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.
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Apr
Knee pain is a common presentation for clients of any range of age and gender. Knee pain indeed is a vast topic. So in this post, we are going to go through how to identify the reason why we can experience knee pain. For doing so we are going to look at some special testing, that we use for the knee joints. Next, in a further post, we may analyse individual conditions. What about the Knee Joint? The knee is the strongest joint in the body. It takes a lot of pressure from the upper body and still has to handle the shock coming from the lower leg session, shock as walking, running and jumping. Indeed, whenever we do one of these actions, the knee plays a big role. Knee Anatomy Bond: Above: Femur Below: Medially the Tibia, laterally the Fibula. Patellar is the front “floating bond” Ligaments: Anterior Crucial Ligament Posterior Crucial Ligament Posterior Menisco-Femoral Ligament Fibular Collateral Ligament Tibial Collateral Ligament Transverse Ligament (this one is visible only from the front side of the knee, below the patella). In between the bonds we have: Medial Meniscus Lateral Meniscus If this post is talking to you, book your next massage session by clicking here. So, the knee joint can be divided into two parts: Tibiofemoral joint Connects through the collateral ligaments, cruciate ligaments and menisci; Patellofemoral joint Gives stability to the medial and lateral retinaculum and allows the extension mechanism through the tendons of the quadriceps f.. Now that we have a better idea of what the knee anatomy is, we can look into his functionality. Knee ROM are: Extension: 0° Flexion: 140° Internal Rotation: 30° External Rotation: 40° Abduction/Adduction: 15° Said so, we can see that the major movement that the knee can accomplish is, flexion. Even if the Internal and External rotation since to be a big move for the knee, in the reality, that’s not always the case. The older we get, easily this motion actively gets tighter. Indeed, one of the main reason for meniscus injury is the twisting of the knee, when the feet is holding the ground and the body rotates. But as previously mentioned in this post we would look into the knee special test. What knee functional test have to tell us? As we already mentioned in another post, a generic active, passive or resisted ROM tell us about muscle functionality. On the other hand, a special test for the knee can show us if a ligament or a meniscus is loose, in the case of ligament or injured. Furthermore, special tests, on the knee are essential to prevent further injury and reduce joint degeneration. To start with we have the drawer test: Anterior Draw test and Posterior Draw test. The Anterior one is to test the anterior crucial ligament, and the posterior, obviously, is for the crucial posterior ligament. Both these tests are done with the client lying supine on the table, with a hip and knee flexed, and foot on the table. The therapist will ensure that the foot doesn’t move and will place its hands around the knee, with the fingers (except the thumb) seating at the top of the calf and the thumbs seating on the patella. For the A.D. test, the therapist will lightly pull the knee joint away from the patient body. On the other hand, for the P.D. test, the therapist will push the knee towards the patient’s body. These tests are positive if there is a loose movement within the knee, in the direction of pull or push. If the client has a history of injuries, to the ACL or PCL the therapist wants to make sure not to push or pull with great effort, or injury could occur. Vagus and varus test. Those tests analyse the status of the medial and lateral ligaments. For the valgus test, the therapist places one hand above the knee laterally, and the other hand above the ankle on the medial side. By applying opposite pressure in the 2 directions we put the medial ligament under stress. If pain is reproduced, or there is a loose movement the test is positive. The same action is for the Varus test. In this case, the hands are placed still above the knee and ankle, but the bottom hand is placed laterally and the top one, is placed medially. Apleys Test This test is used to evaluate the state of the meniscus. The client, in this case, would be lying in a prone position, with the knee flexed. The therapist will be standing next to the client, on the side of the knee flexed and will apply pressure to the knee. If no pain is reproduced with pressure only, the therapist can gently apply a rotation movement to the flexed knee. The test is positive if the pain is reproduced. McMurray test. This is luckily the most efficient and most used knee test used by therapists in case of meniscus injury Here is how it works: The patient lies in the supine position with the knee completely flexed (heel to glute). Lateral Meniscus: the examiner then medially rotates the tibia and extends the knee. Medial Meniscus: the examiner then laterally rotates the tibia and extends the knee. McMurray is a positive test if the pain is reproduced. There are still a couple of tests that can be done for the knee, but so far we did cover the most important. About the therapy that I can offer for releasing knee pain, MLD is what I would suggest the most. Especially for acute pain and swelling or oedema reduction. Whereas, Myotherapy or Remedial Massage and Thai Massage can be used too but more to facilitate and or strengthen the muscle surrounding the area.
