Tag Archives: dry needling

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.

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

Remedial massage now available at Real Fit Malvern East

It is with great excitement that I inform you, as of start of February 2018 remedial massage will be available from the new location of Real Fit Personal Training, 135 Waverley Road, Malvern East.

Just 3km from my current location, with tram access and street parking out the front, I will be available on Tuesdays and Fridays from 10:30am to 7pm. My contact details have not changed. You can still book online or call me to book on 0450 721 661.

Since I opened in Malvern East, your loyal support has helped my business grow, and now I need a more accessible space to serve you better. I have been looking for a new home for the past few months and I’m happy to say that I’ve found a friendly and welcoming local environment at Real Fit to work from.

If you have any questions about the new location or my services, please call and I’ll be happy to help. I look forward to seeing you at Real Fit!

Muscle in Review: Sternocleidomstoid

Sternocleidomastoid muscle highlighted in red

Sternocleidomastoid, regularly abbreviated to SCM is located superficially, either side of the neck.

It originates at the sternum (sterno) and inserts at the clavicle (cleido) and mastoid process of the skull. It’s main function is head rotation and flexion of the neck.

How does SCM become injured?
SCM can be easily injured with sudden movement or jerks of the head, mostly commonly with whiplash.

 

Muscles in Upper Cross Syndrome

 

It is also often innervated in ‘upper cross syndrome’ where the upper neck and lower shoulder muscles are weak, while the upper shoulder and chest muscles are tight. This is largely due to poor posture as we hunch to use the mouse/keyboards or crane our necks over to look at our laptops or mobiles, or while driving.

What are the symptoms of an injured SCM?
A strained SCM can produce swelling and redness along the muscle, at the site of the injury. In severe cases, you also may see bruising along the path of the injury. If the strain results in a muscle spasm, you may notice a twitching or fluttering beneath the surface of the skin along the side of your neck. Stiffness, muscle fatigue and difficulty holding your head upright may occur, along with dull pain along the path of the injury, accompanied by sharp pain when turning or tilting your head.

Trigger points in SCM can cause headache pain in the back of the head, behind the ear, in the forehead but it can also cause a list of other symptoms that some may not normally attribute to muscles.

SCM trigger points

Primary Symptoms include;
Back of Head Pain
Cheek Pain (like Sinusitis)
Dizziness When Turning Head or Changing Field of View
Double/Blurry/Jumpy Print Vision
Dry Cough
Ear Pain
Earaches/Tinnitus (Ringing)/Itch
Feeling Continued Movement in Car After Stopping
Feeling Tilted When Cornering in Car
Front of Chest Pain
Frontal Headache
Headaches or Migraines
Post Nasal Drip
Runny Nose
Sore throat
Tearing/Reddening of Eye, Drooping of Eyelid
Temple and Eyebrow Pain
Temporal Headache (Temples)
Temporomandibular Joint (jaw) Pain
Throat & Front of Neck Pain
Travelling Nocturnal Sinus Stuffiness
Vertex Pain
Visual Perception Problems

How is SCM treated?
Applying ice for 10 minutes several times daily may relieve swelling and redness. Wearing a neck brace supports the weight of your head, temporarily relieving the stress on SCM although may only recommended temporarily and only in severe cases. Over-the-counter nonsteroidal antiinflammatory drugs (NSAIDs) such as ibuprofen (Advil, Neurofen) and naproxen (Naprosyn, Aleve) and analgesic rubs can relieve some of the pain associated with the strain.

SCM is very responsive to massage and other soft tissue techniques such as gentle cupping, dry needling, and stretching.

  • Rotate your head to look over your shoulder, as far as is comfortable, not to strain.
  • Then gently tilt the head to the same side, as if trying to reach the ear to the shoulder.
  • Hold for 20-30 seconds, rest and stretch the other side.

 

 

If you are a yogi, some basic yoga poses that can help lateral and anterior neck tension include;

Bitilasana (Cow Pose) and Marjariasana (Cat Pose)

Cow-Cat pose is a gentle up-and-down flowing posture that brings flexibility to the entire spine. It stretches and lengthens the back torso and neck. It’s a wonderful and easy movement to open and create space through the entire neck.
To begin with cow pose, kneel on your hands and knees in a neutral, tabletop position. Be sure to align the hands below the shoulders and knees directly beneath the hips. Looking straight ahead, inhale, and slowly extend through your spine as you look up and forward, softly arching through the back and neck. Take care to expand through your chest and lower your shoulders down and back.

Move into cat pose by reversing the movement as you exhale and bring your chin towards your chest while gently hunching and rounding your back. Repeat this sequence for 7 to 10 cycles, softly flowing with your breath.

Ardha Matsyendrasana (Seated Twist Pose)

The seated twist is a wonderful pose to bring flexibility to the entire spinal column. It provides an inner massage to the abdominal organs and encourages side-to-side flexibility of the neck.

Begin seated on the floor with both legs extended in front of you and hands at your sides. Bend the right knee and draw the right foot to the outside of the outstretched left leg. Sit up tall, inhale, and extend your left arm out to your left. As you exhale, draw your left arm across your body so the elbow joint gently wraps around your right knee. Take your right hand and place it palm down on the floor near your tailbone, fingers pointing away from you. Draw your chin toward your right shoulder, making sure to keep your spine tall, and the crown of your head reaching toward the sky. Bend the right elbow slightly to allow the right shoulder to sink down.

