Stand at the edge of a stair or a raised platform that is stable. Put the front part of each foot on the stair. This position allows your heel to move up and down without hitting the stair. Hold on to a railing or support to help your balance.

Slowly lift your heels off the ground and slowly lower your heels to the lowest point possible. Be sure to do this in a controlled manner 20 times. You can also do this starting on the floor rather than the stair.

Unilateral (Single Leg) Heel Drop: This is similar to the bilateral heel drop except it’s done on one leg while the other leg is bent. Raise your heel off the ground and slowly lower it down. Do it in a slow controlled manner. Then switch to the other leg. [4]

Unilateral Heel Drop

 

 

 

 

 

 

 

 

 

 

 

 

 

[1] https://www.webmd.com/fitness-exercise/picture-of-the-achilles-tendon#1

[2] http://physioworks.com.au/injuries-conditions-1/achilles-tendonitis-tendinitis

[3] http://m.kidshealth.org/en/teens/achilles.html#kha_11

[4] https://www.webmd.com/fitness-exercise/stretch-achilles-tendon

Muscle in focus: Hamstrings

The hamstrings

I know I call this ‘muscle in focus’ but the hamstrings is really a group of muscles, three to be precise. At the back of the thigh, between the hip and the knee, semimembranosus, semitendinosus and biceps femoris all have two main actions, extension of the hip and flexion of the knee. They play a crucial role in standing up, walking, running, jumping… and are the major antagonist of the quadraceps. [1]

They are also the most injured muscles in the body.

Hamstring muscle injury is a common athletic injury, particularly for runners, running & jumping athletes like footballers, long & high jumpers, and dancers.

The most common cause of a muscle or tendon strain is overuse, which weakens the tissue fibers. Muscles and joints may also be forced to perform movements for which they are not prepared or designed, over stretching and potentially damaging the surrounding muscle or tendon. An injury can occur from a single stressful incident, or it may gradually arise after many repetitions of a motion. [2]

The word “ham” is derived from the Old English ham or hom meaning the hollow or bend of the knee, from a Germanic base where it meant “crooked”. … String refers to tendons, and thus, the hamstrings are the string-like tendons felt on either side of the back of the knee.

Injuries to the hamstring group of muscles can range from a minor strain to a major rupture. A minor or grade I tear to a hamstring will most likely heal with a small amount of physical therapy, such as massage and dry needling. A major, grade III tear or full rupture could be a major disruption to an athletes sporting career and may require surgery.

World Athletics Championships, 2017

Even someone at an Olympic level like sprinter Usain Bolt is not immune to injury, tearing his hamstring in the World Athletics Championships earlier this year.

How do they happen?

At the knee, these muscles act to slow down your leg as it swings forward very quickly during in preparation for footstrike. It’s this action that commonly leads to injuries because the muscle is trying to shorten and contract, but the knee is extending very quickly, which pulls on the hamstring and creates a tremendous amount of strain.

At the hip, these powerful muscles generate force just prior to the foot coming off of the ground as they extend the hip backwards. Injuries can occur at this point of the running cycle because these muscles are generating tremendous amounts of force to maintain, or increase, forward running velocity. [3]

What are the symptoms?

You don’t have to be an elite athlete to injure the hamstring. Over use, misuse and lack of stretching or massage can put you at risk. Even tight quadraceps can contribute to tight hamstrings.

Symptoms of a strained or torn hamstring could include sudden and severe pain during exercise, along with a snapping or popping feeling in the area, pain in the back of the thigh and lower buttock when walking, straightening the leg, or bending over; tenderness; bruising in the area. [4]

In severe cases, you can tear your hamstring from its point of origin on the ischial tuberosity (sit bones). This is called a hamstring origin avulsion. In extreme cases, an avulsion fracture will occur where the hamstring muscle tears the bone where it attaches off your pelvis. This happens after a sudden and forceful eccentric contraction of your hamstrings with your hip flexed, for example, when hurdling or performing the splits. When this occurs, it is necessary to undergo surgery in order to reattach the bones.  [5]

How is it treated?

If you feel you have strained or torn a hamstring muscle, the first thing to do is R.I.C.E.R. – Rest, Ice, Compression, Elevate and Refer, as in refer to a health care practitioner.

The risk of hamstring injury can be reduced with a regular stretching program and exercises. However, a strained or torn hamstring will need soft tissue therapy, some biomechanical assessment to find the cause of the injury, heat & ice therapy and stretching. Once the pain has eased, the muscle will benefit from gentle exercise and a strengthening program.

