Jun 15

The Chicken or the Egg?

Bad_posture.121027As much as farmers may not know which came first: the chicken or the egg, Massage Therapists often debate which caused the tightness first: the muscle or the fasciaFascia is connective tissue containing collagen fibres that surround every muscle, bone, organ, blood vessel, and nerve.  Fascia binds all of these structures together, while still allowing them smooth movement over one another.  If fascia becomes tight or dehydrated, this smooth movement can become impaired; limiting range of motion and even causing pain.

This impairment can be a result of shortened or “knottedfascia caused by the following:

Internal or external trauma causing scar tissue, whether it be surgery affecting the external and/or internal body, or a strain or sprain.  This will “knot” the fascia, pulling surrounding fascia and body structures (muscles and bone) towards the knotted fascia.  This can also cause Trigger Point referral pain.

Repetitive strain injury, which simply means applying the same movement again and again over time. Examples: Throwing a ball or swinging a tennis racquet, bending and lifting.

Posture. Examples: Sitting at a computer desk, tilting head-to-shoulder to talk on the phone. This will shorten the fascia, constantly pulling it and surrounding structures back into that learned position.

Don’t panic yet! There is hope. Fascia can be realigned and scar tissue can be diminished (even in superficial appearance) by Massage Therapy techniques.  The “crunchies” we find and sometimes painfully try to “elbow away” for you, is this knotted fascia.  Other techniques are more static in application to allow the fascia time to respond and “loosen” on its own; what we call a Myofascial Release.

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To save time and minimize pain, an effective technique to realign fascia is Cupping Massage Therapy.  The tradition originated in ancient China and involved glass cups and fire (to expel the oxygen from the cup).  Modern times include glass and plastic cups (no fire).  The effects are the same, but the purpose somewhat updated.  Whereas realigning ones energy was the ancient, and still modern, purpose – the effects on releasing toxins, blood, and materials caught in knotted fascia while also elongating the fascia to allow greater range of motion, mobility, and decreasing pain is now the clinical practice.  In turn, the surrounding muscles are elongated, as well leaving the same positive effects.

The treatment involves placing the cups on the skin and “sucking” the air out, which pulls the skin and fascia into the cup releasing the tension, caught materials, and realigns the fascia. Feeling a slight “burn” or “tingling” is normal and actually expected, as it is the feeling of the fascia releasing.  Be prepared to tell your friends you just got into a fight with an octopus, because the cups will leave suction cup marks (red in colour as blood capillaries have been broken and materials released). This can last 2 days to 2 weeks depending on the person.

Since fascia acts as one structure, attached from head to toe, tight fascia in one’s neck can create a fascial pull so long the pain can be felt in one’s foot. I know, you think I must be crazy, but it’s true! If the chicken is the muscle and the egg is the fascia, I am a firm believer the egg came first. So, whatever your musculoskeletal condition may be – pain, strain, or range of motion gain, give Myofascial Release and Cupping a try!

– Serena Dixon, RMT

Do you want to encourage a loved one to become healthier? Consider a gift certificate. We offer gift certificates for both massage therapy and physiotherapy. They also make great birthday presents!

May 13

COMMON HAND AND WRIST CONDITIONS AND HOW PHYSIOTHERAPY CAN HELP YOU GET A GRIP

Wrist-Pain-620x330.114920We use our hands and wrists to perform all the activities in our daily life. They allow us to manipulate objects so that we can perform essential and non-essential tasks such as personal hygiene, tool work, sports and good ole computer games.

The wrist is a joint where the radius and the ulna meet the 8 carpal bones of the wrist. The carpal bones allow for tiny movements of the wrist and these meet the 5 metatarsal bones of the palm, from which the fingers and thumb attach to. Ligaments connect the small bones of the arm, wrist and hand to provide stability to the joints.
One muscle group bends the fingers and wrist and the other group straightens them. The small muscles within the hand assists with finger and thumb movements. The median nerve travels through a tunnel within the wrist called the carpal tunnel. The muscle tendons of the wrist and finger flexors also run through this tunnel.

