Kerrie Baumgartner * Massage Excellence

What massage can do for you!

• Improves circulation and relieves congestion in the tissues.

• Stimulates the production of red blood cells.

• Promotes lymph flow which hastens the elimination of cellular wastes.

• Helps clear muscles of lactic and uric acid that forms during exercise.

• Relaxes muscle hypertonicity and relieves muscle tension.

• Improves muscle tone and delays muscle atrophy for inactivity.

• Deep massage can separate fascial fibres and prevent the formation of adhesions.

• Massage helps reduction of inflammation and oedema in joints and soft tissue.

• Can alleviate or reduce pain, stiffness or soreness.

• Stimulates increased proprieties and kinesthetic awareness of the body.

• And massage assists the body’s natural ability to heal itself. It relaxes and tones the muscles preventing injuries, increases circulation and therefore improves the delivery of oxygen and nutrients to all body cells.

• Plus feels great!!

Remedial massage is the application of different techniques in the treatment of muscular pain and dysfunction that affect human movement.

Remedial Therapists can help relieve stress, work injuries, muscles joint and stiffness, lower back pain, neck pain and headaches etc.

It is a form of treatment that is applied in the preventive, corrective and rehabilitative phases of treatment.

Remedial Massage is concerned with the restoration and maintenance of the soft tissue structures of the body.

Subscribe to: Comments (Atom)

There are a variety of different types of massage available depending on your needs.

For example, Sports, Remedial,Relaxation,Corporate,Pregnancy,and Manual Lymphatic Drainage (etc)

What is Manual Lymphatic Drainage?

Dr Vodder in 1932 developed Lymphatic drainage to help drain the swollen lymphatic glands. Eyal Lederman an osteopathic physician developed on this method with different techniques. All types of massage stimulate the circulation and lymph movement but structuring a massage to focus on this system is a specific therapeutic intervention. Lymphatic drainage is not a muscular massage but a harmonious massage of the connective tissue, facilitating the clearing of the lymphatic ducts and allowing regenerative lymphatic fluid to flow.

Lymphatic drainage is facilitating in ridding the body of waste products and allows better functioning of the organs. It has a regenerative action and strengthens the autoimmune system. (Victoria University Manual Lymphatic Drainage Work Book 2006)

What is Lymph?

Lymph is similar to blood but it does not contain red blood cells or clotting factors. The lymph enters the open ended tin capillary like lymphatics and then is transported to the central lymphatic vessels under pressure generated in the peripheral tissues. This system has lymph nodes which serve as large filters that clear bacteria and other noxious substances. The lymph nodes contain white blood cells, primarily lymphocytes which enter the lymph and are transported into central circulation. (Damjanov 2006)

What is the Lymphatic System?

Amalo Ron, best explains in an article in “Mens Health” (2001) based on Dr Gerald Lemole, a professor of surgery at Thomas Jefferson University Medical School.

· The Lymphatic System is a network of fluid vessels and nodes that sweeps toxins from around our cells, filters out infectious organisms and ensures that harmful substances get to the liver for extraction and the kidneys for excretion.

· The elaborate system of lymph vessels snakes through our bodies, intertwined with our blood vessels. It’s punctuated by series of lymph nodes-mesh-like tissues loaded with killer cells that catch and destroy invading germs. The most famous ones are the two you can feel are at the base of your jawbone (called cervical nodes), that swell when you have an infection. But there are hundreds of such defenders, concentrated in the armpits, groin and neck.

· At the countless points in our bodies where blood flows from bigger arteries into smaller capillaries, hydrostatic pressure forces fluid containing oxygen and glucose through the blood vessel walls and into the lymph. The oxygen and glucose float across a sea of lymph to nourish our cells.

· Cell waste (lactic acid and metabolites) make the return trip across the lymph fluid and back into the bloodstream. But the exchange isn’t perfectly efficient and harmful substances are left behind in the lymph.

