It’s a time of joy, because giving birth to new creation blesses most women with an immense sense of purpose and fulfillment.  To me, the birth of a child is another miracle of God.  Nevertheless, while most women enjoy the bright side of being pregnant, mere men must acknowledge that every pregnant woman goes through her share of discomfort and anxiety, and being pregnant is possibly the most stressful time she will ever have.

The changes alone in a woman’s body are enormous.

A woman who has been pregnant previously would know just how hard it can be.  The first few weeks or months entails morning sickness and confusion.  During the forty weeks before the birth, she will have endured periods of back pain, neck pain, nausea, varicose veins, swelling of the feet and legs, anxiety, fatigue, forgetfulness and constant lethargy.  Her blood circulation is reduced and general movement is likely to be limited.

From a males point of view, all this is not much to look forward to.   However, the mums I know reckon it’s worth every second!

There are so many things ladies  give up during their pregnancy because their baby’s well-being is the centre of their focus.   Prenatal Massage helps a woman through what can be a both interesting and difficult time.  During this time, women rightly deserves to be indulged and comforted often (remember this, men), and Prenatal Massage will fit the bill for her.

Prenatal Massage soothes and relaxes the pregnant woman’s sore, overburdened and aching muscles.   The baby in the woman’s womb also benefits much in Prenatal Massage.  It improves health and well-being.  Prenatal Massage is said to promote a healthier and more comfortable environment for the unborn inside its mother’s body.

Does Prenatal Massage help?

Like any massage, Prenatal Massage loosens and relaxes the pregnant woman’s muscles while improving the blood circulation in her body.  Most importantly, Prenatal Massage helps to increase the flexibility of the pregnant woman’s body making her labor and subsequent delivery easier and less painful for her.

Some ladies can easily lie in their tummy up to the four month stage with no discomfort but after that, she is more comfortable in a special massage chair.
Some women even ask for their massage therapist to be present while they are in labor.  It is proven that mothers who have undergone Prenatal Massage during their pregnancy and in labor have an easier time of the birth.  Massage stimulates the body to release endorphins, which are natural pain-killers.

Benefits of Pre-natal Massage.

• Eases backaches, headaches, shoulder and neck aches that may be caused by muscle tension and shifts in posture to accommodate increasing weight.

• Helps reduce swelling in such places as hands and lower legs.

• Decreases pain in the pelvic/hip area.

• Increases blood circulation which provides more oxygen and nutrients to both mother and fetus and stimulates the lymph system, thereby increasing immunity and removal of toxins.

• Soothes and relaxes the nervous system by releasing endorphins into the mother’s body.  As a result, the expectant mother feels more relaxed and at-ease and will also sleep more easily and more deeply.

• Improves  and aids digestion.

• Reduces fatigue.

• Improves skin elasticity that can help reduce stretch marks.

• Can alleviate the stress on weight-bearing joints, like the knees, which take the extra weight of a growing baby.

• Promotes relaxation and deep breathing.

• Stabilises hormonal levels and helps relieve depression or anxiety caused by hormonal changes.

• Eases the load on the heart and helps keep the blood pressure in check

• Enhances the pliability of skin and underlying tissues

• Prepares the mother-to-be for an easier delivery with its sedating effect on the nervous system, promoting relaxation and stress relief.

• Offers a natural, safe, drug-free alternative choice for pain relief because taking medications are often limited during a pregnancy for the risk to the unborn child.

Pre-natal massage may not be recommended to expectant mothers with high blood pressure or diabetes.

All expectant mothers should check with their midwife or obstetrician prior to getting a massage.

It is important to share information about your condition and your preferences with your pregnancy massage therapist so that he can a render a massage suitable to your personal needs.

During labor, massage brings you closer to the midwife or whoever is caring for you.  Just being touched by someone who wants to help you can be very empowering when you’re coping with contractions and are perhaps tired and anxious.

In advanced labor, your husband can use the heel of his hand to massage firmly over the base of your spine. He will need to apply quite a lot of pressure to counteract any strong contractions. He can also use his thumbs to make circles over the dimples in your bum, but you need to tell him what feels best.

Don’t forget the Feet.

It’s also important to know if your therapist is aware of certain trigger points that are to be avoided.

There are women who say that they can’t tolerate having their feet touched, but enjoy a firm, rhythmical foot massage. The massage does need to be firm, using the flat of the hands rather than the fingers or thumbs.

Prenatal Massage is not suited to all expectant mothers.  Some may benefit from it, while others will not… in fact there are those who should refrain.  It is therefore important for a pregnant woman to ask her midwife or obstetrician if she can have Prenatal Massage and if it is going to be safe for her.

After the birth, massage is also helpful.  The massage is supposed to bring back balance back into the woman’s body, which has been through literal turmoil.  As well as helping the mother through possible depression afterwards, it helps improve the skins resilience, which has been stretched by pregnancy.

This brings back her muscle tone and helps get rid of her ‘mummy tummy’.

If you’ve been trying to find the best massage tool to relieve your tired body of its aches, pains and stress… forget it… give it a miss.

All of those different massage balls, electric massager chairs and other hand held tools that claim to make you feel good  are absolutely nothing in comparison to a good old fashioned “hands on” massage where a therapist can feel your muscles and know what to do with them.

People think these massage gadgets, which can include exotic chairs worth thousands of dollars are great, but they can never match the motions and feelings that you will receive if you are getting a “hands on” massage from a qualified and experienced therapist.

Put simply, there is no tool or machine that can do what a human hand can do on your body during a real massage.

