Muscle and Tendon are two types of fibres that connect bonds, allowing the joint to be moved by contracting or extending. Muscles and Tendons characteristics. A muscle consists of fibres of muscle cells covered by fascia, bundled with many more fibres, surrounded by thick protective tissue. So each muscle fibre is covered in the fascia, then wrapped as a whole muscle in more fascia. A tendon is a high-tensile-strength band of dense fibery connective tissue. Indeed tendons can transmit the mechanical forces of muscle to the skeletal system. Tendons, as per ligaments, are made of collagen fibres. Compared to a tendon, a muscle is elastic and sits in between 2 tendons parts which keep the muscle itself connected to bonds. So yes, muscles are not directly connected to bond themself. Luckily, there is to say, because if this was the case, it would be really easy to suffer from injuries like a muscle tear. Said so, it is now easy to understand that tendons are capable of holding more force. Injury type Due to the consistency of the tendon and its functionality, we can now understand why a tendon tear or rupture is a severe injury that requires surgical intervention and months of rehabilitation. On the other hand, often, after months of rehabilitation, still, the tendon would not go back to its original state. A common tendon rupture is Achille’s tendon. Achille’s tendon connects the lower part of the Gastrocnemius and Soleus to the foothill. Repetitive movement and repetitive partial load on this tendon are the leading cause of injury. Healthy muscle and tendon Simple and gentle exercises are a good way to keep your muscle and tendon out of trouble. The key points of these types of exercises are: Consistency Resisted load (by using rubber bands) Starting with light weight to then building up with time heavier load Good posture doing the exercises Have a day of rest from exercises once a week Avoid exercises that aggravate your pain. Said so, other critical points for muscle and tendons good health seating into: Having a good night’s rest Eating more fresh food than overprocessed food Regarding recovery from an injury, as previously mentioned in the ice pack and/or heat pack posts, the usage of temperature is recommended based on the stage of the injury and the pain experienced with it. Even though on an inflamed tendon, never apply a heat pack. Are you in need of treatment? Don’t look any further, and book your initial consultation by clicking here.
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Jul
In a previous blog, we did talk about heat packs, now it is time to talk about the Ice Pack. Ice pack application, in the last few years, is a practice that got reviewed. What Ice Pack is about? An Ice pack, as the name says, is a cold (icy) bag. As better explained in this study an ice pack is something that can be applied to an acute injury, to prevent swelling and reduce pain, but it can’t be used for too long. As per the heat pack, an Ice Pack burn the skin, and that’s one reason why its usage has to be short (10 to 15mins at a time). In addition, extended exposure to icy temperatures, would reduce the blood flow around the injured tissue and can also damage nerves. Ice Pack usage recommendation: You have a new injury or aggravation of an existing condition, and the pain is above 7 out of 10. Where you want to minimize swelling to keep you mobile later. There are different types of Ice packs: Home-made one, ice from the freezer wrapped in a towel. Gel pack Ice Bag (as per the photo) Instant one – most of the time found in the first aid kit. Snap it and a chemical reaction would occur in the bag and freeze the bag. Those last ones are efficient as you can store them anywhere safely and use them as you need them. The cold lasts for about 20 minutes. Not to be used if they are broken. On the other hand, if you running out of ideas of what to use as a Cold pack, you can even use a bag of frozen food. Still would do the work. We have the ice bath and the cold show related to this topic. I did experience cold showers myself, most of the time not of my choice, but because of a limited supply of hot water, and I have to say that even on this topic, there are a series of debates on how that works and if it’s beneficial. So far, a cold shower, compared to a hot shower, is better for dry skin. This is because the heat of the water combined with soap can wash away the good oils of the skin. Then the benefit of an Ice bath can be more of a placebo effect. But again, I haven’t done much digging about myself, so I would stay out of any comment regarding it. Ice pack after a Massage? Well, as mentioned above, the usage of Ice Pack is suggested after an acute injury. So, either after a Remedial Massage or a Thai Massage, firstly there should be no acute injury, secondly, you want the blood flow along the worked area to stay active and not restricted. That’s why a heat pack would be more recommended. If you find this helpful information and need a massage, book your next session here.