· If your lymphatic flow is strong, this isn’t a problem because the toxins get swept away in the lymph carried via ever bigger channels to the thoracic duct in the chest. From there, they re-enter the bloodstream and are just a blood vessel ride away from the purifying liver and eliminating kidneys. But if your lymphatic flow is weak the toxins hang around a d get mischievous.

· The longer toxins and metabolites linger in the lymph fluid the more potential there is for inflammation and hardening of the arteries.

· The thoracic duct which is just under your chest is the lymphatic mighty Murray the largest duct in the system all the other vessels drain into the thoracic duct.

· The lymphatic system has no heart so it has no pump to force the fluid along. Even though minor movement and breathing pushes the lymph fluid along we need to find ways to push this system along.

· It’s primarily a drainage system.

· Lemole believes that wearing a bra may inhibit a woman’s lymphatic health. Bra’s may squeeze the lymphatic ducts in breast tissue and compromise toxin clearance.

In conclusion, let’s all take some deep breaths, (which helps move the lymph along) however, only deep breathing whilst watching our favorite soapy with our legs ups, (but that does help move the fluid towards the heart!) is not all we can do. Apart from good nutrition and cleansing fluids, (yes maybe a dash of vodka in your grapefruit juice occasionally won’t hurt!) But try a spoonful of manual lymphatic drainage with me, a pinch of yoga exercises (with Andrew) such as the cobra stretch and shoulder stand, and a drop of swimming and well exercise in general of course to build good health!!

Bibliography:
Text Book

Damjanov Ivan 2006, “Pathology for the Health Professions”, Elsevier Saunders, USA
Article
· Amalo Ron, “Confessions of a Lymphomaniac”, Mens Health, p65-67, Nov 2001)
Work Book
Victoria University Workbook 2006, “Manual Lymphatic Drainage”.

Frozen shoulder (Adhesive Capsulitis)

By Kerrie Baumgartner

Background Information of the shoulder joint

The glenohumeral joint, (shoulder joint) has a tremendous range of movement. The shoulder joint is too shallow to offer any bony security for the head of the humerus. As ligaments would severely limit joint movement, muscle tension must be employed to pull the humeral head in to the shallow scapular (shoulder) socket during shoulder movement. Four muscles fulfill this function: supraspinatus, infraspinatus, teres minor and subscapularis (S.I.T.S muscles, the rotator cuff muscles). (Kapit 2002)

Apart from these rotator cuff muscles many other muscles attach to the shoulder blade. On this note it is important to consider the holistic picture in a shoulder injury. Plus keeping in mind the whole kinetic chain, as any deficiency in the chain, (e.g. stiff lumbar spine) puts additional stress on distal (outer) parts of the chain, (e.g. rotator cuff). (Brukner 2005)

The shoulder joint is encased in a ligamentous joint capsule that helps provide some stability at the joint. It is often the joint capsule that is the primary factor in limiting the end range of motion for the shoulder in certain directions. (Lowe 1997)

What is Frozen shoulder (Adhesive Capsulitis)?

Frozen shoulder is when the joint capsule of the shoulder becomes fibrous and adheres to adjacent tissues, which greatly limits mobility in the shoulder. This condition is often very long standing and slow to respond to treatment and occurs more often in women in their forties.

Reasons for developing this injury?

Numerous factors including recent trauma, immobilization or emotional stress.

How to access if it is frozen shoulder?

The signs of frozen shoulder are limited range of motion and often displaying difficulty moving their shoulder into abduction, (moving the arm away from the body) and external rotation, (with the elbow bent at 90 degrees and fixed at the waist attempting to move the forearm outwards).

When performing these movements the scapula will raise or their will be lateral flexing of the torso. The “Apleys scratch test” is a good test to use to access range of motion in the shoulder. (Please see the photo below).