Another great reason why you should get a “hands on” massage instead of the current massage tool that you are using is because a proper massage can get all of those places that relax you instead of just giving you a bit of a rattle.

It’s possible to use your home massager and find a spot that allows your muscle to feel nice and relaxed.  It may work for a little while, but eventually you realise that the tool is really not really doing much for you at all.

Massage involves various pressures and a variety of techniques such as kneading, effleurage, cupping, hacking and stroking… and you won’t find a chair that can do all that.

A “hands on” massage from a skilled therapist will have lasting effects and you will feel the results for days.

A massage conducted by a qualified and experienced massage therapist will be able to loosen you up in ways you could never imagine.

Experienced therapists know all of the tender, “ooh-aah” spots on your body… places you probably didn’t know know existed.  Do yourself a favor and arrange  a real massage today.

If you’re reading this, chances are you are in pain and have probably already seen a doctor or therapist who hasn’t helped you much. You’ve probably even had injections… even surgery with little or no improvement!

There is currently no evidence that conventional treatments including anti-inflammatory drugs, steroid injections, physiotherapy and even surgery reduce the duration of this condition.

In a nutshell, a Frozen Shoulder is a condition that causes intense pain and stiffness of the shoulder and has the medical profession stumped.  There’s lots of theories about the cause and pain killers are prescribed by the bucket load, but from my experience, nothing works.  If there was a medicinal cure for Frozen Shoulders, the chemist shops would have walls covered with the stuff.

Some doctors say “Leave a Frozen Shoulder alone for 18 months or so and it will get better on its own”. I’ve heard of others saying “You have what’s called a Frozen Shoulder.  Get used to it, because you’ll have it for two years.”

It will eventually get better on it’s own… but never completely.  In reality, a Frozen Shoulder will take a bit longer than that to heal itself.

X-rays can’t reveal the cause of shoulder stiffness in most cases of primary adhesive capsulitis, and an MRI (Magnetic Resonance Image) shows soft tissue and may be used in cases in which another disorder is suspected, such as a torn Rotator Cuff.   So when nothing shows up, it’s frustrating to be told there’s nothing wrong with your shoulder when it’s really hurting like blazes.

At this point, let me say that I was sent for a MRI when I had the condition.  I listened to the technicians discussing their findings and heard the boss say “Write your report and say muscles appear to be normal, and leave it at that.”

The technician then went on to say he did find a thickening in the Synovial Fluid around the Gleno-Humeral Joint.
The response?  An off-handed  “So what?”

That told me everything I needed to hear… that’s what.  I was then sure of what I was dealing with!

Signs and symptoms of Frozen Shoulder.

The pain of a Frozen Shoulder can be horrendous. Ask a sufferer what the pain would be on a scale between 1 and 10 and you’ll often hear 20.

The major symptoms of Frozen Shoulder are:

• Pain and loss of motion:

• Night pain and especially when trying to lay on the affected side.

• Severe sharp catching pain at the front of the shoulder when you inadvertently extend the arm and lasting up to a minute or so. (You have to protectively hold the shoulder tightly.)

• Pain reaching for the hip pocket, (not necessarily a bad thing if it’s your shout), putting on or taking off a coat, brushing the hair and inability to do up a bra.

• Pain down the outer upper side of the arm.

• Inability to drive.

• Swelling of tendons causes severe limitation in movement, especially reaching up behind the back.

Immobility / Stiffness

This is the key diagnosis of a Frozen Shoulder. You can’t move the arm and neither can anyone else if they attempt to lift the arm for you. If they do try, it’s very painful and you want to kill them for their effort.

From when you first notice the pain, the shoulder becomes stiff or stuck for a period that could be between 48 hours to a month and it’s all downhill from there. If your shoulder is not ‘stuck’ you may not have a true Frozen Shoulder. Many people are forced to give up work as a result of the pain and stiffness that commonly persist for many years.

The inability to work and the constant pain and stiffness can have a considerable impact on you psychologically as well as financially, and you can become extremely depressed and anxious as a result.

Frozen Shoulder Facts:

• 2-5% of the population suffer from it. This doesn’t mean 98-95% enjoy it.

• It is more common in women (60%)

• It is five times more common in diabetics

• It is common, but not limited to people with Dupuytren’s contracture (an uncommon hand condition where the connective tissue under the skin of the palm contracts and hardens over time.

• It may be genetic. i.e it can run in the family.

• It seems to affect 40-70 year olds.

• About 15% of people get it on both sides.

There are three phases to Frozen Shoulder, (which lasts an average of 30 months. Some say longer).

1.    Freezing (1 – 8 months) You notice some things you normally do are starting to hurt.
2.    Frozen (9 – 16 months) It’s full on! Any movement using the arm is incredibly painful.
3.    Thawing (12 – 24 months) Slowly gets back to normal and pain free use of the arm.

Not much to look forward to, is it.

The pain and loss of function associated with this condition can become so severe that it can significantly affect the quality of life, and prevent some people from sleeping well or working.

What causes a Frozen Shoulder?

There’s no explanation for the development of Frozen Shoulder in most patients. The majority of cases seem to be more prevalent in women. Some who develop Frozen Shoulder have sustained an injury and developed stiffness as a result. The trauma can be quite mild or severe, and the body’s response to the event is probably more important than the event itself.

What is happens inside a Frozen Shoulder?

The shoulder joint is a ball and socket (Gleno-humeral) joint. The ball is at the top of the Humerus (arm bone), and the socket is a shallow cup on the end of the Scapula (shoulder blade).

