1. Static Stretching Before Exercise
Static stretching involves slowly stretching a muscle to its end position and holding it for a short period of time, usually 10-30 seconds. This is the most common form of stretching and is best used when stretching a tight, sore muscle.
If you work in a repetitive job or sit at a desk for long hours, or have overdone it at the gym, then this is the stretch you need. Don’t use this stretch for warming up for exercise, instead perform it a few times a day for up to 30 seconds on the tight muscle.
The best way to warm up for exercise is to perform low-intensity, dynamic movement that is similar to the main type of activity that you will perform. For example;
A five minute walk before a half hour run
Two or three sets of weights at 50-70% of the weight you intend to lift.
Other dynamic warm ups include star-jumps, arm circles, skipping rope… any low impact, low intensity start to a higher intensity workout.
2. You’re Stretching Between Sets. Even if you really feel the burn after those 10 bicep curls, resist the urge to stretch it out the second you drop the weights. Stretching in between sets can impair performance.
After your initial dynamic stretch at the beginning of your workout, lay off stretching until your workout is done. Turns out, when you stretch one part of your body (like your arms), you activate a central nervous system reflex that affects muscles you haven’t even moved — and impairs their performance too.
3. Overstretching
Think of a stretch for injury as relaxing the muscle, rather than trying to make it longer. If you think of your muscle as a rubber band, it is possible to over stretch that band, and cause further pain and/or injury.
Stretch the muscle to the point you feel a gentle tug of tension and then take deep breaths for 20-30 seconds, then rest for 10 seconds and repeat. You should feel the muscle eventually release, and be able to take the stretch gradually deeper.
4. Bouncing While Stretching
A ballistic stretch uses vigorous momentum, such as rocking a body part back and forth to create a “bouncing” motion. On a cold or injured muscle this action is hard to control the depth of stretch and may lead to further injury.
5. Only Stretching One Muscle
If you’re tight in one area it pays to look up stretches for the whole group of muscles in that area. If you’re unsure, check with your massage therapist or fitness trainer.
The triceps brachii, or more commonly known just as the triceps, are located at the back of the arm and is the major muscle in the extension of the elbow, or straightening the arm. Triceps brachii muscle means “three-headed arm” muscle as it originates in three places, attaching at the scapula (shoulder blade) and at two places at the top of the humerus (arm bone). The three heads act in varying movements of the upper arm and elbow, but with its origin on the scapula, the long head also acts on the shoulder joint and is also involved in backward rotation and adduction of the arm. The muscle inserts in just below the elbow at the olecranon of ulnar.
Injury to the triceps can cause a range of symptoms including;
Pain patterns for tricep trigger points
Commonly;
Back of Arm Pain
Back of Shoulder Pain
Dorsal Forearm Pain
Upper Thoracic Back Pain
Volar Finger Pain
Less commonly;
Front of Arm Pain
Lateral Epicondylar Pain
Medial Epicondylar Pain
Olecranon Pain [1]
Your massage therapist will likely work the triceps in conjunction with other muscles in the area such as the biceps, muscles of the forearm and muscles of the rotator cuff, depending on where your pain is.
Stretching Triceps
Tricep stretch
The best way to stretch triceps is to reach up with you the arm you want to stretch, bend at the elbow, and reach over with your other hand and grasp your elbow on the top, so your palm faces down towards the mid-back.
If your flexibility is not good enough to be able to reach your elbow with the opposite hand, have a towel in the hand of the affected side, and reach the bottom of the towel with the other hand at the back of the body. Gently tug the towel down while gripping.
A cross body stretch will also stretch the long head of the triceps. Reach your straight arm across the body and use the other arm to create tension and support the elbow.
Strengthening Triceps
Exercising the triceps directly will achieve the best results, with compound movements.
Close Grip Bench Press
Lie on a flat bench with your feet flat on the floor. Make sure your back is completely flat on the bench, with no “arching” of your spine.
Grip the barbell with an overhand grip, shoulder width or slightly less than shoulder width apart. (Do not make your grip too narrow as it limits stability of the barbell which can lead to injury)
Push up using your chest and shoulders to lift the barbell above your body, then lower it slowly ( a count of 2) towards the centre of your chest. Hold for a count of one.
Without “bouncing” the weight, force the barbell back up over the middle of your chest, straightening your arms and locking your elbows once your arms are fully straight. Hold for a count of one.
Repeat.
Tricep Dips
To get into the starting position, hold your body at arm’s length with your arms nearly locked above the bars.
Now, inhale and slowly lower yourself downward. Your torso should remain upright and your elbows should stay close to your body. This helps to better focus on tricep involvement. Lower yourself until there is a 90 degree angle formed between the upper arm and forearm.
Then, exhale and push your torso back up using your triceps to bring your body back to the starting position.
Repeat the movement for the prescribed amount of repetitions.
Overhead Extensions
Sit on a bench with back support.
Grip a dumbbell at one end using both hands. Your palms should be facing inward.
Hold the dumbbell overhead with your arms fully extended. This is the the start position.
Keep your upper arms close to your head (biceps roughly level with your temples) and near to 90degrees to the floor.
Moving only your forearms, lower the dumbbell in a smooth arc behind your head until your forearms and biceps touch. Hold for a count of one.
Return to the start position by using the triceps to extend your arm and raise the dumbbell. Exhale as you do this.
Repeat.
Lying Chest Overhead Extensions
Lie on a flat bench, holding a barbell on your chest with an overhand grip. (Your hands should be shoulder width apart)
Get into starting position, raising the bar above your chest by extending your arms, but do NOT lock your elbows.
Keeping your arms slightly bent, slower lower the weight in a smooth arc to a position behind your head by rotating your shoulders. (as if putting your hands in the air)
Keep moving the barbell behind your head until you feel a slight stretch in your chest. Hold for a count of one.
Return to the start position in a smooth revers arc.
Continue holding the weight above your chest, then repeat.
Tricep Cable Rope Push /Pull Downs
Set up a cable station with a straight bar on attached to the top pulley.
Grip the bar with an overhand grip,with your hands slightly less than shoulder width apart.
Position your feet shoulder width apart,with knees slightly bent for stability.
Pull the bar down until your forearms are parallel to the floor with your elbows close to your body and your wrists locked in a straight position. This is your staring point.
Moving only your forearms, push the bar down towards the floor until your arms are fully extended and you feel a stretch in your triceps. Hold for a count of one and squeeze your triceps.
Return to the start position moving your forearms only. Hold for a count of one then repeat. [2]
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…
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.
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.
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]
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.
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.
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;
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!
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
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:
Rest: Don’t exercise for a few days, or try an exercise that doesn’t stress your feet, such as swimming.
Ice: Apply 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.
Compress: Use tape or an athletic wrap to keep swelling down and help support and immobilise the tendon.
Elevate: Lie 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]