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What Causes Hand and Wrist Pain?
There are many causes of hand and wrist pain including:
• Wrist Sprain
• Carpal Tunnel Syndrome
• Arthritis-osteoarthritis and rheumatoid

Wrist Sprain
A wrist sprain happens when the ligaments of the wrist are overstretched. This typically happens during a fall on an outstretched arm or moving the wrist at the end range of its normal mobility. The symptoms of this injury include: pain especially with wrist movements, tenderness, and swelling, bruising and a feeling of popping or tearing inside the wrist during and after the fall.

Carpal Tunnel Syndrome

This injury is the compression of the median nerve as it travels through the carpal tunnel in the wrist. It commonly occurs as a result of repetitive flexion of the wrist and fingers, which in turn causes the tendons in the area to swell. CTS can also be caused by pregnancy because retained fluid can compress the nerve. There is pain in the wrist and palm, as well as tingling and numbness in the middle 3 digits. The pain is often worse at night and with flexion activities.

ei_2608.115244Osteoarthritis occurs when the cartilage on the ends of the bones break down over time. The joints become stiff and it becomes difficult for someone to move their wrist. This kind of arthritis is uncommon and it normally occurs in people who have injured the wrist in the past. Rheumatoid arthritis is an inflammatory disorder in which the body’s immune system attacks its own tissues and it can involve the joint between the ulna and radius. The chronic inflammation can erode the ulna and can damage the tendons that straighten the fingers. The wrist can then become deformed into a bent wrist or gnarled fingers if the inflammation is not treated

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What can you do if you have hand or wrist pain?
At Balance Physiotherapy, your physiotherapist will determine the cause your symptoms and will set up your treatment that may include:

• Modalities for pain/swelling relief including low level laser therapy, TENS, ultrasound, dry needling and acupuncture
• Manual therapy, including manipulations, to improve the movement of the joints in your wrist and hand.
• Massage to promote soft tissue healing and break up scar tissue.
• Strengthening and stretching exercises
• Recommendations to wear a brace in the injured area.

– Erika Turner, PT

Apr 30

Whiplash: Facts and Symptoms.

One of my primary roles as a Registered Massage Therapist is to evaluate and alleviate pain. In order for me to treat both properly and effectively, it is best that I have a clear understanding of the discomfort being felt. When a client first comes to see me, an initial assessment is performed including a series of informative questions, thorough palpation, and special testing. My clients insight on the pain being temporarily experienced, provides me with a respectable approximation of the injury at hand. I seek to develope a full understanding of the experience.whip-2.122906

However, I always found it somewhat difficult, for I myself have never experienced it. I’ve had my fair share of mild strains and sprains from playing sports, and some increased tension in certain muscles due to overuse. Still my funny bone is as close as I’ve gotten to experiencing nerve pain, and a torn muscle? Well I can’t imagine, but with the knowledge and understanding I gain from the assessment, I strive to provide a compassionate, effective treatment. Which brings me to this article, for following a slightly unfortunate event, I have gained insight on the emotional and physical grounds of whiplash.

Whiplash is an acceleration-deceleration injury to the head and neck. Commonly caused in motor-vehicle accidents, sports or other trauma. Just following the event I found significant relief in the fact I was aware of the Mechanism of Injury and the Healing Stages of Soft Tissue. Let’s look at the Mechanism of Injury, the circumstance in which an injury occurs, in a rear impact accident to understand the direction of the head and neck on impact.

In the first phase the vehicle is struck from behind. The persons torso is hit by the back of the seat moving it forsymptoms-of-whiplash.122419ward with the vehicle while the head stays due to inertia (the resistance of any physical object to any change in its state of motion, including changes to its speed and direction). The torso then moves abruptly upwards. It is in this phase where it’s possible for the cervical discs to be injured.

In the second phase the vehicle and torso reach there peak forward acceleration placing the head and neck into hyperextension. Force occurs between the cervical and thoracic spine. Anterior neck muscles and ligaments, facet and temporomandibular joint injuries are possible in this phase.

In phase three the head and neck are now at peak forward acceleration while the vehicle and torso are slowing down.

Brining us to the fourth phase where the head and torso are now at full deceleration. Shoulder harness restrains the torso while head and neck continue to flex forward into hyperflexion. It is in this final phase that posterior neck muscle, and ligament injuries are possible.

These four phases happen within milliseconds.