Surrounding the Gleno-Humeral joint (shoulder joint) is a bag called the Capsule. When the arm is raised above the head, this Capsule is fully stretched. When the arm is lowered to the side, the capsule hangs down like a small pouch.

To improve the stability of the shoulder a group of four muscles called the Rotator Cuff braces the joint as well as an elaborate bunch internal ligaments.

Inflammation.
In a Frozen Shoulder Syndrome the Lax Capsular Sack and the Synovial Fluid it contains becomes sticky and thick and can sometimes form adhesions. The stickiness is brought on through inflammation. This can occur after a small injury, but often you may not remember anything about it. Once established, this inflammation spreads into other shoulder soft-tissues and can cause swelling in other shoulder sacks (bursae).
Stiffness.
The stiffness is an ‘overreaction’, or the shoulders attempt to counteract the inflammation within the Biceps groove. The body seems to ‘switch off’ muscles in a coordinated sequence. This sequence is the same for everyone.  Arm movements start to diminish, and within a few weeks the arm literally becomes frozen and for many, cannot be raised more than 40° in any direction. The muscles of the Rotator Cuff become weak and start slowly to waste away, leaving the arm to hang stiff and immobile.

The shoulder may not be completely stiff for several months and both active and passive movements are stiff and neither you nor anyone else can lift it because it’s too painful!

At this point, you’re probably saying “He’s talking about me!”

Traditional treatments may include:

Cortisone Injections:
Cortisone injections are often tried during both the freezing and frozen phases. It is usual to have up to four injections. Cortisone injections may give brief periods of pain relief, but mostly, they seem to give only a few days or weeks of symbolic respite. Cortisone, which is a steroid, is a crystalline substance and is injected into the joint capsule.

Suprascapular Nerve Block:
The suprascapular nerve is the major sensory supply to the shoulder joint and motor supply to the Supraspinatus and infraspinatus muscles.

A Suprascapular Nerve Block has been used in patients with severe pain associated with Frozen Shoulder syndrome. This injection technique is usually performed 3 times over as many weeks. It has given some relief for pain, but has no effect on the stiffness in the shoulder.  This injection consists of a local anesthetic and steroid, and is done with x-ray guidance and involves inserting a needle through skin and deeper tissues.

The procedure is not without pain.  However, the skin and deeper tissues are numbed with a local anesthetic. Most of the patients also receive intravenous sedation which makes the procedure easier to tolerate.

Manipulation:
Under anesthetic, manipulation can be performed in the freezing phase (after about 6 months).  It is performed under general anaesthetic and followed up by several months of physiotherapy. Complications arising from this include fractures and dislocations of the Humerus, Rotator Cuff tears, increased inflammation and scarring. Nerve damage can also occur, especially to the Radial Nerve.

Physiotherapy:
Physiotherapy is commonly advised  by doctors during the ‘Frozen’ stage and is mainly aimed at keeping the shoulder mobile through stretching and pushing the joint.  However, it rarely seems to hasten the recovery of the condition.

Halleujah.
The good news is that even very severe types of Frozen Shoulder syndrome can be treated effectively. Treating Frozen Shoulders is massage based and naturally utilises the body’s own healing mechanisms. No drugs, no surgery. It utilises a specific sequence of manipulations to the shoulder joints and soft-tissues.

In a Frozen Shoulder there are masses of inflammation and on top of this the brain starts to recruit the ‘wrong’ muscles to move the shoulder.

The body and the brain is tricked into healing itself by addressing the two main components of the problem … pain and stiffness. Initially the aim is to significantly reduce the pain by treating the swelling around various shoulder tendons, especially the biceps tendon.

Following this, the technique moves on to rapidly ‘thaw’ and improve the range of shoulder motion by stimulating a unique sequence of reflexes hidden within the muscles. One reflex is triggered against another in sequence and the arm is not forced. Instead it’s kept still whilst applying the pressure.

Patients treated in this massage based technique will notice a definite improvement with each treatment session. These should be twice a week for twenty to thirty minutes a session and complete relief should be within twelve weeks.

There is a couple of testimonials regarding Frozen Shoulders you might care to visit, and if you believe you might be displaying the symptoms of this condition… call me to talk about it.

Frozen Shoulders CAN be fixed… but it won’t happen with medication.

When dealing with patients, as Therapists,we need to view the body as a whole. Our perspective should be modified to incorporate a complete picture from head to toe including an appreciation of its component parts.

By becoming aware of our own posture, and of ways to correct it, we are often able to give advice to all those who are open to receive it.

Posture’ means simply position or alignment of body-parts.  It means:

• Body-alignment that favours function.
• Position that requires the least muscular work to maintain, and which puts the least strain on muscles, ligaments and bones.
• Keeping the body’s center of gravity over its base.

Good posture in standing position, for example, means head and chest held high, chin, abdomen and buttocks pulled in, knees bent slightly and feet planted firmly on the ground slightly apart.

Thanks to gravity, the only way the body can be kept upright is through muscles exerting a continuous pull on the bones in the opposite direction to gravity.

The muscles are able to do that thanks to their property of tonicity.

Tonicity or muscle-tone refers to the constant readiness of the muscles to react.  Our muscles are never completely at rest.  They can lose their tone through illness, old age, accident and lack of exercise, and become flabby.

Massage is an excellent way to restore muscle-tone.

