Tag Archives: stress incontinence

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.

Stress Urinary Incontinence: a Muscular Problem

Urinary incontinence amongst women is an unreported epidemic. Reportedly 30 to 40% of women will suffer from incontinence of some form by the time of menopause and then rises steadily between the ages of 60 and 80. It does also occur in men, but for the sake of this article, I will be predominantly addressing the problem in women. There is little research to show the true causes of incidences but are likely be a result of bladder dysfunction, sphincter dysfunction or a combination of both.1

9e309625-de78-47bb-8b7c-1afe86633f93Determining whether the condition is stress or urge incontinence, or a mix can be difficult, based on symptoms alone.

The major symptom of stress incontinence is the loss of bladder control during physical activity. Such as experiencing anything from a few drops of urine to a larger involuntary flow while exercising, during sexual intercourse, coughing, sneezing, laughing or other kind of physical exertion.

The cause of stress incontinence is when there is tension and/or weakness in the muscles that control and support the bladder and the release of urine (urinary sphincter). These muscles include the pelvic floor muscles (otherwise known as the Kegel muscles, named after Dr. Arnold Kegel, American gynaecologist who invented the Kegel exercises), the deep gluteal muscle that attaches to the sacrum  and coccyx, Piriformis; and the large inner thigh muscle, Adductor Magnus that attaches to the pelvic bones.
The pelvic floor muscles act as a sling from the coccyx to the pubic bone supporting the bowel, bladder, the uterus and vagina in women. If they are tense or weak, the downward pressure of these organs can easily cause problems, and problems with these organs are likely the only symptoms you may have from these kinds of muscular tension or weakness.

What can cause these muscles to be tense or weak?

Injury or overuse, like any other muscle, can cause these muscles to be tense or weak. This could be from exercise, childbirth, constipation, heavy lifting, chronic coughing. Excess weight can cause undue pressure on these muscles and to cause weakness. Surgery, such as prostate surgery in men, can also cause weakness.

How can stress incontinence be treated?

Massage of the gluteal and thigh muscles and pelvic floor muscle exercises are the best way to treat and maintain muscular health and avoid incontinence, and maintain bladder control.
Massage has been shown to reduce incontinence by more than 20% after the first treatment and up to 100% within a month of regular treatments.2

How to locate your pelvic floor muscles


Pelvic floor in women

Sit or lie down with the muscles of your thighs, buttocks and stomach relaxed.
Squeeze the ring of muscle around your anus, as if you are trying to stop passing wind. Now relax this muscle. Squeeze and let go a couple of times until you are sure you have found the right muscles. Youre not just squeezing your buttocks, but deeper, down to the tailbone.
When sitting on the toilet to empty your bladder, try to stop the stream of urine, then start it again. Do this to learn which muscles are the right ones to use – but only once a week. Your bladder may not empty the way it should if you stop and start your stream more often than that.
If you don’t feel a distinct “squeeze and lift” of your pelvic floor muscles, or if you can’t slow your stream of urine, ask for help from your doctor, physiotherapist, or continence nurse. They will help you to get your pelvic floor muscles working right. All women can benefit from pelvic floor muscle training.

How to exercise your pelvic floor muscles

Sit or lie in a relaxed position. Squeeze and draw in the muscles we just identified. Lift them up and squeeze them away from the tailbone. Hold them strong and tight for 8 seconds and then relax, letting all the muscles go.
If you can’t hold for 8 seconds, hold for as long as you can. Gradually build up the length of time you can hold them for.
Do 8 to 12 squeezes, three times, daily. If you do not see a marked improvement within three months seek help from your doctor, physiotherapist or continence nurse.
Once you get used to doing them, you can do them sitting, lying or standing. Be sure not to hold your breath while holding the muscles, oxygen will help the muscles stretch and release tension.