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.
The Scalenes are an incredibly important for a multitude of reasons. They are involved in many different issues involving the cervical spine including upper cross syndrome, improper breathing, cervical disc injuries, and nerve entrapments which affect the arms and hands. Obviously, they are important to know how to stretch correctly.
It is important to know two key facts for these muscles. The first is knowing that they insert into the ribs so we can use the movement of the ribs to help increase the stretch. The second is that there are three of these muscles which all track in different angles. So, in order to stretch all of them, we will need to use slight variations throughout our stretch focus on these angles.Continue reading “Stretching Series: Scalenes”
The Suboccipital muscle group is one of great importance. When these are hypertonic it is usually because of postural reasons. They are usually not just tight but in a chronically shortened state which locks down the upper cervical region. They are very much connected to chronic headaches and migraines. Also, when shortened down, they will limit the amount of cervical rotation which is possible. Continue reading “Stretching Series: Suboccipitals”
Some of you may have experienced weeks where you seem to see the same conditions over and over again. Its as if you should title your work “hip fixing week” or “headache day”. For me, more often than not, it is “pain in my shoulder…fix me” week. Shoulder joints are one of the most treated areas in my practice, which has provided me with a pretty good idea as to some of the common denominators for why they go funky. Obviously, every client is unique and you cannot generalize because each injury or pain condition is its own process. However, recognizing some of the typical traits of shoulder dysfunction can help you assess some areas which can be treated to help restore shoulder function. And by doing this, we can treat a good number of shoulder pain cases.
The condition which is one of the most frequent that I see, and which I want to cover is shoulder impingement syndrome. Although I said that you should not generalize for proper assessment sake, many cases of shoulder pain are due to impingement syndrome. Yes, there are plenty of other conditions which occur in the shoulder, but for the sake of this post, I want to focus on impingement as it is a condition which pops up a lot, and is highly applicable to massage therapy. Continue reading “Shoulder Impingement”
I can’t tell you the number of times I have seen a client and the first thing they say to me is “can you work on my shoulder blades or wings…or whatever they are called?” I don’t know about you but if I had wings back there I would be pretty excited. Also, I don’t remember being trained in wing massage….hmmm. All kidding aside, the upper thoracic and scapular region do get a lot of attention from massage therapist because it is a source or a great deal of discomfort for many clients. This area affects just about every human it seems (which is a lot of people) especially anyone who tends to spend a lot of time in front of a computer. It is also an area where we tend to gather tension related to stress which adds to the discomfort. Combine all of these factors and it is definitely an area most people are going to want work done on.
I would like to take this common treatment area and open up the reasons why it is such a prominent area of pain. I would also like to delve a bit deeper and see if we can figure out why so many people have, not only soreness here, but many times ongoing acute and chronic pain. What is that “burning” and “aching” feeling that is described to us therapists so often? Also, why does it always seem to come back even after treating it? Hopefully, I can answer those questions and give you a better knowledge of how to treat what seems to be everyone’s bane. Continue reading “Shoulder Blade Pain…Everyone’s Bane”
Pectoralis Minor is probably one the hardest muscles in the body to stretch. It is commonly done in an exact manner as pectoralis major which, in my opinion, can be improved upon. Because of its attachments, it does not have the ability to move through a large range of motion which, of course, limits how we can move it to stretch it. The main issue with singling out pectoralis minor is that pectoralis major usually comes to tension before we can stretch minor, or shoulder mobility does not allow for enough movement. So, in order to reach pectoralis minor, we will need to take these factors out of the equation. Instead of focusing on glenohumeral movement, we are going to focus more on scapular motion (retraction) to gain the lengthening we require.
Now some of you may ask why we are not going to incorporate more elevation of the scapula since the pectoralis minor depresses the shoulder. I answer this by saying that elevation, at least the way we need it, is almost impossible to accomplish when stretching on your own (someone assisting you is a different story). Also, we can accomplish more lengthening and single out pectoralis minor much more effectively with shoulder retraction in this circumstance. If you look back and look at Figure 1, I want you to imagine a simple pulley system on top of the shoulder. Pectoralis minor is a rope on the front side of the pulley and the scapula is the back side of the system. By depressing the scapula while at the same time retracting it, we are, in essence, “hoisting” the insertion of pectoralis minor up and drawing it away from its origin in the ribs.
Although Pectoralis Minor does not have an attachment on the humerus (unlike Pectoralis Major), we will use it to affect how we want the scapula to move. We will also use the ribs where the Pectoralis Minor originates to help lengthen the muscle from the other direction.