Effects of Bad Posture:

• Poor posture throws more work on the muscles to counteract the pull of gravity and therefore hastens fatigue.
• It puts more strain on ligaments… more abnormal strain on bones… and could lead to deformities (e.g. spinal misalignments).
• Bad posture interferes with respiration and heart action.  It can even diminish the feeling of self-confidence.  You’ll probably start feeling like a dag and your quality of life heads south.

Ideal Plumb Alignment:

If we were to drop a line down the side of the body and line it up with the Lateral Malleolus (aka ankle bone), on the way up, it should pass slightly to the front of the midline of the knee.
Progressing higher, it should pass through the centre of the hip joint… higher and through the shoulder joint and through the lobe of the ear.
Slightly posterior to the apex of the normal surface.

Muscle Role In Posture:

Mans basic instinct is to prevent himself falling forward, consequently his muscle maintain the original stance.

The muscles that hold man erect against gravity are called postural muscles.
These muscles have a majority of slow twitch (red) muscle fibres, which can hold a contraction for a long time before fatiguing. If posture is not balanced, postural muscles are required to function more like ligaments and bones. Postural muscles tend to shorten and become hypertonic when under strain.

In contrast the phasic muscles, which have a majority of fast, twitch (white) muscle fibres and will tire out fast. It is more common to find muscular tendinous junction problems in phasic muscles. The four most common problems are micro tearing of the bursitis. Phasic muscles will weaken in response to postural muscle shortening. Phasic muscle can become hypertonic. This almost always results from some sort of repetitive behaviour and is a common problem in athletes.

Imbalance between these muscles leads to postural abnormalities, which need to be corrected by an exercise program that stretchs thePpostural muscles and strengthens the Phasic muscles.

Military Type Posture:

Many people try to solve their slouching problem by telling themselves to “Stand Up Straight!” … and if they didn’t correct themselves, their parents or teachers did.  These people take on a military-style posture. But in reality, military-style posture causes just as many problems as slouching.

The phasic muscles are purposely being used to maintain the military-style posture and these muscles will fatigue quickly. This is why when most slouchers try to correct their posture they can only maintain the “correct” posture for a few minutes and then they collapse back into their comfortable slouch.

In this ‘military type’ position, the chest is elevated and the pelvis is tilted forward putting the rectus abdominis in a somewhat elongated position. The lower back and the hip flexor muscles are in a shortened position. Due to the anterior pelvic tilt, the hamstrings are in a slightly longer position than in ideal alignment.

Although this posture is not one of the four main types of postural alignment, the Military type posture can occasionally be observed.

With  this “military type” position, the chest is elevated and the pelvis is tilted forward putting the rectus abdominis in a somewhat elongated position. The lower back and the hip flexor muscles are in a shortened position.

It is characterised by an increased curve in the lumbar spine of lower back and an anterior pelvic tilt.

The client shows a posture in which the chest is pushed forward.

Kyphosis Posture:

This image shows the typical posture of someone with an increased Thorax (Kyphosis) and an hyper extended lower back (Lordosis).

This position places stretch on the anterior hip joint ligaments, the one-joint hip flexor muscles and the external oblique abdominal muscles. These muscle groups usually show stretch – weakness. The lower back and hamstring muscles are likely to be strong and somewhat short. In the upper trunk, the opposite conditions prevail. The upper back muscles show stretch ‘96 weakness and the upper abdominals are likely to be strong.

Kyphosis is usually associated with an increase curve of the thoracic spine. Along with this, a slightly posterior pelvic tilt is seen along with a reduced lumber curve and a forward head position. The client will show a hunched over posture with a depressed chest.

Lordosis:
We speak of Lordosis when there is an increased curve in the lumbar spine of lower back. Often there is also an increased pelvic tilt. This posture shows the stomach and head are pushed forward.

Lordosis is defined as an excessive inward curve of the spine. It differs from the spine’s normal curves at the Cervical, Thoracic, and lumbar regions, which are, to a degree, either Kyphotic (near the neck) or Lordotic (closer to the low back).

The spine’s natural curves position the head over the pelvis and work as shock absorbers to distribute mechanical stress during movement.

Lordosis is found in all age groups. It primarily affects the lumbar spine, but can occur in the neck (cervical). When found in the lumbar spine, the patient may appear swayback, with the buttocks more prominent, and in general an exaggerated posture. Lumbar Lordosis can be painful, too, sometimes affecting movement.
Not every Lordosis requires medical treatment. However, when the curve is rigid (fixed), medical evaluation is warranted.

Flat Back Posture:

The term ‘flat-back’ describes a faulty posture where the spine appears straight.  It doesn’t have the normal curves of a healthy spine. A ‘flat-back’ posture has a forward head, or excessive extension of the cervical spine. He has increased flexion of the upper portion of the thoracic spine while the lower portion of the thoracic spine is straight. His lumbar spine is flexed. As a result, his pelvis is tilted backward and his hip joints are extended. His knees may be extended as well.

People who have flat-back posture often have strong abdominal muscles, though the positioning of the pelvis indicates that the hip flexors are weak. The hamstrings will be tight also, pulling the pelvis into a backward or posterior tilt. Weak neck flexors and tight neck extensors contribute to a forward head.

In flat low back posture, generally the hamstring muscles are tight, which brings the back side of the pelvis closer to the thigh. As the pelvis moves forward, it has a straightening effect on the curve of the lower spine.

Along with tight hamstrings, the flat low back posture will also show strong lower abs, back muscles and weak quadriceps muscles.

While it is good for your back to have strong abdominal muscles, a flat low back posture is a deviation from ideal alignment, and affects posture and balance.