Dec
Different ways of using a Cup. The cup usage is a gentle way to dissolve body tensions, and as already mentioned in the previous post cupping is a fabulous way of working on the body. Indeed, let’s not forget, that when I talk about cupping on this blog, I don’t refer to any practice that involves blood extraction or skin cuts. The usage of cupping for me, starts and stop to do work on the skin and fascia. Cups can be made of plastic, glass or bamboo. Depending on the type of cup in use differents are the methodology used to create the suctions. When glass cups are in use, in order to create a vacuum, heat is applied to the cup. In fact, the heat will burn out the oxygen in the cup, creating the vacuum effect. On the other hand, when the cup is made of plastic, fire is not in use. To create the vacuum with the plastic one is used a pump. So, when plastic ones are in use, the cup gets placed on the body of the receiver and with the pump, the air is pulled out. As per result, the therapist is to be aware of the type of skin she/he is dealing with. Paler skin is keener to bruise. Furthermore, the skin of an older client may be keener to break. So again, when a manual massage is given, not all the clients can receive the same type of treatment. If this post is talking to you, and you are in need of a massage, book your next session by clicking here. Moving forward, once the cup is applied to the skin, and the vacuum is created, the cup can be moved. This type of cupping is called dynamic cupping. Moving the cups around allows the skin to be pulled, and can create a change in a full fascia area. Furthermore, is by observing the client’s skin elasticity that the therapist can decide in which direction to apply the cupping. In fact, the aim would be to drug the cup in a direction in which the skin doesn’t move so easily. Said so, not let’s forget that, before applying the cup, on the client’s body will be applied cream or oil. This will allow reducing the frictions between the cups and the skin. In conclusion, to make the cupping even more effective, when the cup gets drugged around, the client can also move the joints which are in control of that skin section. For example, if we are doing cupping on the quods, we can ask the client to flex the knee. That would create extra skin pulling.
Oct
Fascia. What is Fascia? Why is it so important? How does it work?How can Thai Massage help improve fascia mobility? Fascia (from Latin: “band”) is a band or sheet of connective tissue, mainly made of collagen, that seats below the skin and attaches to, stabilizes, encloses, and separates muscles and other internal organs. Firstly, fascia can be classified by layers: Superficial; Deep; Visceral or parietal or by its function and anatomical location. Like as per other body parts, such as ligaments, aponeurosis, and tendons fascia is made from fibrous connective tissues. In addition, these connective tissues contain bundles of collagen fibres oriented in webby patterns, parallel to the direction of pull. About collagen fibres, they are produced from fibroblast, contained within the fascia. In conclusion, fascia differs from other body components such as ligaments and tendons. This is because ligaments hold bonds together and the tendon attaches the muscle to the bonds. Going ahead we can define F. based on its location and Superficial F. This is found just below the last skin layer, subcutis, in most regions of the body, blending with the reticular layer of the dermis. Muscular F. Defined as the fibrous layer seating around the muscle, or other body parts such as nerves, bonds. Visceral or parietal F. This type of structure suspends the organs with their cavities and wraps them in layers of connective tissue membranes. In regards to the functionality of the F., we look in too the ability of this tissue to allow the muscle to move freely. If this post is talking to you, and you are in need of a massage, book your next session by clicking here. So let’s imagine this really thick web, seating between the skin and the muscle and around the muscle too. If the web is overconnected, that means is tight, the muscle would find difficulties in moving and sliding. The same would happen for tendons and organs that need to function by being able to move freely. For example, it does often happen to see customers that when asked to flex the shoulder, as they bring the arm over the head, past the 90° point, it is noticeable a dragging in the fascia along the anterior and or posterior and or lateral thoracic area. The person itself, unless get told to feel what happens in the thoracic area, would hardly be aware of any restrictions along the thoracic area. Said so, we can now open a pandora Jar and talk about the fascia lines. Fascia lines connect the body side to side in the long, for the horizontal and diagonal directions. As per the example, we have an F line that travels from the foot to the head. Indeed this F line starts from the Fibularis M, going up for the IT Band, in too the TFL, Obliquos Abdominal muscles, opposite Serratus Anterior, Rhomboids, and Finally to Splenius Capitis. As per result, someone that suffers from flat feet, and so has Fibularis M, under constant pulling force, may experience shoulder pain on the same side of the body because of Fascia restrictions. But the are more F. lines than the diagonal ones. In fact, we got a Superficial F. line, Functional F. line and Lateral Lines. So, lastly, how Thai Massage can help? Thai Massage can help with stretching the fascia by applying a force on the skin in the direction where the restriction is. Is enough to check in which direction the skin feels tight, and that’s the direction in too we want to apply a stroke with a pulling force, strong enough that the client does actually feel a stretch. At Melbourne Thai Treatment I use techniques of work like MFTT and or Cupping and static/dynamic stretching. In regards to cupping add MFTT are a technique of work that I did learn at RMIT along with my study for the Diploma in Remedial Massage. The static/dynamic stretch, indeed, is part of the techniques used along with the Thai Massage. In conclusion to this blog post, I then would like to invite you to see this video from Dr Gil Hedley, that dives in too the magnificence of Fascia.
