When experiencing pain around the head, we talk about Headaches. Headache is a common condition, and for most cases, is not considered a serious illness. Migraine and headache. 4.9 million Australians experience migraine. Migraine is a specific type of headache, so consider that the number stated above is still a small figure. Headache and muscle. If you ever experience a headache, you may notice that the pain sensation does start from your cervical area. Or, by confronting yourself with who is around you, your headache pain pattern, is consistent, but it is different from the one of someone else. On the other hand, you may associate headaches to the result of a heavy drinking night, or of lack of water (which is why you get headaches after a heavy drinking night, by the way), but often headaches are there because of cervical muscle tightness. Wait, what? Yes, you did read right. How can we define then if the headaches come from muscle tension? So in order for this to happen, the muscle responsible for referring its pain up to the head must be tight or stretched out, and loaded with trigger points. As massage therapists, especially in the first consultation session, we would ask about headaches and if there are any, “where about do you feel the headache”? Indeed, the answer to this question is most luckily the giveaway to know which muscle is may responsible for your headaches. To confirm the suspicions, we would then assess your posture, looking for any muscular-skeletal unbalance, and then we would assess the Range of Motion (ROM). If the ROM show up to be limited on the muscle that we believe is responsible for the pain in the head, then most luckily we are halfway through the solution. I do say halfway through, a single massage session either Myotherapy, Remedial Massage, Thai Massage, or MLD is maybe not enough to release all the tension that is in needs to be alleviated to eradicate the headache. Said so, no journey starts, without doing the first step, isn’t it? When a headache is a Red Flag? For red flags, we refer to symptoms that may be present due to serious illness or condition. Some example includes clients who had a clinical history of stroke and or brain cancer, a recent car accident or recent head trauma, or blurred vision. If that’s the case, the next step is referring the client to a GP immediately for further investigation. What about the cervical muscle tension headaches type of presentation? As already mentioned in another blog post, the Occipital muscle can have headache type of pain in the lower section of the posterior side of the skull. If we then look into the area of the skull that seat above the ear, could be more tension from the Upper trap or Levator Scapulae. By keep moving more medially and above the head, Splenius cervis can refer to the medial superior side of the head and Splenius capitis to the middle top side of the head. Sternocleidomastoid, indeed, can refer to the frontal lobe of the skull. Now, all these muscles are sitting on the neck and throat and from above the shoulder. So, ensuring that those areas are free or not overloaded with tension can help in staying headache-free. Now, in this blog post, we are keeping the headache presentation type of pain to its simple aspects. On the other hand, the topic can be further discussed in person with Giovanni during your next massage appointment. Book now your next massage session, if you are trying to get to sort out your headache presentation. Other approaches to a headache-free life, out of massage therapy. There is a series of things that complimentary massage can help with to relieve headache pain. Exercises Keep yourself hydrated Good posture when seating and standing Good variety of food as diet intake Wearing glasses if needed. Meditation for stress management In conclusion, headache is a really common problem for all Australians, for both women and men. Don’t wait for your symptoms to get worse; you may not need to take medicine all the time if you have a headache, as the medicine will just numb the symptom but will not sort out the problem. If you are keen to learn more about where your headache may be coming from, book your next Massage Session today.
