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Tag Archives: shoulder pain

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Frozen Shoulder

Posted on by Giovanni La Rocca
Normal and Frozen Shoulder
19
Nov

Frozen shoulder is also known as per the name “adhesive capsulitis”. A frozen shoulder as per the name is a shoulder that would barely move. Both signs and symptoms typically begin slowly and then get worse. Recovery time is subjective. Causes and Symptoms of frozen shoulder. Causes A common cause of a Frozen Shoulder is having to keep a shoulder still for an extended period, like after an accident. Even if it is not clear yet why there are also psychosomatic reasons why a shoulder can get frozen. Another reason why a shoulder could get to freeze is traumatic events, such as a high level of stress or a physical accident. On the physical level, what happen is that connective tissues that surround the shoulder joint, like a capsule, thickens and tightens around the shoulder joint, and by doing so, it does restrict the joint’s movement. Symptoms Frozen Shoulder symptoms developed in 3 different stages. The stage’s timing is subjective. Freezing stage Shoulder range of motion starts decreasing, and pain shows up/increases. Frozen stage The Shoulder would freeze up. The movement is minimal, even though it is less painful. Thawing stage In this stage, the range of motions are slowly coming back Pain can be worst at night. This may happen because of the sleeping position or because the sensory feeling is more acute at night than in the daytime when the body perceives more sensations. Suffering from Frozen Shoulder and need some help. Book now an MLD treatment at Melbourne Massage and Treatment. Risk factors for Frozen Shoulder Age and gender Women are more luckily to suffer from this condition. Also, age plays a crucial role in this type of pathology. People 40 and over are luckier indeed to develop F.S. Systemic diseases Here is a list of specific conditions that can increase the possibility of suffering from F.S.: Diabetes Overactive thyroid (hyperthyroidism) Underactive thyroid (hypothyroidism) Cardiovascular disease Parkinson’s disease Prevention There are not many preventive factors when it gets to F.S. This is because the main cause of F.S. is holding the shoulder back from doing movements, due to a previous injury, most of the time. What can help, and this is how Melbourne Massage and Treatment services come in handy is to do MLD sessions on the area surrounding the injury. How MLD can help by stimulating the lymphatic system work and boosting the recovery process. Also, MLD would help in reducing inflammation. Other massage technique such as Myotherapy or Remedial Massage and or Thai Massage, is not as effective for this type of condition. Another successful method that can help once Frozen Shoulder is already developed is by using Hydrodilatation. This methodology consists in injecting sterile water into the joint capsule to stretch the open space and bring the shoulder back to its ROM.

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Joint Mobilisation

Posted on by Giovanni La Rocca
Feet Metatarsal Mobilisation
08
Oct

Joint mobilisations are manual therapy techniques that improve joint mobility and flexibility and reduce joint pain. Joint mobilisation can be applied to many body joints. Some contraindications have to be taken into consideration for mobilisation: Joint swelling Osteo Arthritis Bone Fracture Bulge disk (if the mobs are intended on a vertebra) Mobilisation VS Adjustment. Mobilisations are different from Chiropractic adjustment. The difference is that Chiropractic adjustments are fast movements applied with more significant pressure. Mobilisations are constant slow, repetitive movements applied to the joint. Along with a Myotherapy treatment, Giovanni would evaluate if mobilisation is the proper treatment for your condition. For example, mobilisation along the spine is recommended when someone presents with a stiff back in the sacrum, lumbar, thoracic or lower cervical area. Giovanni would always double-check with you about what the mobs felt like. Types of Mobilisation. As we already know, the body is made of different types of joints. Given the different types of joints, like socket joints, plane joints and more, others are the type of mobilisation. For example: For a joint like the hip, we can apply mobility like a distraction, anterior-to-posterior pressure or posterior-to-anterior pull, internal rotation or superior-to-inferior pull. Some of these techniques can be applied to other joints, and each way of using a mobilisation aims to improve a specific range of motion. So, all up, the type of mobilisation that we have are: Superior to Inferior; Inferior to superior; Distraction; Posterior to Anterior; Anterior to Posterior; Posterior glide; Anterior glide; Lateral glide; Medial glide. Mobilisation Belt. A mobilisation belt can be used to deliver the mobilisation based on the joint we aim to work on. A belt is a tool wrapped around the designated joint we want to work on and is used to apply stretches that would not be as easy to achieve by hand. An example is a hip distraction. For distraction, we refer to it as a force that pulls a joint apart. In the case of a hip, the head of the femur is pulled away from the hip’s socket from the medial to the lateral direction. As you would imagine, using bare hands for applying this technique not only could result in an uncomfortable approach to the intimacy of the patient, but it would requireFr too much effort for the therapist, resulting in poor mobilisation delivery and risk of injury. Therefore, the best tool is a belt wrapped around the patient’s hip and the therapist’s waist. Why use the mobilisation technique? The mobilisation technique aims not to reproduce pain, cracking sound, or sharp sensation. Indeed, the aim is to reproduce a firm pressure/pull on the joint area. Regarding the thoracic area, if any of those vertebrae reproduce pain or sharp sensation, applying the mobs along the vertebrae/ribs joint would be better. Doing so would still possible to affect spine mobility indirectly. Giovanni’s training for this type of modality started during the Advance Diploma in Myotherapy at RMIT and continued at the Bachelor of Health Science at Torrens University. Mobilisations technique can be applied to Big Toe, Ankle, Shoulder, Feet, Hip, Wrist, Elbow, Vertebrae, SIJ joint, Facet Joint, Clavicle and other body areas. An example of joint mobilisation for the feet. Mobilisations at the ankle area are used for improving ankle mobility. Indeed, improving ankle mobility is to better support during the walk, standing and or running. Always talking about the feet area, the mobilisation applied to the Big Toes is used along the Metatasolphalangeal Joint. Do you feel your joints stiff? Your booking for a Myotherapy treatment with Giovanni is just a click away. This mobilisation is applied by creating a distraction movement within the joint, pulling the toes away and then using it for passive flexion and extension. As mentioned in another blog post about wearing bear foot shoes, the Big toes are meant to extend from 65° to 70°. Conclusion The Big Toes are the feet joint that should push the most in the feet strike as we walk. In conclusion, mobilisations are a great way to increase mobility within a joint allowing better movement and improving the range of motion.

