Rotator Cuff Dysfunction

Have you ever said, or heard someone say that they have injured or torn their rotator cuff? 

As a massage therapist, I hear it often. My first question is, " which one?" I usually get an inquisitive look and the response is; " I don't know, just my rotator cuff." That unfortunately leaves me with very little information. So, I do a little assessment (which is helpful, but doesn't always pin point the real problem.) The truth is, the rotator cuff isn't just one muscle. It's a combination of four muscles, all used to stabilize your shoulder joint. 

Photo source NRS website

A nice little mnemonic to help you remember this group is:

Supraspinator
Infraspinator
Teres minor
Subscapularis

Unfortunately, some of us may already have damaged rotator cuffs and may not even know it. Common causes are things like normal wear and tear, poor posture, falling, and repetitive stress.  The latter is usually found in people who are athletes. ( tennis players, swimmers, baseball players, etc) Sometimes, normal wear and tear can be found in people with physically demanding jobs, like construction workers. Age is no friend to us either. As we age, the collagen in our tendons breaks down, we may develop calcium deposits and bone spurs. All set us up for weaken and strained muscles and tendons.


When the rotator cuff muscles become too weak and the shoulder joint capsule is too tight, the result is shoulder impingement. Impingement is caused by decreased space in the subacromial space (poor posture is a behavior indicative of this, as medial rotation of the shoulders creates this small space.) This space is located in the coracoacromial arch; between the acromion process posterior and coracoid process anterior. This impingement inhibits our range of motion, causing shorten muscles and pain. 

If you have injured this area, the common theme is pain. You may find reaching over your head or behind your back particularly challenging, in turn you protect it, by limiting the use of your arm.

As a massage therapist I cannot diagnose someone as having a  shoulder dysfunction; only a doctor can diagnose weather or not you have an injury. They will conduct tests like: X-Rays, MRIs (Magnetic Resonance Imaging) and ultrasound imaging to detect if there is any damage. They may provide treatment options like: 

• Steroids: sometimes doctors will use corticosteroids to reduced pain and inflammation.
• Surgery/Arthroplasty: doctors will sometimes recommend surgery for a damaged tendon or muscle. If arthritis has set in and is very severe they may replace the shoulder altogether.

If you're like me and prefer a more natural take on your road to recovery,  here are some simple things to consider:

• Rest: Take it easy for a few days. Continuing to over work the area may only exacerbate it causing irritation, inflammation, and pain.
• Ice/Heat rotation: If there is inflammation, it is recommended to use ice for the first couple of days before incorporating heat. This will help in reducing inflammation while assisting the muscle to relax. I'm a fan of frozen veggie like peas or a simple ice pack for icing and heated water for relaxing the muscle. (Heated water allows you to control the temperature better than using electrical pads.) The rotation should be about 20 minutes for each.
• Massage: a massage therapist can use neuromuscular and myofascial release techniques to eliminate adhesions and trigger points. A deep massage can help reduce pain as well as discomfort and improve range of motion. 
• Reconditioning: by keeping muscles limber through flexibility exercises and strengthening the lower and mid trapezius muscles, along with the rhomboids and serratus anterior. This will aid in the prevention of secondary impingement by elevating the scapular ( shoulder blade) control. As the muscles in the front and back of the body work together.

A combination of these things will likely be what helps you recover. Always use proper lifting and stretching techniques, and work within your comfort zone. 




Here is a link that will take you step by step through some rotator cuff exercises:
http://d13094505.z155.divergencehosting.com/rotator-cuff-injury.html




Natasha Triplett, CMA, LMT
Owner of Artistry in Motion Massage Therapy
http://www.ammt.massagetherapy.com/services

Why does stretching feel so good?

I think we all, at some point have experienced DOMS (delayed onset muscle soreness) a day or two after having done an intense exercise routine. Maybe we spent too long at our desks or driving around in a car and, as a result, experience muscle stiffness and pain. Upon stretching the sore muscle, a sigh of relief escapes us. So it begs the question, why does stretching feel so darn good?


A stretch feels good because during the process the CNS (central nervous system) receives a "feel good" response from your muscles and sends the response to your brain. Stretching can also enhance the proprioceptors (neuro-muscular receptors that register stimuli) of one's own body position and movement, making us more aware of our body and the coordination of it. It can also aid in the elimination of a knot or a trigger point.

A knot or a trigger point is a sustained contraction which prevents adequate amounts of nutrients and oxygen from traveling through the muscle. It can be caused by: a chronically irritated muscle spindle, inactivity, orthopedic procedures, and chronic dysfunctions of the musculoskeletal system. A slow stretch can increase oxygen and metabolism in the muscle spindle, allowing the muscle to relax, and decrease the severity of a trigger point.

                                                             

Key components to a good stretch:

•  Warm up the muscles, do a light walk/jog for few minutes first.
• Hold for 30 seconds.
• Make sure the stretch is pain free to avoid over stretching.
• Relax and breathe.
• Stretch both sides.
• Stretch before and after activity.

Not only can stretching improve your flexiblity and athlectic performance; but it can also: increase blood flow, increase oxygen and nutrients (which can help keep bones stronger and healthier), stretching aids in the ability to hold proper posture, and may even keep you feeling young!

I find that yoga is a great tool for my mind and body. If you're interested in a whole mind/ body connection through yoga; there is a wonderful instructor, Spira, at yoga-well-being in Grandview Heights.  I highly recommend her. She is truly amazing!

More information about Spira at yoga-well-being can be found here:
http://yoga-well-being.net/

References:

Elemental.com

livestrong.com

myoclinic

eorthopod

nakesscientists

wellsphere

spark people

conwaymedical center

healthy crush

proform







How to Heal Plantar Fasciitis

Have you ever gotten out of bed and the first step you took sent you straight to your knees? Not because you felt like given thanks to your higher power, but because you thought for sure you had just planted your foot down on broken glass. And the pain engulfed your entire foot with an intense agony that sent you crashing to the floor with an OMG!

