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Massage for Repetitive Stress Injury (RSI)

A common type of injury is the repetitive stress injury (RSI). The most well-known RSI is probably carpal tunnel syndrome, but it’s just the tip of an iceberg. Other repetitive stress injury include thoracic outlet syndrome, De Quervain’s syndrome (inflammation of the thumb muscles), tendonitis, and ligament injuries.

Repetitive stress can cause problems in your hands, wrists, forearms, shoulders, neck, or back. Runners, heavy lifters, or other people who stress their legs and hip joints can have repetitive stress problems in their hips, knees, ankles, or feet.

Symptoms of Repetitive Stress Injury

Any repetitive activity, be it work, hobby, or sport, can potentially cause injury. I sometimes hear people say, “I’ve been doing this [insert activity] for years and it never hurt before.” That is the nature of repetitive stress injuries; they develop slowly over time. Some people are more susceptible to injury than others.

Common symptoms of repetitive stress injury include:
Chronic tightness, discomfort, stiffness, or pain in any part of your body, especially your hands, wrists, fingers, forearms, elbows, neck, shoulders, or back.

  • Tingling, coldness, or numbness in any area.
  • Clumsiness or loss of strength and coordination in your hands.
  • Pain that wakes you up at night.

How Can Massage Help Repetitive Stress Injury?

Carpal tunnel and thoracic outlet syndromes involve nerve compression. What is compressing the nerves? In most cases, tight muscles. Massage releases muscle tension, which relieves the compression and pain. Regular stretching is also essential.

In other repetitive stress injury (such as tendonitis or ligament injuries), muscle, tendon, or ligament fibers are torn. Specific work on the injured fibers speeds healing by breaking up adhesions (stuck together tissue) and excess scar tissue and by increasing circulation, which brings in nutrients and removes waste products.
Regular massage can help any problem caused by tight or injured muscles or injured tendons or ligaments.

Consider massage before resulting to more drastic treatments. Do realize it’s not a miracle cure and requires a regular treatment schedule. You must also take responsibility for stretching and making any needed changes in your activities.

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Massage for Chronic Pain

Pain creates a vicious cycle. Pain leads to muscle tension, reduced circulation, and restricted movement, which in turn lead to more pain. Massage therapy can play an important role in breaking this cycle.

Muscle Tension

Muscles contract around any painful site to protect the area. If pain is resolved quickly, muscles relax. If pain persists, muscles can become habitually tight. Sometimes tight muscles press on nerves, causing tingling, numbness, or more pain. Massage helps by stretching tight muscles and by stimulating the nervous system to relax muscle tension.

Reduced Circulation

Tight muscles reduce circulation, letting waste products accumulate, which can leave you feeling fatigued and sore. Plus waste products can irritate nerves, causing pain to spread. Massage releases contracted muscles and increases circulation. Also, as massage relaxes the nervous system, blood vessels dilate to increase blood flow. Waste products are flushed away and replaced with oxygen and nutrients.

Areas with poor circulation often develop trigger points- highly irritable spots that refer pain, tingling, or other sensations to other places in the body. Trigger points respond well to specific massage techniques.

Muscle Shortening and Restricted Movement

Eventually, the body lays down connective tissue in any contracted area with poor circulation. While helpful for healing injuries, this natural reaction can “glue” muscles and their connective tissue coverings into a shortened state. The stretching and kneading of massage softens and lengthens connective tissue.

Irritating waste products, painful trigger points, and shortened muscles make even simple actions difficult and tiring. As your capacity for movement and exercise decreases, you lose the most important means for maintaining good circulation throughout your body, risking pain in new areas.

Massage helps restore normal movement by releasing trigger points, removing waste products, and stretching shortened muscles. Also, because you feel better after a massage, you may have renewed energy and motivation for physical activity.

For massage to be really effective, you need to set up a regular schedule–certainly once a week at first, and then possibly less often as you respond to the massage. Remember, it takes time.