Treatment

Massage is a very effective approach when used in conjunction with other range of motion techniques, stretching and strengthening activities. Massage is particularly effective because the change in tissue consistency that can be encouraged is slow and the results will tend to stay longer than an abrupt intervention. Deep longitudinal stripping techniques on the anterior (front) and posterior (back) of the shoulder girdle muscles are generally successful. In severe cases where the shoulder is not responsive to conservative treatment, a manipulation under anesthesia is often performed. This is done to forcibly elongate and “tear” (ow!) the adhered fibers loose so the capsule can resume its free movement. (Lowe 1997)

As mentioned the glenohumeral joint relies on four main muscles for stability; supraspinatus, infraspinatus, teres minor and subscapularis (S.I.T.S muscles). Considering the treatment of this injury these muscles may have developed trigger points that need to be deactivated. It is also important to treat the muscles around the scapular.

Most likely many muscles around the scapular have wasted in protecting the injury and need strengthening. Some strengthening exercises are:

Closed chain of protraction, (the scapula pushes the arm forward) and then retraction, (the scapula is pulled forward from protraction) and scapular elevation/depression. (Performed against a wall)

Modified push ups. (Push up performed on ones knees in a modified range of movement).
Ball catch:- which is throwing and catching a basketball against a mini-trampoline.
As the treatment progresses an exercise that allows the development of the kinetic train, (using other muscles to support the movement e.g. Lumber, lower back muscles) is a modified shoulder press standing on a mini tramp.

(Brukner 2001)

Clair Davies in The Trigger Point Therapy Workbook found recovery from a frozen shoulder injury was from trigger points in the infraspinatus, (the muscle that covers part of the outside of the shoulder blade) and the subscapularis, (the muscle on the underside of the shoulder blade) plus anterior scalenes, (muscles down the front of the neck).

What are trigger points?

A Trigger point is a small contracted knot in muscle tissue. The place where contractions actually occur is in the muscle fibres which consists of microscopic units called sarcomeres. Trigger points exist when over stimulated sarcomeres become unable to release their contracted state. Which limits oxygen and nutrients to the muscle. This keeps the muscle and then even surrounding muscles weak and tight. Trigger points generally refer pain elsewhere. This means that often other muscles need to be treated rather than the original source of pain. (Davies 2004)

How to treat them?

Use deep stroking massage not static pressure.
Massage with short repeated stroked.
Do the massage stroke in one direction only.
Do the massage stroke slowly.
Aim at the pain level of seven out of ten.
Limit massage from six to twelve strokes per trigger point.
Work a trigger point six to twelve times a day.

(Davies 2004)

In conclusion, to treat frozen shoulder a variety of massage techniques with stretching and strengthening exercises can be very successful.

Bibliography

Brukner & Khan 2005, Clinical Sports Medicine, McGraw Hill, Australia.
Davies C 2004, The Trigger Point Therapy Workbook, New Harbinger Publications, USA.
Lowe W 1997, Functional Assessment in Massage Therapy, OMERI, USA
Kapit & Lawrence 2002, The Anatomy Coloring Book, Benjamin Cummings, USA

Anterior-lateral shin pain

By Kerrie Baumgartner
(m:0402 125 962)

What is it?

Anterior-lateral shin pain is often referred to as “shin splints”. The term “shin splints” is a layman’s term used to describe a variety of overuse problems affecting the lower leg resulting in inflammation.

Lower leg pain can be caused by a variety of different issues. A stress fracture of the tibia or fibula can be indicated by increased pain with jumping, pain at rest and at night. Compartment syndrome, pain worsens with exercise and a sense of tightness and maybe a sense of “dead foot”. Once these issues have been eliminated it is usually the inflammation of the lower leg that is causing pain. These are generally categorized into either Anterior-lateral shin pain which is anterior (front), lateral (outer side) of the tibia or posterior-medial pain which is the distal (refers to the structure being furthest away from the root of the limb), medial (inner) posterior (back) of the lower leg. (Lowe 1997)

Anterior-lateral (AL) shin splints is usually caused by over use of the dorsiflexors and often the inversion of the foot, which is when the bottom of the foot turn inwards. Dorsiflexion is when the toes are lifted towards the front of the shin. The muscles used in dorsiflexion of the foot are Tibialis Anterior, Extensor Digitorum Longus and Extensor Hallucis Longus.