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Blog

Range of Motion

Posted on by Giovanni La Rocca
Range of Motion Cervical Lateral Felxion
07
Mar

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.  

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Blog

Water after a massage

Posted on by Giovanni La Rocca
27
Jan

Water after a massage. Have you ever noticed that after a massage you feel thirsty and depending on the treatment you may have an urgency to go to the toilet? Well, massages are diuretics, that’s why. Indeed, independently of the type of treatment that you receive, whether is MLD, Remedial Massage, or Thai Massage, the body fluid gets pushed and pumped around the all body. As per consequence, all these substances moved around need to find their way out. So, after any session, you wanna make sure to rehydrate your body. Drink water after a massage. Why water and not orange juice? Or an energy drink? Or coffee? Water is what is recommended after a massage because it’s what can at the best re-oxygenate the muscle and re-hydrate the body. Drinking a sugary drink, or a really acid beverage as it can be coffee will just dry off the body even more. Furthermore, water is quicker to be absorbed and can help the stomach to keep its natural PH balance. If this post is talking to you, book your next massage session by clicking here. Another effect of the massage can be the deep relaxation of the body, which can affect the stomach and abdominal feeling. Indeed, adding sugar or other substances to the PH of a stomach that feels so relaxed, may not work at the best. What about the water temperature then? Cold or warm? Well, let’s take down the myth that cold water makes you feel fresher. Sorry, it doesn’t. Drinking cold water brings the body temperature down, increasing then the difference in temperature between within the body and outside the body. That will make you feel even hotter. But I do understand that hot water unless is herbal tea, doesn’t feel so nice. Even though, warm water would be ideal, as its temperature would be the same as one of our inner organs. So, temperature-wise just drinks water at room temperature if you can’t stand hot water.  