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In the previous post, we did look into plantar fasciitis and we only mention the Corrective Exercises for Plantar Fasciitis. Indeed, we did get to the conclusion that Myotherapy, Remedial Massage and Thai massage can help in reducing muscle tensions, for those muscles which take part in the foot’s unbalance, and that MLD can help in reducing the pain and reducing the inflammation within the plantar itself. What’s the role of the Corrective Exercises for Plantar Fasciitis? Exercises are a crucial step to take for a successful healing process. Corrective exercises for plantar fasciitis can be simply practised at home, without the aid of a personal trainer to follow you. In fact, corrective exercises are often simple movements, that require precision more than strength. Furthermore, is better to start slowly and gradually implement more difficult exercises and extra load. Indeed, the corrective exercises world is a step-by-step journey. If this post is talking to you, book your next massage session by clicking here. Corrective Exercises for Plantar Fasciitis: Foam rolling below the foot. Take a seat on a chair and start gently rolling the affected feet along on the foam roller. The bigger the foam roller, the gentler the exercises, due to lower pressure. If you have no foam roller, you can use a tennis ball too. The aim of these exercises is to gently self-massage the plantar of the feet and stimulates blood circulation within it. Plantar pressure with a towel. Always in a seated position, roll a towel on itself, and by holding it with both hands, put the towel under the foot. Start pulling the towel against the plantar of the feet Pull and hold for 15 to 30 secs about Drag the towel with the toes. Place a towel on the floor. The backside of the towel will be right below your toes Now gently, start grabbing the towel with your toes These exercises will reinforce the flexors muscles of the toes, in specific Flexor hallucis longus and Flexor digitorum longus, with the aim to improve the arch below the foot Single Calf Raise For this exercise, you will need a small stool or an Aerobic Step Kit Step with the front of the feet on the Areboic Step and start pushing up through the foot. For safety, you may wanna hold yourself to a wall with your hands You can start doing 1 foot at a time to increase the load. These exercises would create strength in the plantar flexor muscle of your foot. Along with the same muscles that do plantarflexion, there are the ones that do eversion and toes flexion too. In specific Perenous Longus, Perenous Brevis (eversion) and Flexor hallucis longus and Flexor digitorum longus (Toes flexion) If you suffer from plantar fasciitis because of an excess load of the body weight on the external side of the foot, these exercises would help you in recreating balance in the body load on the foot. Said so, those are some of the exercises that can be done. Few more are out there. If specific to your condition, you may want to do some exercises more than others. Most important is to have someone diagnose you with the specification of the condition and then suggest to you what exercises are the best. Plantar Fasciitis is a chronic condition, that with the right exercise and determination can be fixed. If you need help with it, don’t hesitate to book now your next session with Melbourne Massage and Treatment. And what about Orthotic Insole? The orthotic insole can be a quick-release type of approach for foot pain. On the other hand, orthotic insoles are most luckily the more common and misunderstood tool for foot pain. Yes, good to quickly reduce severe symptoms, but by itself is not going to fix the problem. Indeed, before spending hundreds of dollars on Orthodics, give a fair trial to exercises.
Plantar Fasciitis is a foot condition that can cause severe pain when walking or standing. Pain may be more intense in the morning when you step out of bed. If you ever had plantar fasciitis you will well know, that is not a fun thing to deal with. How to fix plantar fasciitis? In most cases, corrective exercises are the best way to retrain the foot and heal it once and for all from this condition. In this blog post, I talk more in detail about exercises for plantar fasciitis. How does Plantar Fasciitis manifest itself? Plantar Fasciitis manifest itself when the load of the foot is predominately put on the outside of the foot or on the back of the foot. It is the case we talk about an over-inverted foot, indeed a foot that is overloaded on its lateral portion. By doing so, the big toes flexor, the muscles that connect the big toes to the heel, get inflamed. As per consequence, pain does manifest below the heel. “It feels like if I got glass under my feet” someone that offers this condition would say. Plantar fasciitis demographic. People who spend a long time standing up/walking (waiters) Runners (who run with a heel strike) Pregnant women (due to the abundance of weight) The foot is a complex body part. Indeed, the foot contains 29 muscles, 26 bones and 30 joints. Therefore if not loaded correctly, the consequence can lead to major body musculoskeletal dysfunctions and unbalance. As already mentioned during the blog about the Fascia line, unbalanced feet can reproduce tension up to the back and shoulders. Plantar fasciitis functional test. A simple test that we do as massage therapists is to passively extend the big toes. (Windlass Test) If pain is reproduced on the heel, the test is positive. Therefore, this test tells us that the big toes, which most luckily would not even extend to their full range (65°), are not used when standing and or walking. That’s why is weak and tight. How can massage help reduce plantar fasciitis pain? At Melbourne Massage and Treatment, Myotherapy, Remedial Massage or Thai Massage can help reduce the tension along with the foot’s supinator muscles, which are responsible for over-invert the foot. That’s one of the reasons why the body weight gets overloaded on the lateral side of the foot. Regarding MLD, it can be most beneficial to reduce the inflammation within the plantar of the foot and help manage the pain. But as previously mentioned, massage can help in reducing the symptoms, and improve mobility. Where for full recovery, corrective exercises are essential. Was this post helpful? If you are suffering from Plantar Fascitis and would like to find a way out of the pain, book now your next appointment with Melbourne Thai Treatment. Here on the right side, is an example of a pair of shoes, for someone who suffers from plantar fasciitis. As you may notice, the lateral portion of the show is completely worn out, where the medial portion, is nearly touched, especially at the big toes area. So back to the fact, that the big toes are what should drive the foot along the strike motion if that shoe area is untouched, it means that person is not loading any weight on there. Footwear examination can be also used to identify weight balance in the foot area.