When I first heard of plantar fasciitis a couple of years ago, I thought, phha achy feet, yeah yeah... ok get some rest, elevate them. Maybe you just walked around too much. I thought it was just regular foot pain. And then, I developed it. I can tell you from personal experience, it's quite the opposite, debilitating really. It changed how I looked at things and the activities I took part. Instead of running, I would bike. Instead of cute little shoes, I settled for New Balance, with inserts, and a brace. Then I began thinking to myself, I'm too young to be hobbling around like an old lady. After about 6 months, I was at my wits end. This pain had to end, and it did.
I started doing some research to get a better understanding of what exactly I was dealing with. Because at this point, I was ready to cut my foot off. If you’re at that point too, maybe this will save you the time, pain and money. As sometimes this results in unnecessary surgery.

Plantar Fasciitis is inflammation of the plantar fascia that creates the arch of the foot. It's connected to the calcaneous (heel bone) and the toes (some of you may know it as "policeman’s heel.") Over time injuries to the tendon results in microscopic tears, causing pain.






How development of plantar fasciitis occurs:

- Over strain to the ligament that supports the arch.
- Excessive pronation.
- High arches or flat feet.
- Overweight.
- Ill fitting shoes.
-tight Achilles tendon and/or calf muscles (excessive walking or running)

For me, it was boxing. The training requires a lot of jumping, which proved to be over kill for my calves.
Recovery from plantar fasciitis can be a slow road. However, if you're persistent in your treatment it will get better over time, without surgery.

Non-surgical self care:

- Kinesiotaping and braces.
- Supportive shoes.
- stretching calves, ankles and feet.
- rolling your foot over a medium to hard ball. (Tennis balls, baseballs, golf balls)
- massage therapy.
- Acupuncture.
- Ice. (is rolling over a ball is too intense? Freeze a water bottle and roll your foot over it) Ice will create a  numbing effect making it less painful.
- Exercise.





I know this last one sounds crazy, since this is more than likely why your foot hurts in the first place. However, exercise with a proper warm up and cool down (stretching before and after) can sometimes help. Your muscles will be nice and warmed up, flexible and blood will be pumping through them; carrying nutrients and oxygen required for healing. Take care to focus a little extra attention to your calves and foot muscles while stretching. A stretch should be held for about 15-30 seconds. It will hurt in the beginning. Make sure you know your limits and don't over do it.

In my personal experience with plantar fasciitis, I tried it all. And it all helped some. However, I decided to start exercising again, despite the pain; and after 3 weeks the pain was nearly gone. I no longer need a brace and could slip back into my cute shoes again.


If you’re struggling with plantar fasciitis and have any questions or concerns feel free to contact me. I'm happy to answer questions and give suggestions.































References:
WebMD
plantarfasciitisrx.net
natural-holistic-health.com
myoclinic
mv hospital
nucleus medical media
innovative chiropractic
workingperson.me

Massage Therapy as Migraine Relief

Imagine it's a beautiful Saturday afternoon. You're nauseated laying in a dark room with the curtains pulled together, and a pillow over your head. The television downstairs where your child is playing is set on a volume level of two, and it's still too loud. All you want out of your day is for this debilitating torture, for which you've been afflicted, to end.

If you're a chronic migraine sufferer, you know this scene all too well.

A migraine is the constriction and dilation of the cerebral and cervical blood vessels. This initiates the release of inflammatory substances that cause painful pulsations. They can last anywhere between 4 hours to a week and as frequently as 2 to 4 times a week. Approximately 28 million americans suffer from migraines annually. Massage therapy is a great alternative to using over the counter and prescription drugs to treat migraine headaches.

Research shows that massage therapy is a safe and cost effective way to use in prevention and treatment of migraine headaches and stress management. The national headache foundation's case studies reflect that some of these headaches stem from postural imbalances and limited range of motion. They also indicate muscle tension and joint or nerve involvement play a big role in association with migraines. A qualified massage therapist can help alleviate your migraine pain by using kneading and gliding techniques in combination with gentle, passive stretching. This can help soften, add length and flexibility to shorten muscles; with special focus and detail to: the splenius, trapezius, sternocleidomastoid (SCM) and suboccipital muscles. These muscles are often valnerable and posture is a affected due to our desk jobs, long distant driving, previous injuries, and even the way we sleep. The common treatment plan is an over the counter or a prescription medication routine. Which can grow into dependency with no relief from a daily headache or migraine pain. This tug of war with migraines and medications, which can lose their affect, may leave you feeling helpless. Massage therapy is a great tool for the treatment and prevention, but it doesn't stop there. Finding the underlying causes and prevention is equally as important.

Specialists estimate that 60-90% of all visits to a primary care physican are for stress related complaints. Among those complaints: depression, anxiety, fatigue and insomnia can not only be stress related, but can progress into migraines. Many of us may not even realize that something as small as our morning cup of coffee, or those pickles on our sandwich could trigger an onset. Everyday foods that could initiate the onset of a migraine are products such as: caffeine, aged cheese, nitrites, monosodium glutamate (MSG) and foods that have been pickled or fermented. With attention to diet, regular exerise and preventive massage therapy; a chronic migraine suffer may be able to subdue the pain and reduce the frequency of occurance.

While massage therapy is an excellent way to treat and prevent migraine headaches, if you find that your pain is still consistent; you should visit a neurologist. Your pain could be your bodys' expression of a much bigger problem.

Natasha Triplett CMA, LMT, Artistry in Motion Massage Therapy, http://www.ammt.massagetherapy.com/,