Occasionally due to the position of the hip it can be difficult to fully straighten the knees when standing.

Sway Back Posture:

A Sway back posture can be seen with a neutral or posterior pelvic tilt with the hip almost rolled upward to the front. The client shows a relaxed posture, leaning backwards with the upper body.

A Sway-Back posture has several characteristics.

The head is forward. There is increased flexion in the upper back.

• The ribs are positioned behind the hips.
• The pelvis is tilted back, yet it sways forward from the feet. Both hip knee joints are hyperextended and the ankle joint is usually neutral.
• The consequence is someone whose trunk seems to be behind the rest of the body. The chest seems to be depressed, and the hips seem to thrust forward.
• Pregnant women tend to have this posture, and some continue to stand this way when carrying their children after birth, to offset baby’s weight and have their arms free to do chores.
• Someone with sway-back posture may complain of back pain.

A person that has the sway-back posture has weak hip flexors and external obliques. The muscles that extend the back are weak also. The forward head position makes for weak neck flexors, and the low back can be very tight, requiring stretching. The hamstrings and internal obliques may also be tight.

Scoliosis:

With this condition, we have a lateral or sideways curve in the spine that is apparent when viewing the spine from behind. It can be genetic or due to abnormalities or diseases of bone, muscle or nerves. A mild degree of Scoliosis is common, occurring in up to 50 per cent of the population.

Scoliosis generally does not require any specific treatment. However, severe scoliosis does indeed need treatment. Scoliosis occurs mainly in the thoracic and thoraco-lumbar regions.

Between the ages of about nine and fourteen, children bones grow rapidly and can in some children form excessive bony deposits in spots of the skeletal structure. At this time the backbone or spine may show signs of developing Scoliosis.

There are two basic types of Scoliosis.

Structural and Functional.

In the structural Scoliosis the mechanics of the curve are such that rotation of the vertebrae occurs in combination with lateral curvature, and this usually produces a protruberance of one side of the rib cage, seen best when a person bends forward. This is the worst type of scoliosis, and it can be progressive.

In the functional Scoliosis, fixed rotation does not occur, and the curvature is usually non-progressive. This type of Scoliosis is classified into postural, and most commonly due to a short leg.

This occurs most commonly from a car accident, but can also be brought on through contact sports or a fall onto the head. Whiplash is known as injury to the neck, caused by a rapid forwards and backwards motion of the head.  The speed of the cars involved in the accident or the amount of physical damage to the car may not relate to the intensity of neck injury as speeds as low as 15 miles per hour can produce enough energy to cause whiplash in occupants, whether they wear seat belts or not.

Common causes of whiplash include contact sport injuries and blows to the head from a falling object  assault.

Whiplash is essentially a muscle strain and/or ligament sprain in the neck muscles. The muscles injured most often include the Levator Scapulae and the Sternocleidomastoid. In more severe cases, there can also be nerve damage and fractures of various processes of the Cervical Vertebrae.

Symptoms of Whiplash?

• Pain and stiffness in the neck which might not appear at once, but develop over the next day or two.  There could be swelling as well.

• Reduced range of movement in the neck (Cervical Spine).

• Muscle spasms in the side or back of your neck.

• Difficulty moving your neck around

• Pain shooting from your neck into either shoulder or arm.

• Feeling dizzy.

• Headaches.

• Blurred vision. This should not last long, if it persists see your doctor.

• Pain and stiffness may last a few weeks, depending on the severity.

• Child abuse, particularly the shaking of a child, can also result in this injury as well as in more serious injuries to the child’s brain or spinal cord.

If you feel:

• Severe pain in the back of the head…

• Pins and needles or numbness in the shoulders or arms…

• Loss of memory…

• Loss of consciousness…

You could have a more serious injury, and possibly concussion.   If you have any of these symptoms, see your doctor without delay.

The amount of time that elapses between injury and the onset of symptoms can predict the severity of injury. A shorter time signifies a potentially severe injury with more continual long-term complications.

Treatment of Whiplash.

Try to gently move your neck in all directions as soon as you feel up to it and try it every couple of hours or so.
If possible and if it’s not too painful, increase the range of movement each time.

Stretching can be beneficial for the neck as well starting about three days after the injury to restore flexibility, but stop if it’s painful.

Deep Tissue Massage will help get you back to normal and an experienced therapist will know how much you can tolerate, but it’s advisable to see a doctor first to check for spinal damage.

The Rotator Cuff is an amazing piece of kit that allows the arm to raise and rotate at the shoulder and helps to stabilise the shoulder joint during movement.  Although each Rotator Cuff muscle moves the arm from the shoulder joint in a specific direction, they all work together to stabilise the shoulder joint.

A strain or tear in the Rotator Cuff may occur suddenly from trauma like a fall or happen gradually from overuse.

Strengthening exercises for the muscles that control the Shoulder Blade is also important, as the Shoulder Blade (Scapula) helps the Rotator Cuff to dynamically stabilise the shoulder.

The Importance of Strengthening the Rotator Cuff

Many muscles are involved in shoulder movement and all work together, but strengthening the Rotator Cuff is especially important. The Rotator Cuff is the main stabiliser of the shoulder joint during movement of the shoulder.

If the ball of the upper arm is not kept centered, abnormal stress is placed on surrounding tissue and may cause gradual injury. Strengthening the Rotator Cuff helps prevents common Rotator Cuff injuries including Tendonitis, Rotator Cuff tears, and Shoulder Impingement Syndrome.