TMJ or Temporomandibular joint is bilaterally located on the side of the human head. TMJ and Movement Upper Compartment Protrusion Retrusion Lower Compartment Lower the Jaw Raise the Jaw Lateral Deviation Said so: the opening is the combination of Protrusion plus Lowering the Jaw closing the mouth is Retrusion plus Raising the Jaw. TMJ and Pain When TMJ is in pain, we can find it hard to talk, eat and sometimes even rest, as the pain can be pretty strong. Moving forward, not everyone knows that deep under TMJ we have what we call Parotid Gland. The Parotid Gland is a salivary gland, and if gets infected, it can swallow up and be quite painful. What can happen at the Parotid Gland is an accumulation of calcium in its duct, and saliva can’t be expelled. Even though viruses or bacteria can also be responsible for TMJ infection. What also most people are not aware of is that in the Parotid Gland, there are lymph nodes. TMJ and MLD. The fact that the gland can be swollen is an indication that fluid is stuck in it. MLD, thanks to the boosting of the lymphatic system, which is responsible for reducing swelling in the body, can be the perfect technique to reduce the swelling and so restore the functionality of TMJ. If this post talks to you, book your next massage session by clicking here. The Parotid Gland lymph nodes unload their Lymph Obligatory Load into the cervical nodes. So as per usual, at the start of the MLD treatment, we will work along the upper neck, medial neck and then the terminal (just between the clavicle and the upper trap). In addition, what makes a difference with MLD is that is a pain-free technique. That would allow the client suffering from TMJ pain to receive a treatment that would not aggravate the pain feeling and would end up giving a deep relaxation too. Other work techniques can be used, such as Myotherapy and Remedial Massage trigger point, or dry needling for Myotherapy treatment. The Remedial Massage TMJ treatment is a valuable technique but would not resolve the problem at the root cause. In conclusion, MLD is probably the best manual, not invasive treatment that can be done for TMJ. Talk to your dentist about this option, and if they are not aware of what MLD is, don’t be surprised, it is, yes an excellent technique, but it is still not well known by many practitioners, dentist included.
Range of Motion is the movement of a joint within a 3-dimensional space. For each joint, we expect a minimum and a maximum degree of movement. When to use a range of motion evaluation. Before performing a Myotherapy, Remedial Massage, or a Thai massage session, we check for a Range of Motion, also know as ROM. Checking for ROM is to establish the functionality of the joint and the muscles that surround it. For example, when a client walks in complaining of cervical pain, the first thing we look in too after the postural assessment is the ROM. A postural assessment is an evaluation of the skeletal structure. After that, we ask the client to do specific movements with their head. Like, Rotation side to side, flexion, extension, and lateral flexion. Indeed, these are the basic range of motion for the cervical area. What this range of motion can tell us? Well, depending on the essential mobility of the person, we expect a minimum and maximum range. Let’s say that the client has average mobility; we expect the range of motion of their cervical to be: Flexion (able to flex the head forward and leave a gap of 3cm between the chin and the sternum) Extension, we look in too 70° of movement Lateral Rotation we look in too 80° of rotation (the chin is nearly in line with the shoulder) Lateral Flexion we look in too 45°. If this post talks to you, book your next massage session by clicking here. Are the range of motion movements the same for everyone? A person with a hypermobile joint range may have a 10° about less ROM than this. Indeed, a person that has a hypermobile joint range can reach 10° furthermore. That’s why every person needs