Jul
Applying a heat pack or cold pack to the body after an injury or when we are in pain is a widespread practice. In this post, we are going to look into Heat Pack. What is a Heat Pack? A Heat Pack is a heat source, most often made from a fabric bag containing grains (like wheat or barley) that get placed in the microwave for 1 or 2 minutes (or till it is warm enough). What are the benefits of a Heat Pack? Stimulate the blood flow around the painful or restricted area. Improve mobility Pain Relief How does a Heat Pack work? When applying an H.P., the blood vessels beneath the tissue dilate, consequentially increasing blood flow. As a result, more healing elements such as oxygen, vitamins, minerals and so on can reach the area needing attention. On the other hand, heat is a short-term solution for releasing tensions. In the longer-term, massage therapy such as Remedial Massage, Thai Massage, Myotherapy, or MLD would be recommended. I still recommend that my clients use the heat pack momentarily and occasionally, even after the treatment, when they present with a poor Range Of Motion. For how long should I use it? 15 to 20 minutes at a time is enough. Why not for longer? Firstly you can burn your skin. That’s even why as a massage therapist, I recommend anyone to place a towel over the skin before applying a heat pack. Secondly, with a heat source, as the vessels stay dilated for a long period of time, more inflammatory cells can reach the sore area. This would make the situation worst than better. What type of HP are there? Fabric one staffed with grains. Heat patch Hot Bottle Wet bag The wheat bag is most often found in clinic settings. Are bags containing a gel, and it sits all the time in hot water. For home use, a fabric one does the job. You can heat it in the microwave or the oven. In any case, handle it with care, as it can get really hot. When to use and heat pack? You have low-level pain, like 1 to out of 10 You have joint stiffness and pour mobility You have muscle tightness that limits your mobility
Jul
A muscle tear is an acute injury caused by a laceration of the muscle cells/fibres and or tendon to which the muscle is attached to. How can happen a muscle tear? A muscle tear happens when a muscle is weak and don’t activate at the right time. Weak muscles are common in repetitive movement or when a muscle overcompensates due to a fragile pattern. For example, tearing a hamstring is expected when the Gluteal Firing pattern is incorrect. This type of injury is common in sports activities. Still, it can also happen within a home environment by lifting a box incorrectly or during garden activities. The three grades of muscle tear. Grade 1 muscle tear is the mildest one. As per this case, only a few muscle cells have been torn. Symptoms are like: mild pain, moderate swelling, none or light bruising. In grade 2, a moderate amount of muscle cells have been damaged. Symptoms are like: Bruising is now more evident as per the swelling You must luckily hear a sound as the tear happens More severe pain, especially when trying to use that muscle. Grade 3 is the worst-case scenario. In grade 3 muscle tear, the muscle has fully torn. Still, a pop or a sound would happen as the tear happens. On the opposite side of where the muscle did lacerate, you will notice a bulge as the muscle coiled up after tearing. Weakness in using the limb where the muscle got torn. In case of a Grade 3 muscle tear, surgery is needed to reattach the muscle. How to treat a muscle tear? The immediate appliance of heat or cold packs is highly debated. A cold pack would numb the area and help with the pain symptoms. As mentioned in the “Ice Pack” blog post, that is actually recommended. On the other hand, a heat pack would help stimulate blood circulation in the affected area, reduce swelling, and boost recovery. It’s important to note that applying a heat pack too soon after an injury can actually make things worse. It’s best to wait until the acute phase has passed, which typically takes around 48 hours. At that point, heat therapy can be a helpful way to alleviate pain and promote healing. Regarding massage treatments, MLD can be the only technique used as soon as the tear happens. Indeed MLD would be highly recommended for boosting the recovery, especially in case of a tear in 3rd grade, where operation is needed. In case of a 3rd-grade muscle tear, the first thing to do is see a doctor. Other massage techniques, such as Myotherapy, Remedial Massage and Thai Massage, are still valuable for muscle tears. On the other hand, either Myotherapy, Remedial or Thai Massage can only be practised after 48 hours of rest are passed after the incidents. Indeed that 48 h is considered the acute phase of the muscle tear. How to prevent a muscle tear? More the body moves, the less the chance of injury. Making sure to do simple exercises involving basic body movement can help in muscle tear prevention. but not only. Keeping the joint moving is another essential aspect of injury prevention. How can massage help? Along with a massage treatment, the area of focus will be the torn muscle and surrounding area. Initially, the technique used with a massage treatment, especially for the injured area, would be MFTT and passive movement/mobilisation. That would help muscle recovery and facilitate joint mobility, reducing the muscle’s load. Going ahead with the treatments, techniques such as MET, a resisted muscle force technique, can be used. This would allow the muscle to gain elasticity. Book your next session by clicking here if you are suspicious of a muscle tear and need treatment.