Static hamstring stretch

Straight leg hamstring stretch

Lying on your back, raise your leg straight up until you feel the tug of the muscle. Don’t over stretch or force the stretch. If you feel numbness in your foot, ease the stretch off a fraction until the numbness subsides.

Breathe deeply and hold the stretch for 30 seconds. Lower the leg and rest for 10 seconds. Repeat each leg 3 times.

If you need to support the leg, use a towel or belt looped around the arch of the foot.

 

To increase flexibility

Lie on the floor in a doorway or close to a corner of a wall.

Place one leg up against the wall, the other is straight on the floor and your buttock is as close as possible to the door frame or wall.

Extend the elevated leg and pull your toe own as much as possible until you feel a stretch behind your thigh.

Hold the stretch for between 10 and 30 seconds.

Active Stretch

If you’re a particularly flexible person, but still have tight hamstrings, you could benefit from an active stretch.

Lie face up with a theraband around the arch of the foot to be stretched. Bend this knee. Hold the stretch theraband in one hand, arm straight. Stabilize the thigh with the other hand.

Exhale, straighten the knee while lifting up on the theraband, until extended.

Lower the leg and repeat 5 times. Finish with a static stretch.

Foam rolling

Place a foam roller on the floor and sit on the floor supporting yourself with your hands.

Place the back of one thigh over the foam roller and the other leg on the floor for support. Support your core and have proper low back posture during the exercise.

Magnesium: what is it & what does it do for you?

I regularly recommend my clients use magnesium, either in the form of a supplement, topical cream or oil, or as salts dissolved in a warm bath.

But what is magnesium, and what does it do for our body?

The Science

Magnesium

Magnesium is a chemical element. It is the fourth most common element on Earth, and the third most common dissolved in seawater. Magnesium is the eleventh most abundant element by mass in the human body and is essential to all cells and some 300 enzymes.

The important interaction between phosphate and magnesium ions makes magnesium essential to the basic nucleic acid chemistry of all cells of all known living organisms. More than 300 enzymes require magnesium ions for their catalytic action, including all enzymes using or synthesizing adenosine triphosphate (ATP).

Now I don’t want this to turn into a boring chemistry lecture, but ATP is a complex organic chemical that participates in many processes, including providing energy for nearly all of the body’s metabolic processes and muscular contraction. 20% of the body’s magnesium is for skeletal muscle function.[1]

Magnesium is also an imperative part in;

  • Nerve conduction
  • The production of energy from carbohydrates and fats
  • The production and maintenance of healthy bones, including the synthesis of bone matrix, bone mineral metabolism and the maintenance of bone density
  • Maintenance of healthy heart function and normal heart rhythm.[2]

Where can we source magnesium?

The Source

Nuts, Greens, Cocoa & Spices

Spices, nuts & seeds, cereals, cocoa (W00T!) and leafy green vegetables are rich sources of magnesium. [3]

Thankfully, if we are not getting enough magnesium in our diet, or are experiencing symptoms of magnesium deficiency alternative methods for magnesium intake is readily available.

Bath salts

Magnesium chloride

Magnesium chloride is extracted from seawater and is more readily absorbed through the skin than other forms of magnesium, so it’s perfect for bath salts. It is not for ingestion.

Magnesium sulfate

Magnesium sulfate is more commonly known as Epsom salts. A great source of magnesium and available in most supermarkets and chemists, Epsom salts have been popular since it was discovered in the British town it was named after, in the 17th century. [4]

Topical creams and oils

As both magnesium chloride and sulfate are absorbed through the skin, they make great topical applications and are available in creams and oils that can be rubbed directly on the sore or cramping muscle. Great for carrying in your sports or travel bag and cant get to a bath.

Topical spray, supplements, bath salts

Supplements

Magnesium itself cannot be absorbed and needs to be bonded to another molecule to be absorbed. The most common bonding agents are oxide, citrate, glycinate, sulphate or amino acid chelate.

This is the least absorbed form, but also has one of the highest percentages of elemental magnesium per dose so it still may be the  highest absorbed dose per mg. This is a great general purpose magnesium if really Mg is all you need.  It makes a simple muscle relaxer, nerve tonic and laxative if you take a high dose.

This is one of the most common forms of Mg on the commercial market. This is Mg bonded to citric acid, which increases the rate of absorption. Citrate is a larger molecule than the simple oxygen of oxide, so there is less magnesium by weight than in the oxide form. This is the most commonly used form in laxative preparations.

In this form, Mg is bonded to the amino acid glycine. Glycine itself is a relaxing neurotransmitter and so enhances magnesium’s natural relaxation properties. This could be the best form if you’re using it for mental calm and relaxation.