his evaluation. Moving forward, if the range of motion is limited, it could be a muscle tightness or a joint mobilization issue. The best approach for improving joint mobilisation is the Myotherapy treatment or Thai Massage. Both techniques relieve muscle tension and improve muscle tone and joint mobility. The release of tension from the muscle would improve the ROM. On the other hand, when we ask a client to do a ROM, we don’t look only for the length of movement. Quality of movement. For the quality of movement, we refer to how smooth the movement is. Is the client trying to compensate for the cervical rotation by flexing the head? Is the client compensating for the flexion by shrugging the shoulder? Indeed, the movement of a joint is the key to understanding what muscle is responsible for the pain, discomfort or limited ROM. Once we individualise the key muscle/s, we can address the issue. Different types of ROM. In conclusion, the ROM can be active, passive and resisted. The client itself does active ROM. Passive are ROM done by the therapist with no assistance in controlling the movement by the client. Reisted is ROM active done by the client, with a resistance force applied by the therapist again the client’s movement. Each of this ROM can tell us something different about the joint. Active is about muscle lengthening. Passive is about joint mobility (ligament and tendon) Resisted is about the strength of the muscle. We can’t use the Resisted if Active or Passive reproduces pain. That would not be safe. Regarding the Resisted ROM, the resistance is applied in 3 different levels. When the pain gets reproduced, we stop the test. Occasionally, an orthopaedic test can be performed too. Orthopaedic tests are specific tests to evaluate in specific the muscle involved in the limited ROM.
Massage appointments, how often? How often should I come for a massage appointment? Often I got asked this question, and the answer is not as simple as. A massage, that is Remedial Massage, Thai Massage or MLD treatment, has the aim to heal a condition or alleviate the pain. Well, at least that’s the main aim of those techniques. Said so, the second, but not less important task for a massage is to induce relaxation. Therefore, if you are aiming to get some relaxation, I would suggest considering getting a massage appointment regularly. Like, every 2 weeks, every month or every 2 months. Of course, depends mostly on finance. So, a regular massage appointment, allows the body and mind to aim for something positive. It is like a reward. On the other hand, if the message is not limited to relaxation time, then, you may need it more often. That’s the case when the client comes to the appointment that is in pain (99% of the time). If this post is talking to you, book your next massage session by clicking here. The fact that you are in pain can be a sign that the body issue has been there for a while. Indeed with a massage, we can alleviate the pain, but to actually fix the issue (if it’s fixable by the way) or to make the best out of what the condition is, we need to do more than one session. In fact, one session may release the pain for a couple of days, but then, as you go back to your daily routine, the pain would come back. Therefore, a series of close massage appointments, in a short time can actually help for the best. Another important aspect of pain management is exercise. Corrective exercises are a key role in expanding the time between one session and the next one. If you actually do the exercises, you can by yourself improve your body conditions, reducing the risk of injury and pain. In conclusion, the frequency for which you should attend a massage appointment is based on your needing. For a Remedial massage or a Thai Massage, you may wanna initially see the therapist once a week for the first 3 to 4 weeks. With MLD is different. With MLD the need for seeing a therapist can be more frequent. Obviously depending on the condition that has to be treated.