Jun
Lymph nodes (or lymph glands) are small lumps of tissue containing white blood cells that fight infection. They are part of the body’s immune system and filter lymph fluid, composed of water and waste products from body tissues. Introduction to Lymph Nodes Lymph nodes are located in different body areas. On average, we have approx 600 LN. In the neck area only, we find 160 LN itself. LN can vary in size and go from 2 to 30 mm. Lymph Nodes are connected by vessels, better known as afferent and efferent vessels. The afferent vessels carry the lymph to the lymph node, and the efferent vessels take the lymph away from the lymph nodes. So, the lymph nodes are also connected directly to the blood system, veins, and arteria. What is a lymph node made of? Despite the structures that enter and leave the lymph node, these cleaning stations are made of: Connective tissue capsule Supporting strands of connective tissue inside Below the marginal sinus, there are clusters of lymphocytes lymphoid follicles Artery, vein and nerve As for the filtering station, the lymph node is essential to ensure that no bacteria, viruses or dirt can access the blood system. Where we find no lymph nodes in the brain. Indeed, the lymph fluid around this area gets drained by the Optic and Olfactory nerve. Following then the position of the lymph nodes, we can define the watershed. MLD and Lymph Nodes. Lymph Nodes can occasionally be swollen, which happens when the body fights an infection. In my practitioner experience, I often have to refer to the lymph node concept to introduce the client to MLD treatment. Not many clients know about this technique; they are more familiar with Myotherapy or Thai Massage and Remedial Massage. Said so, the client who tried MLD are all well impressed with its benefit. During an MLD session, what happens is that with a gentle stretch and recoil of the skin, I help your lymphatic system to work faster. Consequently, that’s how swollen area gets reduced. In pushing your lymphatic system to work harder, the lymph node would receive more liquid to process. On the other hand, knowing where the lymph nodes are, is essential to ensure we push the lymph liquid in the right direction. If you haven’t booked your appointment yet and wish to set a goal for MLD, please follow this link.
Jun
Calf muscles make up the lower posterior portion of the leg. Calf Muscles are: 2 are the calf muscles, the Gastrocnemius and Soleus. Below is a table with Gastrocnemius and Soleus’s Origin, Insertion and Action. Gastrocnemius Origin The posterior surface of the lateral and medial condyle of the femurs Insertion Calcaneus via calcaneus tendon Action Flex the knee Plantar flex the ankle Soleus Origin Soleal line; the proximal posterior surface of the tibia and posterior aspect of the head of the fibula Insertion Action Plantar flex the ankle So, due to their origins and insertions, we can clearly understand how the Gastrocnemius is involved in knee flexion and how the Soleus is not. The Gastrocnemius does across the knee, as it originates from the femur itself. On the other hand, the Soleus doesn’t cross the knee, so it doesn’t play any role at the knee level. This aspect is so important to differentiate what of these 2 muscles are involved in the restrictive movement at the ankle, and or in calf pain. Calf Muscles testing Firstly the patient is lying down in a supine position (face up) doing active dorsiflexion. Secondly, we will ask the patient to lie in a prone position (face down), and we knee bend (passively), they would go in ankle dorsiflexion again. What happens there is when the knee is flexed passively, the Gastrocnemius is deactivated, and so the ankle dorsiflexion is happening by pulling the soleus only. Now, 2 are the case scenarios that could happen: Still a limited range of motion at ankle dorsiflexion with or without pain A better quality of ROM with a greater angle in dorsiflexion. In the first case, the tension muscles could still be both. In the second case, the Gastrocnemius is clearly the muscle limiting the ROM. For ankle ROM in dorsiflexion, we are looking for a minimum of 20° to up to 30°. It is not all about Muscle Pain. But can calf pain be related to something else and not just to muscle pain? The answer is YES. Calf muscle pain can be a RED FLEG for Deep Veins Thrombosis (DVT), especially after a flight. DVT Symptoms: Sharp pain; Heat at the touch; Soreness at the touch; Redness on the skin. In this case, you want to contact your GP immediately. Massages are absolute contraindications. In conclusion, for a full calf or muscle recovery, we want to look in too some exercises. Remedial Massage, Myotherapy, and Thai Massage are great ways to reduce pain and manage symptoms, but exercises are essential actually to heal a muscle. Indeed, when we talked about plantar fasciitis, those exercises are something that we can look at for calf strengthening.