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Massage for Soft Tissue Injuries

Soft-tissue injuries (such as muscle pulls and strains, tendonitis, ligament sprains, and whiplash) heal faster with specifically targeted massage. Massage benefits you by reducing spasm, pain, swelling, and formation of excess scar tissue. Massage also breaks up excess scar tissue and adhesions (stuck together tissue) that weaken muscles and contribute to further injury.

“Skillful, knowledgeable massage can make the difference between a one-time muscle strain that takes a few weeks to resolve and a painful, limiting, chronically recurring condition… By applying skills to the proper formation of scar tissue, the reduction of edema, the limiting of adhesions, and the improvement of circulation and mobility, massage can turn an irritating muscle tear into a trivial event.” A Massage Therapist’s Guide to Pathology by Ruth Werner

When you have a soft-tissue injury, the tissue fibers are torn. Scar tissue begins to form immediately at the injured site, but the scar tissue does not necessarily run parallel to the fibers of the injured tissue. This process can lead to excess scar tissue that is weak and prone to further injury. Also, because scar tissue is not elastic, it can restrict movement of surrounding fibers, again setting you up for further injury.

Massage benefits you by creating tension and stretch that breaks up excess scar tissue and determine the direction of new tissue fibers. This makes the injured site stronger and less prone to new injury. Massage also increases circulation to the injured area, bringing needed nutrients and removing waste products produced in the healing process.

Massage for injury requires a regular schedule, no less than once a week. In some cases, you will see much faster results with a twice-a-week schedule. For how long? It depends on the nature and extent of the injury, how old it is, and your ability to heal. It also depends on your willingness, when appropriate, to ice the injury, do some exercises or stretches, or identify and eliminate the cause of ongoing injury.

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Posture Principles and the Pain Cycle

1st Posture Principle
Posture Is How You Balance Your Body

If you don’t balance, you fall down! Our bodies would fall forward without muscles pulling us back.

We use our muscles reflexively to balance when we sit, stand, sleep, or work. In order for us to balance, our brain integrates information from three sources to know where the body is in space.

  1. The eyes: We see what is level.
  2. The ears: The inner ear tells the brain where each ear is in relation to the other ear.
  3. The muscles and joints: We feel balanced (or unbalanced) based upon information sent from the muscles and joints. The brain assumes we are balanced when we sense equal stress on both sides of the body.

When there is an injury, the body will move differently to avoid pain. Over time, the body will adapt. Even if there is no continued pain, unbalanced patterns of motion persist. The human body still MUST balance to stand. So, the brain adapts and adopts new muscle and joint positions.
We believe we are standing straight because our brain is being told by our senses that we are balanced, even though the mirror shows we are not.

2nd Posture Principle
The Human Body Is Designed To Move

It is much easier to walk for 30 minutes than to stand perfectly still for 30 minutes. When we walk (or run) we must balance our bodies. In order to balance we switch back and forth between standing and shifting muscles.

Standing muscles are the muscles we use to hold the body up. Our body would fall forward without muscles pulling us back and keeping us balanced. Whether we are standing or sitting we use standing muscles to balance.

Shifting muscles are the muscles we use to change (or shift position). Standing and shifting muscles work together to balance the body in motion.
During walking, we use:

  • STANDING muscles to stand on one foot, and then
  • SHIFTING muscles to shift to the other foot.
  • Standing or sitting still primarily works the standing muscles, causing these muscles to fatigue with time. However, when we walk we alternate between using standing and shifting muscles. This allows each set of muscles a moment of rest, reducing fatigue.

3rd Posture Principle
Posture, Motion, & Balance Depend on the Bones, Ligaments, Muscles, & Nerves

Bones support the body’s structure. Bones connect to other bones at the joints.
Muscles move bones at the joints when they shorten (or contract).

Muscles can only pull, like a rope, to create motion in a direction. A muscle creating motion in a direction is called the AGONIST. Every muscle has an opposite partner that pulls the joint in the opposite direction and returns the joint to its starting position. This opposing muscle is the ANTAGONIST.