What are the origins and insertions of the muscles that are involved with Anterior-lateral shin pain?

The Tibialis Anterior (TA) origin is mainly the upper half of the lateral (outer) tibia and the insertion is the base of the first metatarsal bone. The nerve is the deep peroneal nerve (L4,L5,S1, which lumbar-lower back and sacrum). Extensor Hallucis Longus (EHL) origin is the middle half of the anterior (front) surface of the fibula and the interosseous membrane and the insertion is the base of the distal great toe (big toe). The nerve is the same as TA. Extensor Digitorium Longus (EDL) origin is mainly the upper two thirds of the anterior (front) surface of the fibula. The insertion is along the front surface of four lateral toes. The nerve is the same as TA and EHL. (Stone, 2001)

Why is this important to know?

The nerve of the muscles is an important factor in the treatment of the injury. Often individuals incorrectly believe where they feel pain is the only source of the problem. The real issues of an injury often lie elsewhere. On this note it is important to keep mobility in the lumbar back and sacrum, (the part of the spine below the lumbar) to assist with the rehabilitation of this injury. The origins and insertions are also crucial in dealing with an injury so massage can be performed on these sites.

What is it caused from?

Anterior-lateral shin pain often is a result of excessive eccentric loading on the dorsiflexors. An eccentric movement is when the muscle contracts but it is actually becoming longer, for example, in the down phase of a bicep curl. The extensor muscles which are aggravated in anterior-lateral shin pain is often caused from kicking a football, pedaling a bike, wearing high heels and running especially stairs. (Davies 2004)

Where as the second type of shin splints is posterior-medial which is the over use of muscular structures that resist pronation, primarily tibialis posterior. (Lowe 1997)

How do I treat this problem?

Initial treatment to reduce inflammation is R.I.C.E, (rest, ice, compress and elevate). Alas “rest” is not in most athletes vocab!! Digitial ischemic pressure, (refers to direct pressure applied directly to the skin) should be applied to the thickened muscle of the soleus , FDL and TA plus the origins and insertions. The effect may be enhanced by dorsiflexion and plantarflexion whilst this pressure is applied. Tranverse frictions, (which is oscillating pressure applied transversely to direction of the muscle fibers with no movement between the therapist’s digits and underlying skin) on regions where there is thickening of the soleus and EDL. Sustained myofascial tension, (refers to sustained longitudinal pressure applied to the direction of restriction) can be applied parallel to the tibial border. (Brukner 2005) Trigger points in TA, EDL and EHL need to be deactivated also. (Davies 2004)

How to avoid or rehabilitate such an injury?

Significant biomechanical abnormalities may need correction with orthodics and training may need to be modified, wearing appropriate footwear and running on shock absorbent surfaces. Plus keeping ones body flexible with stretching and maintenance with regular massage will help avoid anterior-lateral shin pain.

Bibliography

Brukner & Khan 2005, Clinical Sports Medicine, McGraw Hill, Australia.
Davies C 2004, The Trigger Point Therapy Workbook, New Harbinger Publications, USA.
Lowe W 1997, Functional Assessment in Massage Therapy, OMERI, USAStone R & J 2006, Atlas of Skeletal Muscle, McGraw Hill, USA

“Piriformis Syndrome”-It's a pain in the behind!

If you feel a bit of a pain in the gluteal region, (buttocks!) or pain that goes down the back of the thigh, (hamstring) the chances are you could be suffering from Piriformis Syndrome. Alas, this syndrome is six times more likely in women. Referred pain is often to the sacrum, (very bottom of the spine) and hip too.

Where is the piriformis muscle?

The Piriformis muscle is the primary lateral rotator, (a muscle that helps move the leg in an outward direction) of the hip. It is the muscle in the middle of your buttocks, (from the rim of the sacrum to the top of your outer thigh bone, called the greater trochanter). The sciatic nerve goes over the other five deep rotators, (muscles that allow the hip to rotate) and under the piriformis as it is leaving he sacral plexus and descending the limb.