Jun
How good is it to receive a massage? What are the benefits of massage? Often in this blog, I have been talking about how the different massage technique works, but never an explicit post about the benefits of massage with a more broad approach. From the modalities of Remedial Massage to the history of massage, to how MLD can be good for bond fracture or swelling along the body. But it is time to draw a line and talk about the general benefit of a massage. Massages are beneficial for endless reasons. For example, massage does stimulate blood flow. Increased blood flow is what mainly does the trick in removing that nasty knot from the shoulder. On the other hand, a massage does also increase the production of neurotransmitters such as serotonin and dopamine. In addition, this does also reduce the Cortisol, which is responsible for the body’s stress response. More information about those chemical reactions is available from this study. Moving forward, massage is also helpful for stimulating the regeneration of the skin. Here then maybe we want to differentiate the benefit of Relaxation massage from Thai Massage or other techniques where there is no topic cream or oil used. Other benefits of massage are then the reduction of body aches and pain. The older we get, the more our body aches and pain manifest, and said so, a tough massage such as Remedial Massage or Thai Massage is not always easy to take. Therefore, I always suggest MLD as a technique for clients who can’t stand strong pressure during a massage session. Improving mobility is another big benefit of massage. I do love to receive Thai Massage from a practitioner who studied with Pichest. The improvement of mobility after a Thai Massage is just amazing. Back to the benefits of massage, let’s not forget that a massage can also be the perfect Gift Card. At Melbourne Massage and Treatment we offer Gift Card for your love ones. In conclusion, don’t wait for the body to stop, or for the pain to be unbearable. A massage can be good for reducing body aches, but it can be good as even just to reduce body and mind stress. Reducing general stress, can improve your well-being and keep your aches away still for a while. Click here to book now your next massage session.