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Rotator Cuff Muscles

Posted on by Giovanni La Rocca
Rotator Cuff Muscles
23
Oct

Rotator Cuff Muscles and Bursitis. What muscles are the rotator cuff muscles? And why are so important? What happens when the rotator cuff muscles are out of balance? What is Shoulder Bursitis? Firstly,  we look in too which 4 muscles are the rotator cuff muscles. Subscapularis Origin Subscapular fossa of scapula. Insertion Lesser tubercle of humerus. Action Arm internal rotation; Stabilizes humeral head in the glenoid cavity. Infraspinatus Origin Infraspinous fossa of the scapula. Insertion Greater tubercle of the humerus. Action Arm external rotation; Stabilize the humeral head in the glenoid cavity. Teres Minor Origin The inferior lateral border of the scapula. Insertion Greater Tubercle of Humerus. Action Arm external rotation, arm adduction; Stabilizes humeral head in the glenoid cavity. Supraspinatus   Origin Supraspinous fossa of scapula. Insertion Greater tubercle of the humerus. Action Arm abduction; Stabilization of the humeral head in the glenoid cavity. Now, that we are more aware of the rotator cuff muscles’ anatomy, we can look into their functionalities. So, the rotator cuff muscles’ functionality is to hold the humerus bond in place in the glenoid cavity. Furthermore, if it was not for those groups of muscles when our arm goes into abduction, the humorous head would pop out of the shoulder joint. Indeed, for abduction, we refer to the arm movement, where the arm goes away from the body laterally. As listed above, all those muscles originate from different areas of the scapula. As per result, muscle as Infraspinatus and Subscapolaris are responsible for balancing the scapula along the sagittal plane. For instance, if the Infraspinatus is overtaking in force the Subscapularis, the scapula would result in a winged position. Consequently, this would affect other muscles that insert onto the scapula, for example, Rhomboids, Lat Dorsi etc… Regarding the injuries, as I already mentioned in the blog post “functional test”, the rotator cuff muscles can easily be injured. This is due to the acromion clavicular joint anatomy. Indeed the space between the humeral head and the acromion is quite narrow and hosts what we call Bursa. If this post is talking to you, and you are in need of a massage, book your next session by clicking here. So, a Bursa is a soft bag, that seats between the bonds, allowing tendons to run through the joint without being exposed to pinch between bonds, and keep the bonds separated, avoiding frictions. As per result, by putting the Bursa under repetitive stress, it tends to swallow and get inflamed. Consequently, the tendons that run below the bursa can get squeezed, creating shoulder bursitis, or shoulder impingement.  

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Blog

Functional Test and Shoulder Pain

Posted on by Giovanni La Rocca
Empty can test, functional test
14
Oct

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.            

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Blog

Upper Cross Syndrome

Posted on by Giovanni La Rocca
Upper Cross Syndrome
30
Jul

What is, Upper Cross Syndrome? Upper cross syndrome (UCS) is a common posture imbalance that affects many people nowadays and it is caused by repetitive poor posture habits. The body‘s muscles work in coordination with another one to keep our posture erected along the Plumb Line. The Plumb line is an imaginary line that runs from the top of the body down to the foot, passing by the: Mastoid process of the skull Middle Acromion (shoulder joint) Centre of gravity of the body (pelvis) Greater Trochanter (GT or Head of the Femur) Side of the Knee Down to the Malleolus. The head and shoulders are protracted compared to the plumb line, for someone that suffers from UCS. This happens when there is an unbalance between the anterior and posterior portions of the cervical area. So, to better understand what UCS is, let’s go through which muscles are involved in this condition, and the muscle’s role. Let’s start by drawing a diagonal line from the shoulders down to the upper chest area of the pectoralis (). The diagonal line would cross first the Upper Trap (UT)  and Levator Scapulae (LS) for then cross the Pectoralis Major (PM). What do these muscles have in common? Tightness. The tight pectoralis would protract the shoulders. On the other hand, UT and LS would elevate the shoulders and scapula and accentuate the shoulder protraction. Indeed, this force applied bilaterally would place the muscle that is attached from the spine into the Scapula (or Shoulder Blade) under constant stretch, as for the muscle that keeps the neck erect, like the Deep Flexor Muscles (Longus Colli, Longus Capitus, Rectus Capitus and Longus Cervicus). Do you feel like you need help with your neck pain? Book now your next appointment, at Fitzroy North clinic. Now let’s draw a second diagonal line, in the opposite direction of the first one . This line would start from the anterior side of the body. From the neck area and go towards the posterior inferior side of the body. Therefore, would cross first the Deeper Flexor Muscles of the neck and then the Rhomboids (RH) and Middle Trap (MT). What this muscle got in common? As mentioned before because those muscles are placed under constant stress, they get weak, and can’t hold the neck and the scapula in place. How massage therapy can help? Massage therapy is a great way to create balance in the body structure. So, along with a massage session, either Thai Massage, Remedial Massage and or Myotherapy, we would start by doing a series of postural assessments and Range of Motion (ROM). This would allow me, the therapist, to pint point out what muscle needs more attention, and if there is more presentation to add to the UCS. From there then, we may start working on releasing tension from the Pec area and the UT, using gentle strokes that involve stimulating blood flow and heat in the area. Where per areas like rhomboids we would use techniques that may recreate some pain, so to stimulate the muscle to be activated. Said so, depending on the massage therapy I am offering, the approach can be slightly different. In conclusion, there is to say, that massage therapy by itself, would not be enough, if the person, at the end of the treatment, would go back to their routine life. It would be important that the patient follows the exercises that they would give at the end of the massage session. Exercises for UCS

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Melbourne Massage and Treatment - - - Close for Holiday till the 25th/9/2023 - - -
To all the new and returning clients, thanks for being here . I am currently in holiday, and I will be back to give treatment on the week of the 25th/Sept/2023. If you are in severe pain, and feel unwell, please reach out for your GP. If you have any inquire, contact me by clicking here. Booking are open for the month of September and onward. Click here to book your next appointment.