Tag Archives: stretching

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?

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.

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.

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)

Allied Health Care Professions: Shiatsu

Shiatsu or Japanese finger pressure therapy practitioners use touch and pressure to rebalance the energy of the body. The practitioners aim is to align the mind, body and spirit of their patients using their energetic system and their meridians.

The practitioner will take a diagnosis of their client using yin and yang, the five elements and their qi (energy). As a result of diagnosis the practitioner will then be able to determine what meridians will be best used in the treatment.

Shiatsu is performed on the ground or lying down on a table. The client is not required to remove their clothing as they are not using any massage oils or lotions. The practitioner will use elbows, knees, feet as well as finger and palms to apply pressure along the meridians they are working on.

The meridians are the energetic pathways through the body that were codified in Chinese Medicine. There are twelve major channels that we deal with, each one being given the name of an Organ (in the Eastern, not the Western medical sense). The twelve Organs are: Lung, Large Intestine, Stomach, Spleen, Heart, Small Intestine, Bladder, Kidney, Heart Protector, Triple Heater, Gall Bladder and Liver.1

According to Tokujiro Namikoshi, the founder of Shiatsu therapy, the underlying principal of shiatsu is that the body can fix itself if the qi is balanced.

The meridians

Modalities Used
The modalities used in shiatsu are; qi (energy), yin and yang; the 5 elements (metal, water, wood, fire, earth), meridians, acupuncture and acupressure points, exercise, stretching, pressing, touch, massage and diagnostics.

When would you seek this practitioner?
Shiatsu is good for treating headaches, back pain, aid relaxation, arthritis, muscle stiffness, sports injuries, digestive problems, menstrual problems, asthma, insomnia, anxiety, depression, sleeping disorders, and pregnancy problems.

 

 


1. http://shiatsudo.co.uk/about-shiatsu/meridians