Strokes that we use as Remedial Massage therapists. As previously mentioned, a remedial massage is different from a relaxation massage. Indeed, a remedial massage aims to speed up the recovery process from an injury or musculoskeletal dysfunction. Therefore, in a remedial massage, we use a bigger variety of strokes, and we can dive them into static, and dynamic. As per result, static strokes, don’t involve the client’s movement, like DIP. On the other hand, dynamic strokes require a resistance or a movement of the client’s body, like MET for example. Indeed, in the table below, we can find a list of strokes that remedial massage therapists use. MFTT – Myofascial Tension Technique Applied skin on skin with oil-based cream. The same principle is used in dynamic cuppings. It aims to break the fascia connecting the skin to the muscles, reducing cutaneous tensions and improving muscle and joint mobility. DIP – Digital Ischemic Pressure DIP is a stroke that consists in applying pressure on a Trigger Point. So, by applying this pressure, as therapists, we aim to reproduce pain within a comfortable zone (7 out of 10 at worst). As the pressure is applied the pain will decrease and the muscle will increase its mobility and length. MET – Muscular Energy Technique MET is a manual therapy that uses the gentle muscle contractions of the patient to relax and lengthen muscles and normalize joint motion. So, as therapists, we passively stretch the joint of the client to a safe level, and then we ask the client to meet our resistance to the movement. As per result, the muscle will increase their lengthening. PNF – Proprioceptive Neuromuscular Facilitation PNF techniques include passive stretching and isometric muscle contractions. Therefore, the PNF protocol involves a specific pattern of contracting, stretching, and relaxing. Cross Fiber Friction Cross fibre friction is a firm pressure applied perpendicular to the fibre direction. In conclusion, not all of these techniques can be used during one treatment. In fact, before applying a technique as therapists we have to evaluate the body tensions and the needing of the clients. If this post is talking to you, and you are in need of a massage, book your next session by clicking here.
In this post, I talk about Remedial Massage and how this technique is applied in my services. What is a Remedial Massage? How does it work? Where did I train for this type of massage? As per the name, remedial massage aims to improve the quality of life of the clients, by giving a remedy to her/his physical disconfort/s. So, to start with we describe the difference between a remedial massage and a general relaxation massage. Indeed, a relaxation massage is a combination of soft and deep strokes. Therefore, those strokes are applied using oils. A relaxation massage aims to stimulate physical and mental relaxation by pushing the blood and body fluids around the body. In regards to the remedial massage, the therapist, before the massage will go through a complete assessment of injuries and or musculoskeletal conditions. As per result, the therapist creates a comprehensive treatment plan to manage or rehabilitate the injuries or pain. Indeed, a remedial massage would speed up the process of healing and recovery. In conclusion, at the end of each session, the therapist would demonstrate and provide the client with corrective exercises that can support the client’s wellbeing and recovery. About my training for remedial massage, I did study at the RMIT University, here in Melbourne. In 2020, the world stopped because of Covid-19 I took the occasion to quit my previous job and get back to studying massage. I don’t regret my choice. Indeed I will keep studying in 2022, for the advanced diploma in Myotherapy. I want to keep learning and improving my massage skills and knowledge, to offer always a better service. Said so, I will keep offering Thai Massage as a massage service too. In fact, as I already mentioned in another blog post, the technique that I work with is not so demanding on my body. In fact, it allows me to enjoy more what I do and allows the client to receive a better level of healing. True fact is that the client after a Thai Massage session, here at Melbourne Thai Treatment, told me always how they feel lighter, better, less stressed and more aware of their body feels. In the next blog post, I am going to talk about the strokes that we use in Remedial Massage and how I implement those strokes in Thai Massage.
Functional test and the empty can test. What is a functional test? What is an empty can test and how does it work? Firstly, functional tests are used to test the strength or load capacity of a single muscle. Secondly, the importance of a functional test is due to avoid misinterpretation of the muscle status and joint health conditions. Furthermore, functional tests can be positive or negative. So, for positive, we refer to a test that gave us the result we were suspicious of. For example, if I do an empty can test, and the client during the test complains of pain in the shoulder acromion, the test is positive. But if for instance, the client complains of pain in another area of the shoulder or arm, the test is negative. Even so, as a therapist, we are aware that other area of the arm or shoulder needs to be looked after. What is an “empty can test”? An “empty can test” is a functional test used to validate the state of health of the supraspinatus tendon, at the high of the acromioclavicular joint. In addition, to better understand how this specific test works, let’s look in too the anatomy of the Supraspinatus m. Origin: Supraspinatus fossa of scapula Insertion: Greater tubercle of the humerus Action: Abduct the shoulder and stabilise the humeral head in the glenoid cavity. As per result, the action of the supraspinatus is to laterally elevate the arm and hold in place the humeral head (the Humerus is the bond of the upper arm). Furthermore, the supraspinatus is one of the rotator cuff muscles. The rotator cuff muscles are: Supraspinatus, Teres minor, Infraspinatus and subscapularis. But let’s get back to the empty can test. The empty can test can be done from seated or standing. In addition, the test is conducted in 2 different stages. Initially, we will ask the client to bring the arm in flexion at about 45° and in abduction at 45°. The arm now is sitting aside from the client’s body, on a diagonal line. Now will ask the client to rotate the arm on itself, as if they are emptying a can. As per the result, if at this stage of the functional tests, the client feels pain in the shoulder at the acromioclavicular joint, the test is positive. If that’s not the case, then we can proceed with the resistant part. If this post is talking to you, and you are in need of a massage, book your next session by clicking here. The resistant part consists of placing our hand on the client’s forearm and asking the client to meet the resistance, at 3 different stages. For each stage, the resistance increases and lasts from 3 to 5 seconds. If during any of the 3 stages the client feels pain, at the high of the acromioclavicular joint, the test is positive. But why the client can feel pain during this type of functional test? To answer this question, we have to look in too the acromioclavicular joint anatomy, but I will talk about this topic in the next blog post.