Jun
Latissimus Dorsi and exercises Latissimus dorsi is a thoracic back muscle that seats superficial to the Erectos Spine muscle groups. As better explained in the table below, one of its main actions is to rotate the thoracic. Latissimus Dorsi (LD) is occasionally related to back pain symptoms. Along with this blog post, we will go through a series of exercises to facilitate of Latissimus Dorsi. Origin Spinous processes of thoracic T7–T12, Thoracolumbar fascia Iliac crest Inferior 3 or 4 ribs The inferior angle of the scapula Insertion the floor of the intertubercular groove of the humerus Action Adducts, extends and internally rotates the arm when the insertion is moved towards the origin. When observing the muscle action of the origin towards the insertion, the lats are a very powerful rotator of the trunk. Now, given away the specification of lat Dorsi we start to get a clear idea of how this muscle can be involved in back pain, especially when going to a rotation or opening the arm side wise (Adduction). Given its origin point, along the Illiac crest and the Thoracolumbar fascia, LD takes part along with Gluteus Max to what we call, Oblique Muscle Sling. Indeed, in the case of the predominant force of the LD, we may observe weakness in the G. Max. Said so, the LD is a muscle that can be easily stretched out and reinforced. To start with let’s look at how a massage therapist can reduce tension from LD. In case of a Remedial Massage, to access and work on this muscle the patient is lying in a side position. MFTT is a myofascial technique used to release fascial tension from this muscle, by stripping the skin over the muscle and by pulling passively the arm away from the chest. On the other hand with Thai Massage the client will be seated on the floor, cross legs and both hands behind the head. In this position, the LD is activated as the lumbar origin points are fixed to the ground and the insertion point is stretched. So, initially the therapist seat on her/his knee behind the patient. After that, she/he places a knee on the tight of the patient on the opposite side of Lat Dorsi that needs to be stretched, and by using her/his hands holds down the tight of the affected side and pulls side way the flexed forearm. This type of stretch must be controlled and done gently. Asking for constant feedback from the patient on how it feels is really important. Despite how to release tension from this muscle with manual therapy, we can look into some corrective exercises. Along with those exercises we include one of the Thai Yoga series. In fact, this specific exercise from the Thai Yoga series is good for working on Lat Dorsi and on Gluteus Max at the same time. Latissisum Dorsi exercises. Open book. Start with lying down on the not affected side, with both knees flexed at 90° and arms and hands seating one on the other one, pointing away from the body. Have a pillow below the head. Start opening the arm of the affected side, by keeping the arm straight. As the chest and arm are opening, rotate with neck and head towards the same side. Stop immediately if you are experiencing pain (as you should not experience any pain) or stop when you feel the knees start moving. Close the arm and restart. Stop before the knee starts moving. Book sliding page. As per the previous exercises lying down on the unaffected side with band knees and arms standing on each other, facing away from the body. This time, start sliding the hand seating above along the line of the other arm. As you slide the hand, as you go to reaching the chest, start rotating the head and neck. Again, stop if pain occurs or if the knees start moving. Close the arm and repeat. Thai Yoga Lattissimus Dorsi twist. Seat on the floor with the leg in Thai Pray position, by placing the leg of the affected side flexed backwards. Hold the back up nice and straight. Take a deep breath in through the nose. And as you breathe out, start rotating with the thoracic towards the unaffected side. Stop if you feel pain, along the back or elsewhere or when you can rotate more. Keep rotating side to side, following the breathing in and out Those Latissimus Dorsi exercises are recommended for those who are aware to have limited thoracic rotation. If you are experiencing any sharp pain or nervy type of pain sensation along with these exercises, don’t practice them and book your next session to better evaluate what is happening there.
May
The scapula is a large triangular-shaped bone that lies in the upper back. It is also known as the shoulder blade. How the scapula is connected to the rest of the skeleton? The scapula, compared to other body bonds, is connected to the main skeleton, a series of ligaments that sit only on one side and extremity of it. The ligaments are: transverse scapular ligament; coracoacromial ligament; coracoclavicular ligament; coracohumeral ligament; glenohumeral ligaments; acromioclavicular ligament. That’s for is also called a “floating” bond. So to be more specific, as any ligaments do not connect the medial or inferior/lateral borders to any other bond structure, the scapula is subjective to the muscle’s force. Indeed, the shoulder blades of an individual often don’t look the same. What do I mean by that? Well, starting from the fact that one body side is more dominant than the other. Take, for example, an office worker. Despite being seated or at a standing desk, most of the time, the dominant hand will be the one using the mouse, right? Where the non-dominant hand will be the one mainly sitting on the keyboard. Now, the hand that moves the mouse is less lucky to leave its