1. Piriformis Impingement

In some instances the sciatic nerve will come over the top of the piriformis muscles or in 10% of cases actually perforate the muscle. This is much more likely to lead to problems with the sciatic nerve being compressed, called Piriformis impingement. Pain from this condition is felt not only in the back of the leg but down to the calf and sole of ones foot. There may also be numbness, tingling and a burning sensation.

Treatment consists of stretching and massage therapy, however in this case surgery may be required.

How to access if you do have an impinged piriformis?

How you can test for this impingement is lie on your side with the hip and knee of the affected side flexed on the edge of the table so there is room for the leg to drop off the table. Bring the hip into medial rotation, (move the leg towards your body) and if you have a therapist they can use one hand to stabilize the pelvis and the other hand applies a gentle amount of pressure on the knee to help stretch the piriformis further. The therapist must watch to make sure that the pelvis stays close to vertical and try not to twist the torso. If the pain that you have been feeling is replicated, the pain down the back of your leg then it is most likely the piriformis is impinged.

2. A contracted Piriformis

A second condition of the piriformis muscle is associated with the muscle contracting, (shortening) and developing trigger points.

Why?

Piriformis muscle can be aggrivated by climbing stairs, squats and even sitting! Especially with ones posture/style is biomechanically unsound. For example, if there is too much external (movement outwards) or internal rotation of the leg when performing these activities. This syndrome can be caused from too much activity or too little. If your job keeps you sitting for long periods of time then you have an excuse to get up and move!!

What can happen as a result of this issue?

Tension in the piriformis can put a twist in the sacroiliac joint, adding to your pain. The resulting tilted sacrum can make you appear to have a short leg. Shortening of the piriformis can make it difficult to move ones leg inwards and outwards. Sitting in one spot for a period of time will be uncomfortable causing you to squirm. A tight piriformis muscle can impinge upon the pudendal nerve, causing impotence in males and pain in the groin, genitals or rectal area of either gender. Piriformis muscles compressing gluteal nerves and blood vessels are believed to be responsible for gluteal muscle atrophy wherein one or both vessels are believed to be responsible for gluteal atrophy where both buttocks can waste away. (Davies 2004) Hmm…although to some of us ladies this may seem like a good idea there is nothing like a round, firm behind to fit into jeans for shape!

Treatment

Massage applications and stretching aimed at the gluteal muscle and deep rotators however your therapist has to be careful over the glut (buttocks) to make sure the pressure does not contact the irritated sciatic nerve.

It is believed by some that ones posture is based on the balance of the piriformis and psoas across the sacroiliac joint. (Myers 1998) The Psoas is the muscle attaches to the sides of the vertebrae from your last rib and continuing down to the pelvis and it flexes the thigh and vertebral column. It is important in treatment to always consider the opposing muscle, the “antagonist” which is in reality the co-worker of the muscles to steady a movement. When one muscle is contracted the opposing muscles are lengthened and weakened. Considering this it is very important to treat the erector spinae, (eg, the iliocostalis lumborum that helps extend the lower spine) with again the whole of the gluteal muscle but in particular the lower part of gluteus maximus that assists in extending the thigh and trunk plus adducting (moving inwards) of the thigh. With the quadratus lumborum, the muscle that connects to the bottom rib and the top of the pelvis on each side that laterally flexes the vertebrae column. Plus stretching the contracted muscles and strengthening the weakened muscles.

Bibliography

Brukner & Khan (2005), Clinical Sports Medicine, McGraw Hill, Australia

Davies C (2004), The Trigger Point Therapy Workbook, New Harbinger Publications, USA

Liebenson C (1996), Rehabilitation of the Spine-A Practitioners Manual, Williams and Wilkins, USA

Lowe W (1997), Functional Assessment in Massage Therapy, OMERI, USA

Kapit & Lawrence (2002), The Anatomy Coloring Book, Benjamin Cummings, USA

Articles:

Myers Thomas (1998), Body Poise: Psoas-Piriformis Balance, Massage Magazine, p72

Kerrie Baumgartner * Massage Excellence

Welcome to my site

About Me

Links