Magnesium amino acid chelate is usually bonded to a variety of amino acids. In this form there is less magnesium by weight but the individual amino acids could all be beneficial for different things. Every formula is different so if you need both Mg and a particular amino acid, then this could be the way to go. [5]

Recommended daily intake of magnesium is;

  • 400 mg/day for men aged 19-30 years, increasing to 420 mg/day for those aged 31 and above,
  • For women aged 19-30 years, the RDI is 310 mg/day, increasing to 320 mg over the age of 30,
  • Depending on their age, the RDI for adult women who are pregnant is 350-360 mg/day.
  • The RDI for breastfeeding for those who are breastfeeding is 310-320 mg of magnesium each day. [6]

What happens if I don’t have enough magnesium?

The Symptoms

If you’re not getting enough magnesium in your diet then you may be experiencing symptoms such as;

  • Muscular cramp

    Muscular problems such as cramps, twitches, slow to recover from injury, aches and pains,

  • Fibromyalgia is sometimes linked to magnesium deficiency,
  • Migraines and headaches, including tension headaches,
  • Period pain and symptoms of premenstrual syndrome, including mood swings , fluid retention, premenstrual migraines,
  • Stress, irritability, insomnia and anxiety,
  • Fatigue, which may be a symptom of magnesium deficiency.

It may also play a role in helping to maintain cardiovascular health and healthy bone density.

What could be causing my magnesium deficiency?

The Seed

  • Stress (especially when prolonged or severe),
  • Inadequate sleep,
  • Profuse perspiration,
  • Excessive consumption of caffeine, salt, sugar and alcohol,
  • Heavy menstrual periods,
  • Eating large quantities of processed and refined foods,
  • The use of some multiple pharmaceutical medications,
  • Gastrointestinal disorders such as short-term diarrhoea or vomiting and conditions that affect your absorption of nutrients,
  • Getting older. [7]

Can I have too much magnesium?

Doses less than 350 mg daily are safe for most adults. When taken in very large amounts, magnesium is possibly unsafe.

Symptoms of magnesium overdose include;

  • diarrhea
  • nausea and vomiting
  • lethargy
  • muscle weakness
  • irregular heartbeat
  • low blood pressure
  • urine retention
  • respiratory distress
  • cardiac arrest. [8]

 

The best way to ensure you’re getting enough magnesium is to maintain a healthy diet of whole foods and steer clear of processed and refined foods. If you are getting regular cramps or muscular pain it might be a good idea to get some advice from your physical therapist.

Maintaining muscular health can be as easy as regular gentle exercise and stretching, fresh air and water each day, a 20 minute magnesium bath a week, some leafy greens and nuts in your diet and regular massage.

If you think you have a serious magnesium deficiency you should consult your doctor.

 

Have you ever used magnesium? How did it work for you?

Need a massage but in a lunch rush?

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‘Gone to Lunch’

Sore lower back? Tight neck and shoulders? Headache? Tight hamstrings from this mornings workout? Whatever your need, try a quick half hour massage to suit.
Book online now, call or message 0450721661

Yoga or Pilates? What’s the difference? Which one is best for me?

Many of my clients, looking for a way to stretch and keep their muscles pain free ask me whether yoga or Pilates is a good option for them and which is best. The reality is that both are great ways to keep moving but are good for our bodies in different ways.

Pilates was developed in the early 20th Century by Joseph Pilates, a German physical trainer. He developed his concept of an integrated, comprehensive system of physical exercise, which he himself called “Contrology” through the study of yoga and the movements of animals combined with his knowledge as a gymnast, bodybuilder and boxer.

Reformer Pilates

Pilates is great for movement of joints and focused strengthening of the muscles. It can help strengthen areas that may be weakened by a sedentary lifestyle, injury or misuse of the area. It can help correct posture and motor skills through use of body weight exercises performed on the floor or with equipment such as the reformer or therabands, foam rollers and exercise balls.

Pilates equipment

Originating in India, yoga has been practised for centuries as a physical, mental and spiritual discipline. Various styles of yoga are popular today for developing greater strength, flexibility, relaxation and meditation. Popular styles throughout the world include hatha, iyengar and ashtunga yoga. Yoga can be used for improving the flexibility of the muscles and it will also increase the flexibility of the joints. Specific poses are said to massage organs, lengthen and strengthen muscles and tendons and promote inner wellbeing.

Yoga

While it’s impossible to tell how many people regularly practise both disciplines, it’s often said that yoga, with its countless offshoots and different styles is the most widely practised exercise system in the world. While Pilates estimate more than 25 million people worldwide as devotees, largely in western countries such as Australia, Canada and the UK.