position and do other tasks. As the mouse is in constant action, that hand is in continuous movement, yes, but it doesn’t go that far. Indeed, the non-dominant hand would move more freely as it is not always typing. Said so, the arm controls that hand per consequence, moving less. Due to the poor ergonomics of many desks, that arm is seated on a narrow-angle, so the elbow is constantly flexed. All this micro action, multiplied for days, weeks, months and years, brings the scapula to the mercy of the muscle force. As per this example, the bicep force. We did mention just now that the elbow is constantly flexed, right? So the Bicep, the primary elbow flexor, will be constantly under tension. Now, looking at the bicep origin, we find that: The short head originates in the Apex of the Coracoid process of the scapula The long head originates in the Supraglenoid tubercle of the scapula This is then how the scapula gets constantly pulled from this muscle. Then obviously, there are other muscles to play a contro-part. In this case, we can think of the lower trap and the lat dorsi, which inserts at the inferior angle of the shoulder blade, so on the opposite side of where the bicep pulls from. But if those muscles are not trained to compensate for the constant pulling force of the flexed arm, then the scapula will be tipped out. What is a tipped Scapula? For “tipped scapula, ” we refer to a scapula with a prominent inferior corner. On the other hand, especially for the coracoid process, there is more muscle originating from that area, such as the Pectoralis Minor and the Coracoid Muscle. Now, after analysing how muscle tension can move the scapula around, we can talk about other scapula facts. So a Scapula should sit with the inferior angle at the high of T7 (vertebrae). But that’s not always the case. So we can have a “depressed” scapula that can sit lower than T7 or an “elevated” scapula that can sit above T7. Lev scapulae and lower trap are the muscles responsible for a depressed or elevated scapula. It all depends on the tightness or laxity of the muscles. Furthermore, we can have a “winged” scapula. Therefore, the medial border is visibly protracted. For this case, is Serratus Anterior responsible for the winged shoulder blade. As this muscle gets loose, the shoulder blade escapes the rib cage. On the other hand, when we look at a scapula, we also see if it is “downwardly rotated” or “upwardly rotated”. Preferably we would like to see the shoulder blade being upwardly rotated. That means having the superior angle closer to the spine and the inferior angle further away. Why so is because when we elevate the arm, either in flexion or in adduction (flexion on sidewise), the scapula is ready to follow the humerus. In this post, I already talked about the muscles involved in the scapula rotation. How can massage help with shoulder pain? We always have to look at the presentation regarding massage and treatment from which a shoulder can benefit. A Myotherapy, Remedial Massage or a Thai Massage is good to: improve mobility; reduce tensions; alleviate trigger points; rehabilitating the shoulder. MLD, on the other hand, is more recommended for fracture; inflammation of the muscle surrounding the shoulder; pre-post operation; swelling; skin rash on the shoulder area. In conclusion, if your shoulder needs some work done, your next massage is a click away.
May
Often when I introduce myself to people, as a massage therapist, and I mention that I work with Thai Massage, they look at me and say things like: “Oh I love Thai Massage, I love that knee in my back” or “Thai Massage? Not for me, it is too painful” Both those ways of talking are often a sign of a poor understanding of the importance of Thai Massage and are based on the commercial knowledge of this ancient technique. Unfortunately, Thai Massage has the reputation of the massage “go hard or go home”. But is that a real thing? I mean, is this what Thai Massage should be? Massage and pain are 2 things that are strictly correlated. Most of us go for a massage when we are in pain, isn’t it? During the massage, even during a Remedial or Myotherapy treatment, we are going to experience pain. And you know what? That’s normal. Actually, that’s what those techniques are based on too. That pain sensation that you experience during the Remedial or Myotherapy session as per the Thai session, is what makes the massage work. What is the purpose of pain during treatment then? Well, that pain is a response of your body to trigger point stimulation. What happens next is that, by stimulating a trigger point, the body will release an immune response that would facilitate the trigger point to dissipate. That’s why during a session as massage therapists we ask: “How does it feel?” “0 to 10? what’s the sensation feel like?” Book now your next Massage. So is pain normal during a massage? Yes, it is normal. But back to the start, in Thai Massage often the therapist due to their poor training are told to “go hard or go home”. It is a tourist thing. It is the westernization of an ancient healing technique. And unfortunately, it will now take years to change the mindset of people about it. Again, a knee on the back is a real thing, but it doesn’t have to hurt more than what a hand can do. So why use the knee on the back? Well, it is just more ergonomic for the therapist. It prevents the hand of the massage therapist to be worn out. But again, in order to use a knee on the back, leg, or shoulder, there is a need for some training, things that at the Thai Massage front shop, often, the person working there, doesn’t have.