In these four phases it’s easy to see how any structures in the neck, upper thorax, and head may be injured in a whiplash.

The Mechanism of Injury in the event of a rear impact accident can be very traumatic firing our Sympathetic Nervous System. Also known as the Fight or Flight response, which is an acute response to stress. It is during this response that chemicals like adrenaline, noradrenaline, and cortisol are released into our bloodstream. Our respiratory rate increases, blood is shunted away from our digestive tract and directed to our muscles switch are requiring more energy, our awareness intensifies and our perception of pain diminishes.neck pain

At the time of injury our body goes into the AcuteProtection Phase of the Stages of Healing. In the acute phase our body’s aim is to protect the injury from further damage. Swelling is at a peak during this phase and symptoms/full extent of injury may not be clear for the first 24-72 hours. This phase usually last a couple of days depending on the severity of injury.

So know that your aware of what your body has and will continue to go through for the next 72 hours, what is it that you can do to aid its recovery?

First you should always seek medical attention. They will check for serious injury and address it accordingly.

However, if they say your good to go home, then GO HOME. REST to avoid pain and further damage. You may not feel particularly bad following the accident but as we mentioned earlier, adrenaline has flooded our bloodstream dulling our pain receptors for a while. It is important to go home and allow healing to take place rather than go to work and place demand on your injured muscles.

Drink plenty of WATER during the days following the accident. Extra fluid can help reduce inflammation by carrying away waste products caused by the injury.

ICE is also excellent for control of the pain and inflammation experienced in the acute phase.Try icing the upper back and neck for 20-30 mins each every 2-3 hours.

The sudden shock during trawhiplash.123248uma may cause us to “gasp”, tightening our diaphragm (primary breathing muscle) depriving us of healing oxygen. Some focused deep breathing for 5-10 mins each day will prove helpful in relaxing the diaphragm and other accessory breathing muscles affected.

Try to AVOID sports, strenuous activity, and yoga, your body in vulnerable in the acute phase and we want to avoid making any injury worse.

GENTLE MOVEMENT however, (light walking, and pain free range of motion) is encouraged even for just a couple minutes, to prevent the muscles from atrophy (waste away, due to degeneration of cells).

These simple tips can go a long way in helping you through the acute stage of healing. If you take it easy in the acute stage you will be rewarded in much faster healing and a greater likelihood of complete recovery. Seeking alternative health care such as Physiotherapy and Massage Therapy may be a smart decision, for they can assess, guide, and treat individuals through all three Stages of Healing.

– Nicole van Zutphen, RMT

Do you want to encourage a loved one to become healthier? Consider a gift certificate. We offer gift certificates for both massage therapy and physiotherapy. They also make great birthday presents!

Apr 24

Knee Pain in Children: Osgood-Schlatter

Osgood-Schlatter disease is one of the most common causes of knee pain in adolescents. It is a painful condition felt just below the knee cap on the upper part of the shin bone (Tibia).  It commonly occurs in teenagers who play sports, particularly sports that involve kicking, jumping, or running.OLYMPUS DIGITAL CAMERA

Osgood-Schlatter usually develops as a result of overuse of the quadriceps muscles. The quadriceps attach to the shin bone through the patellar tendon. The pull of the tendon on the shin bone can cause this area to swell and be painful since the tibia is still growing and can’t withstand the strain on it. As the bone tries to heal itself, callus often forms and causes a hard bony bump on the shin.

The severity of the pain tends to vary. It is usually worse during and just after activity and tends to ease with rest. The “bump” on the shin may be painful to touch as well. The pain can last a few months and may persist until growing has stopped.

Treatment typically focuses on decreasing pain and swelling at the tendon attachment site. L?????aser therapy is often very effective at reducing this inflammation. Stretching of tight quadriceps muscles and strengthening of weaker muscles is also important to prevent recurrence. Sporting activities may have to be modified temporarily to help with healing.

If you have an adolescent who is experiencing sport related knee pain, visit your physiotherapist for an assessment and treatment plan.

– Jennifer Smith, PT

Do you want to encourage a loved one to become healthier? Consider a gift certificate. We offer gift certificates for both massage therapy and physiotherapy. They also make great birthday presents!

For more information about our services, see our website at: www.findyourbalance.ca