Some experts say practising Pilates can help build strength to improve yoga performance. While stretching of yoga, will help relieve muscles sore from Pilates strengthening. As yoga and Pilates have different aims, it’s unlikely that combining the two would cause overuse. However, if muscles and joints are sore, give them time to rest and recover.

So which is best to incorporate into your routine?

Stretching

There is little scientific evidence to say which is best for what. Although I would say that if you are currently injured or not exercising that some stretching and prescribed or clinical Pilates instruction from a qualified physiotherapist or remedial massage therapist might be best. Starting yoga with an existing injury or little fitness could lead to further injury.

That said, gentle styles of yoga such as hatha and iyengar with a good instructor can be beneficial to all, especially for those looking for relaxation and guided meditation techniques.

Devotees to both disciplines will say that theirs is the better option. However, the thing to remember is that all movement is good movement, and the best exercise is always the one that you prefer – as this helps motivation and consistency, with improved and long-term results.

The best strategy? Try them for yourself and see what you like best.

Why Am I Sore After a Deep Tissue Massage?

Deep tissue massage is a style of massage that is usually practised with oil on skin, with a firmer pressure than relaxation massage. It’s aim is to reach the deeper layers of muscle and connective tissue than those underlying the skin.

How does it work?

iStock_000010728710XSmallOur muscles are made of tiny fibres call myofibrils. When our muscles are overused or misused the fibres can adhere together or tear. It’s not really known why this happens but we know that heat and compression helps to break down the adhesions, attracting blow-flow to the area and help heal the tears. This is where deep tissue massage can help.

Deep tissue massage promotes blood flow to the injured area and creates micro-tears in the muscle tissue, to speed up the healing process. Because of this, the area becomes bruised, and this is what causes the pain after the massage. Usually this is only felt when you touch the area that was treated, and normally wont be visible on the skin.

The pain you experience after a massage should only be likened to how you feel after a heavy exercise session, and not a worsening of the pain of your injury that was treated. If your injury feels worse then the massage may have been too firm, or that your condition cannot be remedied with massage.

Who can benefit from deep tissue massage?

Hip painAnyone suffering from chronic or acute muscle tension. This can be caused by overuse or misuse, a pre-existing condition or recent injury.

Deep tissue massage can break down old scar tissue left from injury or surgery. It can help alleviate tension built up from conditions like arthritis or inflammation in the joints. It can help manage pain from poor posture or repetitive motion like sitting at a desk all day, using tools or long hours exercising.

What to expect in a massage?

Your massage therapist will start with a kneading style of massage, generating some heat in the tissue to start to warm up the muscle and help you relax. They then might perform firm stripping motions in the direction of the muscle they are treating. A good massage therapist will normally (but not always) be able to feel the change in tissue tension and know where you are tight, where you have trigger points and taught bands.

shutterstock_412363579Unfortunately this can often be uncomfortable. Your massage therapist should always work within your pain threshold and ask you if the pressure is okay. They may even ask you to grade the pain out of ten. Don’t be afraid to speak up if the pressure is too much for you. In this case, pain is not gain. Too much pressure may be doing further damage to the muscle and cause your injury to flare up further.

The massage therapist will just their palms, knuckles, fist, forearm and even their elbow. The speed of the strokes will most likely be slow and even stop and hold at points with more tension until it eases.

Don’t forget to breathe

Be sure to breathe throughout the treatment, this may sound obvious, but you’d be surprised how many people hold their breathe to cope with the pain. If you need to hold your breath, then the pressure is too much. Deep breathing can help you tolerate more pressure and the oxygen will help the muscles release. Your massage therapist may even ask you to take a deep breath ‘into the muscle’ that they are treating.

What to do after a massage?

shutterstock_252553801Your massage therapist should give you after care advise. It is recommended you rest after your massage, drink plenty of water to replenish fluids that have been flushed out during the massage and apply heat to the area you had treated. This will help your muscles recover from the massage and recover from your injury. Another great way to ease muscle soreness after a massage is to have an Epsom salt bath.

Bursitis: what is it and how can massage help?

What is bursitis?
Bursitis is the inflammation of the bursae. Bursae are small sacs of synovial fluid throughout the body. The bursae primarily rest where muscles and tendons slide across bones, to allow smooth movement of the joint.
When inflammation in the bursae occurs the tracking of joints, muscles and tendons becomes difficult and painful. This can result in stiffened muscle.

Hips, shoulders, elbows and knees are the most commonly affected.