Breathe deeply in this pose for 5 to 7 breaths, making sure to twist (not crank) your spine comfortably. Repeat on the left side to maintain the balance in your body and spinal column.

Ear to Shoulder Pose

This is an easy pose that can be done just about anywhere. The pose facilitates the lateral movement of the neck as well as stretches down into the shoulder and trapezius muscles. This pose can be performed standing or sitting, provided the spine is straight.

Begin by looking straight ahead with your arms down at your sides. Take a deep breath and as you exhale, bring your right ear down toward your right shoulder. Try to avoid leaning your head forward or back so that your head remains in the same plane as your shoulders. Inhale as you draw your head back to center and exhale as you repeat the movement to the left.

To deepen the stretch, place your right hand on the left side of your head as it drops over towards the right shoulder. Don’t pull your head over; just allow the weight of your hand to softly guide it down. Perform this cycle 7 to 10 times per side before returning to centre. (1)

Winter Special Add-on – Dry Body Brush

With the end winter near (thank-goodness!) our skin is likely to be dry, scaled and flakey. The cold air and wind, juxtaposed with indoor heating is drying for skin.

Until the end of November I’m offering a special add-on of a half hour, full body, dry body brushing with your choice of massage.

The technique uses a soft, natural-fibre body brush, starting with the extremities of the body such as the hands and feet, with long flowing movements up towards the body. This aids the lymph system to drain. Small back and forth motions are used between the fingers and toes and small circular strokes in a clockwise direction on the stomach, to aid the movement of the digestive system.

Body brushing helps speed up the process of detoxification via the lymph stimulation. The lymphatic system is important for eliminating waste and dead cells from our body, by transferring them to the bloodstream ready for elimination.

Exfoliating like this also rids the skin surface of dry and dead skin cells, allowing more moisture to penetrate the dermal layers. Following the dry brushing in your choice of massage we use a moisturising almond oil, a refreshing peppermint foot cream and nourishing almond oil hand cream.

Other ways to avoid dry skin in winter is to use a humidifier at home. Increasing humidity means more moisture in the air and your skin is less likely to dry out. Also drink plenty of water, limit harsh facial peels or scrubs and super hot showers during winter, as they are all drying to the skin.

Winter Special Add-on Dry Brushing $30 p/half hour

Click here to book now, then chose Dry Body Brush and your choice of massage.

Overuse Syndrome – What is it? How do I avoid it? How can I help it?

What is Overuse Syndrome?
Overuse syndrome is a disorder where a certain part of the body is damaged by repeatedly overusing it or subjecting it to too much stress.

For example, if you rely on your hands for your work, you are more prone to overuse injury of the arms.

Typists are prone to overuse injury of the wrists

What are the signs and symptoms?
Initially the area affected may feel fatigued, ache or tension; swelling, heat or redness in the area can also occur. If this fatigue is not resolved prior to your return to the activity, micro-trauma may occur, building up over time more serious syndromes can develop.

Weakness, numbness and or tingling in the extremities can occur as well as general aching or shooting pain.

Some common examples of overuse syndromes are:
Tendonitis
Bursitis
Carpal Tunnel Syndrome
Patellofemoral Pain
IT Band Syndrome
Plantar Fasciitis

ITB irritation is a type of overuse injury

Who gets over use syndrome?
Those who are prone to overuse syndrome are usually those involved in occupations that rely heavily on the use of hands or arms. Trades such as builders and electricians; check out or line production workers; typists. Some athletes may be prone to overuse syndrome in other areas of the body, and those with hobbies that require lots of ‘hand heavy’ work, such as knitting or crocheting,

How is it treated?
Most start with conservative treatments such as massage, physiotherapy and some stretching and strengthening exercises such as yoga or prescribed pilates.
At home treatments such as heat and cold therapies, rest, and the use of compression bandages can also help.
If conservative treatments are unsuccessful cortisone injections or surgery may be suggested.
Ideally, the best way to treat an overuse injury is to rest the affected area, and to discontinue the activity that is causing the injury. For some this may be impossible due to their work. The employment of an occupation therapist can be useful to help you change the way you operate and keep you working without pain or further injury.

Are there any complications?
It is always best to seek treatment as early as possible for an overuse injury. The longer an injury of this type goes on, the harder and longer it will take to heal. On-going injury can lead to tendon damage, calcification and spur build up, or cartilage damage, for example, all of which will require surgery to rectify.

How can I avoid getting over use syndrome?
Warming up and stretching before use. Before exercise and even before work, take some gentle exercise and stretching of the area.
Negotiating with your employer to change your routine work throughout the day. The less you repeat the same action, the less you are likely to cause injury.
Resting at the end of the day, to ensure any micro injuries heal before you next return to the activity.
Ensuring you are doing your activity with the best ergonomics possible. For example, ensuring your desk is set up for you.

Correct posture can help to avoid overuse injury

How can remedial massage help?
Remedial massage will use various soft tissue manipulation techniques to relieve any muscle tension build up that could cause further complications from overuse.
Deep tissue massage improves circulation around micro-trauma in the muscle to speed up recovery. It also breaks down calcification build up that leads to spur development.
Cupping stretches the connective tissue surrounding the muscles, allowing for release of compartment tension and greater movement of muscles.
Dry needling alleviates trigger points in the muscles and referred pain that may have built up with overuse.

Stretches for arm overuse syndrome from “Stretching” by Bob and Jean Anderson

Stretches Screen Shot 2015-05-11 at 3.33.54 pm