As we get older, Rotator Cuff tendons reduce in elasticity and become more susceptible to injury. There is also a gradual loss of muscle mass that occurs, but this can be counteracted with strengthening exercises.

Rotator Cuff Muscles

The Supraspinatus is located at the top of the shoulder and abducts the shoulder – it raises the upper arm and moves it away from the body.

The Subscapularis is at the front of the shoulder… same side as your face.  It internally rotates the shoulder.
The Infraspinatus and Teres Minor are in the back of the shoulder – they externally rotate the shoulder.

Though each Rotator Cuff muscle moves the shoulder in a separate direction, though they all work together to stabilise the shoulder joint.

Strengthening the muscles of the Rotator Cuff is important.
The two small external Rotator Cuff muscles are often weaker than the larger internal Rotator Cuff muscle.

The Rotator Cuff muscle involved in abduction (taking the arm away from the body) is the Supraspinatus, and is the one most often injured of the Cuff muscles due to its position between two bones which often squeeze this tendon during overhead movement.

Other Shoulder Stabilisers:
The Scapula or Shoulder Blade helps the Rotator Cuff to stabilise the shoulder joint as it moves. The Rotator Cuff muscles rise from the Scapula and attach to the head of the upper arm bone or Humerus.

If the Shoulder Blade isn’t stable, pressure may be placed on the Rotator Cuff, so strengthening the muscles that support the Scapula are important.

The Bicep Tendon is the one that runs over the top of the Humerus and connects at the top of the shoulder joint helping stabilise it. Overloading the Biceps by lifting something too heavy can result in Biceps Tendonitis (also known as Shoulder Tendonitis).

Strengthening the Biceps helps prevent injury.

Exercise after Shoulder Injury

The question is… how long should the shoulder be rested?
The amount of time to rest an injured shoulder before starting rehabilitative exercises hinges upon how quickly one heals, as well as the type and the severity of the injury.  Working it too soon may cause further damage.

On the other hand, if the shoulder is not used enough, the shoulder muscles weaken, so strengthening exercises are an important part of rehabilitation. Stretching exercises increase the range of motion of the shoulder.

Stretching exercises may… may… help prevent Frozen Shoulder from occurring after an injury that causes one to restrict shoulder movement due to excruciating pain.
Stretching exercises are often started after a few days of rest, but it’s best not to overdo it.

Building up Strength:
Warming up with five minutes of ‘a mini version’ of the exercise you are about to do prepares the body by increasing heart and breathing rates, and increasing blood flow to the muscles, and raising body temperature. Warming muscles and tendons improve range of motion and reduces the risk of injury and warm muscles are more flexible than cold muscles.

Have Patience. Too much too soon can cause overuse injuries. Strengthening a group of muscles should only be done every second day to give the muscles a chance to heal. Strengthening exercises load the muscles slightly beyond their limits and cause micro tears. If given a proper chance to heal, muscles become stronger. If not given a chance to heal, chronic inflammation and problems may develop.

You should feel a bit fatigued by the end of a dozen reps. If you feel fatigued after just a few reps, reduce the difficulty of the exercise by lowering resistance (e.g. use lighter weights or no weights). If you do not feel fatigued after a set, increase the difficulty of the exercise by increasing resistance, but again… not too much.

Don’t “lock” the elbows. Your elbows should be slightly bent. This makes the muscles work harder to increase the effectiveness of the exercise. Locking a joint while exercising also increases the chances of injuring the joint.

Posture: The shoulders should be kept back and down during exercise.  The same goes for when you are standing or sitting.  Slouching reduces the space the Rotator Cuff tendon passes through and puts unnecessary strain on the shoulder joint.

Take it easy and don’t  jerk. Proceed slowly and steadily to use the muscles, not momentum, to complete the exercises. For exercises involving lifting or pulling, slowly lift or pull, hold for a second, and slowly lower or return.

Stretching:
Stretch Gently:  No bouncing. Stretch until you feel a tug but don’t go past. Always hold a stretch for about 30 seconds. Do not stretch to the point of pain. Over-stretching can tear muscles.

Breathe normally during stretching exercises.

Dumbbells or resistance bands are often used to provide resistance in strengthening exercises. Handheld weights come in a variety of weights, so you can gradually increase difficulty of exercises.
Resistance bands provide resistance when stretched. They come in a variety of thicknesses to provide different levels of resistance and are usually color-coded. When using resistance bands, increasing the distance you stand from whatever you have them attached to increases the resistance.

Part of your Shoulder Stabilising should incorporate Remedial Massage and its wise to see a qualified therapist.  If you’re experiencing shoulder problems, call me and book a massage today and see what a difference it can make.

The Rotator Cuff is a group of  four muscles along their tendons working together to give the Glenohumeral (shoulder) joint stability.  Each Rotator Cuff muscle moves the arm (from the shoulder joint) in a specific direction, and work together to stabilise the shoulder joint.

The Rotator Cuff muscle group include:

* Supraspinatus
* Infraspinatus
* Teres Minor
* Subscapularis

Causes of Rotator Cuff Injury:

A strain or tear in the Rotator Cuff may be the result of an injury such as a fall, or it can happen gradually from constant overuse.

Due to the function of these muscles, sports which involve a lot of shoulder rotation including involving repetitive overhead movement such as swimming, tennis, contact sports or continual high reaching.  These sorts of activities put the Rotator Cuff muscles under a lot of stress.

Minor injuries that are not given a chance to heal can cause severe inflammation and degenerative changes in the tissues, so early treatment is important.