What causes bursitis?
A number of things can cause bursitis. Most commonly repetitive movement and excessive pressure on the joint. Other causes include trauma to the joint like a knock or fall, autoimmune disorders, infection and medication.

Who gets bursitis?
Anyone that has had a joint trauma is at risk of developing bursitis. Also those in professions that require repetitive motions or pressure on the joint, such as cleaners, students, trade 2102_LayCarpet_25workers, and athletes particularly in impact sports such as football, rugby and roller derby are all at risk.
Those with other inflammatory conditions such as arthritis, diabetes and systemic lupus can also be at risk.

How is bursitis treated?
Your GP may refer you for an ultrasound scan to diagnose the inflammation. They are also likely to prescribe a course of NSAIDs. Once the inflammation has subsided physiotherapy and soft tissue therapy is recommended.

Your GP may recommend a cortisone injection into the sight of the bursae for persistent inflammation.

Qualified therapist doing pressure point massage on a womans hip

Qualified therapist doing pressure point massage on a womans hip

How can massage help?
Although massage cannot cure bursitis, it can help alleviate the muscle pain and tension that is either a result of the inflammation or the cause. A massage therapist will work to release taught bands and trigger points in the agonist and antagonist muscles; above, below and opposite the site of the bursitis.

What can I do to help alleviate bursitis?
In the 72 hours following the trauma or onset of pain use the RICE (rest, ice, compression, elevation) first aid for the injury. The less you can use the joint, the better. This will help stop inflammation from getting worse. Ice will also help reduce the inflammation and pain.

Once inflammation has eased, massage, gentle stretching and heat to the surrounding muscles will help ease soft tissue pain.

The once soft tissue pain has eased strengthening exercises can be used to help rehabilitate the joint and the muscles around it.

Stretching; the when, what and how.

When should I stretch ?

In the first 24-72 hours of injury the best treatment is R.I.C.E.R. (rest, ice, compression, elevation, and referral). At this stage, stretching is not advised. It’s best to rest the injured area and apply ice for 10 minutes of every hour until the swelling goes down.

Head to the emergency department if you think you may have a bone fracture or to your health physician for further investigation.

After the initial 72 hours, with clearance from your health physician, you can start some rehabilitation techniques over the next 10-24 days.

Over the period of 2 to 5 weeks you should aim to regain your flexibility, strength, power, muscular endurance, balance and co-ordination.

Long term, once you have recovered from your injury, it’s time to regain fitness, strengthen the injured area and improve flexibility.

When we talk about injury, this doesn’t always mean a serious injury. It could be anything from also waking up with a stiff neck or straining a muscle while picking something up to tearing a muscle during sport or exercise.

What types of stretches are there?

Static Stretching

Static stretching is used to stretch muscles while the body is at rest. It is composed of various techniques that gradually lengthen a muscle to an elongated position (before the point of discomfort) and hold that position for 30 seconds.

Passive Stretching

Passive stretching is a form of static stretching in which an external force exerts upon the limb to move it into the new position. This is in contrast to active stretching. Passive stretching resistance is normally achieved through the force of gravity on the limb or on the body weighing down on it.

Active Stretching

Active stretching eliminates force and its adverse effects from stretching procedures. Active stretching stimulates and prepares muscles for use during exercise. … Agonist refers to actively contracting muscle or muscles while their opposing muscles are termed antagonists.

PNF Stretching

Proprioceptive Neuromuscular Facilitation (PNF) is a more advanced form of flexibility training that involves both the stretching and contraction of the muscle group being targeted. PNF stretching is a very effective for rehabilitation.

Dynamic Stretching
Dynamic stretching is a form of stretching beneficial in sports utilizing momentum from form, and the momentum from static-active stretching strength, in an effort to propel the muscle into an extended range of motion not exceeding one’s static-passive stretching ability.

When should i use these stretches?

Static and passive stretching should be used in the early days after injuring.

PNF stretching can be used in the later weeks as the muscles are beginning to regain their strength. This type of stretch is often performed with a physical therapist.

Dynamic and active stretches should only be used when the muscles are healed and are strengthening. They should never be forced and always a controlled action.

What techniques do i use to stretch?

  • Focus on the muscles that are sore;
  • Ease into the stretch, do not over stretch or force the muscle into position or into pain;
  • Hold the stretch for 20-30 seconds;
  • Breathe! Oxygen helps the muscle release;
  • Stretch both sides. The other side is likely to be carrying the work of the sore muscle.

Stay tuned!

In the coming weeks I will be adding some fact sheets on stretching routines for each of the major muscles groups, such as the calves, quadriceps and hamstrings, lower back, neck and shoulders, rotator cuff, and forearms.