Sep
The Lower Cross Syndrome as for the Upper Cross Syndrome is an unbalance between the forces of muscle groups that cross each other between the anterior and posterior of the body. For Lower Cross Syndrome, we look into the Pelvic area. The pelvis’s role The pelvis acts as a hinge between the upper and lower limbs. It is made from a group of bones, ilium, ischium, sacrum, and coccyx interconnected by ligaments. The pelvis is constantly under the force of pressure or force of pull, which either comes from the upper limb or the lower limb muscle group. Said so, we have to point out that, between women and men there is a difference in pelvic shape. The women have a more rounded girdle than men, this is obviously for evolutionary reasons, due to the fact the woman gives birth. Furthermore for a woman is more common to have a wider range for Anterior pelvic tilt. For Women is acceptable an anterior pelvic tilt between 1 and 2 cm, wherein man it should be up to 1cm. This is because of the girdle shape. In fact, when we look into the pelvic level from the side point of view, we expect to find an anterior pelvis tilt, that doesn’t take over the parameters mentioned above. This anterior pelvis position, allows the lumbar spine to be slightly arched, so that it can better take the pressure, without the risk to create injury to the lower back. How to measure the A or P pelvic tilt? To do so we look sidewise at the difference in high between the ASIS (Anterior Superior Illica spine) and the PSIS (Posterior Superior Illiac Spine). As the L and R sides of the pelvis are independent of one another one, we can find a dissociation in the tilt of the opposite side. That means that L can be anteriorly tilted and R. posteriorly tilt, or vice versa. Moving on, now we can analyze what muscles are involved in Lower Cross Syndrome. For an Anterior Pelvic tilt, we look into tensions for this group of muscles: Erector spinae group Iliopsoas muscles Rectus Femoris Are you struggling with pain and or body ache? Book now your next massage appointment, at North Fitzroy clinic. For a Posterior Pelvic Tilt, we look into tensions for this other group of muscles: Gluteus Max Hamstring Rectus Abdominus External Oblique As one or the other group of muscles is tense, the other one as consequence would be weaker. For example, a person that drives for long hours, or an office worker would commonly suffer from an Anterior Pelvic tilt from Lower Cross Syndrome. That’s because their Psoas is in constantly forced contraction (hip flexor) and the hamstrings are constantly weakened from the long seating hours. So when I treat someone with Thai Massage, before the treatment I always make sure to analyze the pelvis level. This would instantly give me an idea of the balance and unbalance that the person eventually suffers from. The work that I would do for this type of dysfunction involved the relative muscles, mentioned above, but not only. During the Thai Massage, as the client lying on a side position, to access areas like the back and or gluteus, I would also work on the client’s shoulders. If initially, I would not work on the shoulders, after a few minutes the client will find discomfort in the area. What I like about this Thai Massage technique, is that is not demanding on my body and give me a wider range of access to the client’s body. Because I can use my feet, knees, elbows, and hands to give a massage, I can freely change the type of pressure to the client’s needs. Whereas if I was working with a Remedial Massage, the limitations are broader. Working with a table would make it much harder to access certain body muscles. Furthermore, it would be hard if not impossible to use feet or knees for massaging.
Sep
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.