Whether injury develops gradually from overuse or suddenly from a traumatic injury, it is often because the Rotator Cuff is not strong enough for the given task

Poor posture and slouching also places unnecessary stress on shoulder joint.

Tears of the muscles and or tendons  tends to happen as a result of a sudden, powerful movement. It can include falling over onto an outstretched hand at speed, making a sudden thrust with the paddle in kayaking, or following a powerful throw.  Test cricketers are high risk candidates for Rotator Cuff injuries.

Symptoms of Rotator Cuff Injury:

The main symptoms of Rotator Cuff injuries are shoulder pain and weakness, and appear to worsen when lifting the arm above shoulder level.

Symptoms may occur suddenly if the Rotator Cuff is injured by a traumatic injury – like an accident or fall -or a blow during contact sport.. Though majority of Rotator Cuff injuries occur gradually and symptoms appear gradually, the  massage therapist should not mistake the symptoms for that of a Frozen Shoulder.

Massage Therapy:

Deep tissue massage is often used in the treatment of soft tissue injuries of the Rotator Cuff. Massage therapy relieves pain and increases range of motion while it improves blood  circulation and speeds healing. Massage therapy also reduces stress.

If there is swelling of the joint, massage should be lightly applied.

If you’re experiencing pain in the shoulder and haven’t tried massage therapy make a call today.  Arrange an appointment and experience the many benefits that massage has to offer.

The shoulder girdle consists of  a whole bunch of bony joints and muscles that connect the upper limbs to the rest of the skeleton and provide an impressive range of movement.
The three bones which form the Shoulder Girdle are the Scapula, the Clavicle, and the Humerus, and the most important feature of the shoulder is the large range of movement that it allows, which is of prime importance to daily life.

Trapezius.

The Trapezius Muscle has many functions:

• Moving the shoulder blade in toward the spine.
• Moving the shoulder blade up and down.
• Bringing the head and neck in a backward direction.
• To rotate and side bend the neck.
• Assists in breathing.
• Rotates the shoulder blade so that the upper-most part of the upper arm faces up.

The Effects on the Neck:

Because the Trapezius Muscle works to move the neck in several directions, its degree of tightness or looseness affects neck flexibility.

For people who work at desks and computers, or who spend many hours driving, the Upper Trapezius is that muscle above your shoulder that becomes very sore and painful.

The Trapezius Muscle is in four parts:

The upper fibres of the cervical vertebrae is the weakest part of the muscle and only provides minor elevation of the clavicle.

• The area commonly known as’ Upper Traps’ is a strong elevator, rotator and retractor of the Scapula.
• The mid-portion of the Trapzius is mainly responsible for scapula retraction.
• The lower fibres of Trapezius assists in retraction and rotation.

Working together they have the effect of simultaneously lifting and retracting the Scapulae. The Trapezius is used most commonly to fix the Scapula to allow the Deltoid to move the Humerus.

Action:

• Laterally rotates, elevates and retracts Scapula. If Scapula is fixed, extends and laterally flexes neck.

Typical uses:

• Shrugging shoulders.
• Overhead movements.

Levator Scapulae.

Shrugging the shoulders (scapula elevation) involves the use of Levator Scapulae and Trapezius.

Fixation of the scapula by other muscles, allows the Levator Scapulae muscles to work together to aid cervical extension, or independently to laterally flex (side bend) the neck towards the side of the working muscle.

Action:

• Elevates the scapula and gives lateral flexion of the cervical spine (each side independently)
• Also responsible for the extension of the cervical spine (each side independently).

Typical use.

• Shrugging shoulders.
• Carrying a heavy shopping bag.

Rhomboids.

There are two rhomboid muscles – Rhomboid Major and Rhomboid Minor.

Rhomboid Major is larger and positioned below Rhomboid Minor.  Chins and dips are excellent activities for developing these muscles.

Action:

• Retracts Scapula (bringing the shoulder blades together). Rotates Scapula downwards to rest position.

Typical use.

• Pulling a draw open.

Pectoralis Minor.

The Pectoralis Minor muscle is the smallest of the two pectoral (chest) muscles.

It works together with the Serratus Anterior  which protracts and rotates the Scapulae upwards.

When the two work together, pure protraction (without rotation) is produced.

Actions:

• Elevates ribs if scapula fixed, protracts scapula (assists Serratus Anterior).
• Rotation of the scapula downwards.

Typical use.

• Pushing a door open.

Serratus Anterior.

The Serratus Anterior muscle is used in activities which draw the scapula forwards.

It is used strongly in push-ups and bench presses. Winged Scapulae are an indication of a weak Serratus Anterior.

Actions:

• Laterally rotates and protracts Scapula.

Typical use.

• Reaching up to open a high window.

Sternocleidomastoid.

Sternocleidomastoid can clearly be seen when you turn your head to one side, on the opposite side of the neck.

Actions:

• Flexes and laterally rotates cervical spine. Protracts head when acting together . Extends neck when neck already partially extended

• Contraction on one side only: Laterally flexes (side bends) to the same side and rotates to the other.

Typical use:

• Looking at the floor.
• Looking over your shoulder.
• Holding the phone between your ear and shoulder.
• Generally being a sticky beak.

The shoulder joint is one of the body’s most flexible and allows the arm to be positioned and moved in just about any direction.

The Shoulder Joint also allows the arm to be rotated inward (internal rotation) or outward (external rotation) to help put the bent forearm in a favorable position to perform a required task.

