Most therapists are aware of what an anterior pelvic tilt and lumbar hyperlordosis are. We have all seen the diagrams plenty of times demonstrating an anterior pelvic tilt compared with a neutral spine and, of course, a posterior pelvic tilt. However, have you ever stopped to think about what is actually going on within the spine and the muscles, and why this is a pain generating condition.
Plenty of clients have some sort of improper alignment in their pelvis and lumbar spine. (and the rest of the spine too) So, I think it is important to break down the commonly visualized lumbar spine/pelvic tilt graphic to show just how important this is for us therapists and what actually causes the pain associated with it. Continue reading “Anterior Pelvic Tilt and Why It’s A Problem”
Piriformis Syndrome might be the most glorified treatment of massage therapy that exists. You seem to hear about it being the culprit for all butt pain and if treated with massage, your days of suffering will be gone forever. I do agree with the fact that massage therapy is an effective tool for combating sciatic pain. However, before we go anointing massage as the absolute cure for sciatica, we should know what it is, and how it comes to be such a pain in the butt…pun intended (my sense of humor is nosediving).
The first fact that we need to establish is “sciatica” and piriformis syndrome are not the same thing. Piriformis syndrome can cause “sciatica” like symptoms, but it is not what causes the medical definition of sciatica…which isn’t a thing. The actual medical term for sciatica is a lumbar radiculopathy which is itself only a symptom of any sort of nerve compression in the lumbar spine. In other words, a nerve compression in the lumbar spine causes a radiculopathy (nerve pain) when some sort of disc or spinal condition causes nerve pressure. This causes symptoms like pain, tingling, and numbness in the gluteal, posterior leg and foot. These symptoms are commonly referred to as sciatica.
Piriformis syndrome is an actual condition involving the interaction of the piriformis muscle and the sciatic nerve. It is defined by some as a “peripheral neuritis” which is a fancy way of saying that the piriformis muscle causes irritation to the sciatic nerve. Per its definition, it has no relation to any sort of spinal condition and should be distinguished as so.
Low back pain is certainly rampant these days. I myself have had my fair share of low back pain over the years stemming from an injury in my teens. Certainly, my education in massage therapy has helped me become aware of causes of low back pain and in doing so helped me develop my own personal self-care routine. This being said, my experience from both viewpoints, that of a practitioner as well as a patient, gives me a well-rounded view on the subject. Although I would love to have never had low back pain, it certainly has given me empathy for clients who come see me who have acute or chronic low back conditions. I really do feel for them as I know exactly how they are feeling as they lie on my table in discomfort.
While there are numerous causes of back pain and treatment does need to be catered to individual cases, there is one technique which I feel is applicable to many forms of back pain. The technique is spinal decompression. Now I’m sure you have heard of spinal decompression in its traditional sense. It gets a lot of popularity, especially in late-night infomercials selling devices which flip your body upside down and suspend you like you are on a playground…..for only 5 payments of 19.99 plus shipping and handling….never mind. I have nothing against these devices but in my opinion, exercises which are meant to help with spinal decompression should be done functionally. While hanging upside down to decompress the spine does work, a better option would be to learn how to do this in a more natural and active way which also allows for conditioning of supportive muscles at the same time. Also not having to buy a large piece of equipment is not practical for your patients. They will appreciate this exercise as it is quite simple and free.
Stretching the Latissimus Dorsi is important to include in any stretching regimen. Not only does it allow for increased shoulder flexion and mobility, but it can also be important with gaining mobility in the thoracic spine, mainly extension. We are going to use the ability of the shoulder to move the insertion of this muscle to do our main lengthening. In order to maximize our stretch, we will use the thoracic and lumbar spine to move the origin. In other words, we will tension the muscle from both directions.
Today I would like to touch on a topic which some massage therapist might find a little surprising. I remember back in school learning about different conditions and how to treat them. Some were obvious conditions which could be affected by soft tissue manipulation, like piriformis syndrome, carpal tunnel and thoracic outlet syndrome( all the classics). We learned how to treat these early on and I have used that knowledge throughout my career to help many people. Okay, great! Then there were the ones we learned about that were basically labeled the untouchables. They were considered far and beyond our scope of practice and, if suspected, should have stayed as far away from treating those patients as possible and referred to a primary care physician for treatment. Now I’m not here to rip apart the massage therapy educational system but I would like to talk about one of these “untouchable” conditions and demonstrate how just knowing a deeper knowledge of anatomy can open up our own ability to treat more complex pathologies, which in turn can help our current and prospective clients. Continue reading “Massage Therapy for Disc Injuries”
In the first part of this article (Upper Cross syndrome…Why Is Everyone So Crossed?), we went over the physical and anatomical attributes that contribute to upper cross syndrome. Not the most simple of things when you start peeling back the layers of possible muscular involvement. Now that we have the understanding lets look at the second part of this syndrome, which to some may seem like a strange angle. The emotional side of upper cross syndrome.