The Psoas Muscle. The Psoas muscle is a muscle that seats in the Lumbar region of the body. It is palpable through the abdominal region when the client is in the supine position. Psoas Muscle is often related to and taken into consideration with iliacus muscle, as those 2 muscles share the insertion tendon and point. For this reason, they get called Iliopsoas Muscle. Origin, Insertion, and Action of the Psoas Muscle: Origin: Body and Transverse process of the Lumbar Vertebrae (L1-L5) Insertion: Lesser Trochanter of the Femur Action: with the Origin fixed: flex the hip externally rotate the hip with the Insertion fixed: flex the trunk towards the tight tilt the pelvis anteriorly flex the vertebral column laterally. Innervation is supplied from the anterior rami of spinal nerve L1-L3 Blood Supply from the lumbar branch of the iliolumbar artery The Psoas muscle has a reference pattern that involved the abdominal area but even the front of the tight. It is often tight for people who spend a lot of time seating on a chair, like office workers and or who drive for long hours. This happens because the muscle is in constant contraction when we spend time seating. On the other hand, the Psoas Muscle is often also related to emotional distress. This can happen because when we live with negative emotions we tend to contract the abdominal area and tight the muscle-up, especially for reaching out a fetal position, which recalls maternity safety. By analyzing the action of this muscle, it is easy to notice how is involved in assuming a fetal position, as it is a hip flexor. In fact, it contracts the 2 limbs, the upper and lower to gain one with each other. Treating the Psoas Muscle directly is not always recommended as direct work unless the person has been going through a series of treatments already. This is because where the muscle is lying it is a sensitive spot to access and as it holds a lot of tension, can be a bit sensitive to the touch. In need of a massage? Book now your next appointment, at Melbourne Massage and Treatment clinic. To treat the Psoas Muscle the client is lying in a supine position. Firstly we identify the muscle. For doing so after the client did lie in the supine position, the therapist will place her/his hands off the rectus abdominis, on its lat. border, and will create resistance on the client’s tight as it goes for active flexion. With the hand seating next to the rectus abdominal area, the therapist can feel the muscle activating. Once the Psoas has been isolated, the therapist can place both hands or one on the muscle, asking the client to breath-in deeply as is flexing the knee (foot running along the table) and as the client’s breath out (it is important here following the breathing wave) the therapist can apply a force straight down. Furthermore, to ensure that we can release tension from the Psoas Muscle, we have to work on the muscle surrounding it, like the other muscle that holds the same Origin/Insertion patterns, like: Erectus Spinae group, Quadratus Lumborum, Quods Hamstring In fact, the psoas muscle can be involved in presentations such as lower cross syndrome (LCS). Are you struggling with pain and or body ache? Book now your next massage appointment, at Fitzroy North clinic. Often as therapists, we would work on the surrounding muscle before doing direct work on the Psoas. This is because direct work in such a sensitive area can be too intense to start with and could make the client feel vulnerable or uncomfortable. A good exercise to keep the Psoas muscle in shape is a daily walk, even though for a nice and balanced walk we want to make sure to have a correct Extension Leg Firing Pattern.