The head of the Humerus is almost spherical in shape and rotates freely in the glenoid fossa of the Scapula.
The shoulder joint’s flexible ligaments, the Rotator Cuff, and the other muscles that cross this joint all add to the shoulder’s stability and its incredibly amazing range of movement.

Deltoid.

The Deltoid muscle is used in all side lifting movements and any movement of the humerus on the Scapula. It is divided into three portions, anterior, middle and posterior, with the fibres having different roles due to their orientation.

Actions:
• Anterior portion – Shoulder flexion and internal rotation.
• Posterior portion – Shoulder extension and external rotation.
• All fibres – Shoulder abduction.

Typical Use:
• Lifting.

Supraspinatus.

The Supraspinatus muscle is one of the four muscles which make up the rotator cuff. Its main function is to stabilise the upper arm by holding the head of the humerus in position.
It is important in throwing motions to control any forward motion of the head of humerus.

Actions:
• Abduction .
• Stabilisation of the humerus and shoulder joint.

Typical use:
• Holding shopping bags away from the body

Infraspinatus.

The Infraspinatus muscle assists the lifting of the arm while turning the arm outward (external rotation). It is the main external rotator of the shoulder joint.

It is one of the four rotator cuff muscles crossing the shoulder joint and is commonly injured.

Actions:
• Shoulder abduction.
• External rotation.
• Stabilises the shoulder joint

Typical use:
• Brushing hair.

Teres Major.

The Teres Major is only functional when the Rhomboids fix the scapula. This muscle mainly helps the Latissimus Dorsi.

Action:

• Medially rotates and adducts arm.
• Stabilises the shoulder joint.

Typical use:
• Tucking your shirt into the back of your jeans.

Teres Minor.

The Teres Minor is one of the four rotator cuff muscles surrounding the shoulder. Its main action, along with the Infraspinatus  is to externally rotate the shoulder joint. It assists the lifting of the arm during outward turning (external rotation) of the arm.

There are two Teres muscles, the other being Teres Major.
The other muscles whose tendons form the rotator cuff are:
•    The infraspinatus muscle, which (like the teres minor) helps in the outward turning (external rotation) of the arm.
•    The supraspinatus muscle which is responsible for elevating the arm and moving it away from the body; and
•    The subscapularis muscle, which moves the arm by turning it inward (internal rotation).

Actions:
•    External rotation.
•    Shoulder abduction and stabilises shoulder joint.

Typical use:
•    Brushing hair.

Subscapularis.

The Subscapularis moves the arm by turning it inward (internal rotation).

The Subscapularis is one of the four rotator cuff muscles which cross the shoulder joint. The muscle also acts to hold the head of the humerus in position and prevents it moving forwards. It is shown here with a couple of ribs cut away at the front.

“Subscapularis” means under (sub) the scapula (the wingbone). The subscapularis muscle originates there, beneath the scapula.

Actions:
• Internal rotation.
• Adduction.
• Stabilises shoulder joint.

Typical use:
• Tucking your shirt into the back of your jeans.

Latissimus Dorsi.

The Latissimus Dorsi muscle is one of the largest in the body.

It is a powerful extensor muscle of the arm and is used extensively in chinning and climbing and its basic function is to pull the shoulders downward and towards the back.

It extends from the spine, hip and ribs to the upper arm.

They are commonly known at ‘the lats’.

Actions:
• Extends, adducts and medially rotates arm.
• Helps with deep inspiration and forced expiration

Typical use:
• Pushing down on the arms of a chair when standing up.

Pectoralis Major.

Pectoralis major is the largest and most superficial of the two chest muscles. Pec Major and the anterior fibres of Deltoid work closely together. Pec-fly and push-up exercises are good for the Pectoralis major.

Actions:
• Clavicular head:flexes and adducts arm.
• Sternal head: adducts and medially rotates arm .
• Accessory for inspiration.

Typical use:
• Applying a roll-on deoderant.

You’ll find a Wry Neck, also called Torticolis, will appear upon waking in the morning or from a sudden, quick movement involving the neck.  In the lead up to condition the patient has usually performed activities that involve slouching, poor posture, repetitive neck movements or over lifting.

This gradually stretches tissue in the neck over time, causing injury to the facet joint.  A Wry Neck may also occur due to sleeping in the breeze of an open window or under a fan.

Symptoms of a Wry Neck.

Patients with a Wry Neck feel sharp pain to one side of the neck. They will find it difficult to turn the head to the painful side and will adopt an unnatural stance due to pain.  This is due to the contraction of the Sternocleidomastoid muscle giving a lateral distortion of the head towards the side of the spasm.

The patient is usually finds this difficult to sit or stand normally this due to muscle spasm and pain.  Pain may be referred into the shoulder blade, upper back or the arm on the affected side.

Symptoms are usually compounded by turning the head to the affected side, bending forwards or leaning sideways, lifting, arching backwards or slouching for extended periods.

Sometimes there may be no identifiable reason as to why the symptoms have started.

Apart from sleeping in the breeze of an open window or under a fan, contributing factors can also be:

• Bad posture
• Neck joint stiffness
• Muscle weakness or tightness
• Incorrect lifting technique
• A lifestyle or occupation involving sitting at a computer or driving for long periods, bending, or lifting heavy objects.

Treatment for a Wry Neck

Most patients with a wry neck will respond to massage  and recover quickly and a competent therapist will work within your pain threshold.  If you display the above symptoms arrange an appointment and begin to feel the relief  massage has to offer.