For example, to bend your elbow, your biceps contract. To straighten it, your triceps contract.
To lengthen, or push, a muscle must be pulled longer by its partner’s contraction. Each muscle in a pair of muscles pulls a joint in the opposite direction.
Note: If one muscle in a pair is used more and one is used less, then the underused muscle weakens and the over used muscles become overly strong and tight.

There are also muscles called SYNERGISTS, which help out a motion, but are not the main mover. A synergist, or helper muscle, assists the main muscle in moving the joint. For example, the forearm muscles mostly control the wrist and hand, but they also help the elbow to bend.

Lastly, there are STABILIZERS. These are muscles that hold other joints. When you bend your arm to lift a gallon of milk, your bicep is the main, or agonist, muscle, but the shoulder muscles have to keep the shoulder still as well.

Summary: The agonist is the main muscle which bends the joint, the opposing antagonist muscle straightens the joint, the synergist helper muscles lend a hand, and the stabilizers keep it all steady. Nerves control the muscles with messages from the brain. The body moves in patterns. Muscles work in specific patterns to control how motion occurs. However, the brain thinks in terms of whole motions, not specific muscles.

4th Posture Principle
The Body Learns What You Teach It

Pain teaches the body to move differently. If it hurts to move, the body will adapt and move in a way to avoid pain.

The body moves in Patterns of Motion which adapt to each individual’s Body Type, history of injuries & daily habits.

LIGAMENTS stretch in the direction they are stretched.
MUSCLES that are used get stronger in the way they are used. Unused muscles get weaker.
NERVES develop muscle memory, reinforcing a pattern of motion.

Posture and body motion depend on an interdependent chain of muscles, bones and joints. In this chain, body motion follows the path of least resistance. The most flexible (or least restricted) joint moves first. The least flexible (or tightest) joint moves last. Because the tightest link in a chain is the last to move, it limits motion the most. The muscles, bones, and ligaments integrate to control body motion.

The body’s motion patterns are like a folded piece of paper that continues to fold at a crease because the fibers have been bent in a pattern. Similarly, the muscles, ligaments and nerves change as they adapt to moving the body in a pattern of motion. Strong muscles lift more. Weak ligaments stretch more. The body posture adapts, creating a postural change, or distortion. Distortions are seen when looking at:

  • Posture: How people stand
  • Gait: How people walk
  • Over time, adaptive patterns of body motion cause increased body stress and breakdown.

INJURIES

When injuries occur, pain and discomfort often will follow. The body adapts as an individual adjusts how they move so as not to irritate the pain. We then compensate for weak muscles by learning to substitute new motion patterns. Unfortunately, this increases joint stress and strain. Thus begins the pain cycle.

“It hurts when I move like that, but I feel okay if I move like this.” The pain goes away, but the changed pattern of motion doesn’t.

The Pain Cycle is the vicious spiral of poor posture and unbalanced motion causing chronic pain and recurring injury. The cycle begins with an injury. Once injured, the body moves in a way to avoid pain. Over time the body compensates and adapts to moving differently. Some muscles become chronically tight and other muscles weaken. Also, ligaments stretch to accommodate uneven body motion. This results in chronic unbalanced motion and postural changes.

Changes in posture and the body’s patterns of motion are like the fold in a piece of paper. Once folded, the paper will bend along the fold when it is stressed. Similarly, once body motion changes to compensate for pain, body motion follows the same poor pattern of motion (bio-mechanically speaking). Over time, unbalanced motion and joint stress cause weaknesses, new injuries and arthritis.

The Pain Cycle is a result of moving in ways to avoid pain, leading to muscle imbalance and joint stress. Your unique Body Type, injuries and Life Habits become part of how your body moves.

HABITS

Our habits are what we do. Practice makes permanent. Muscles strengthen with use (and weaken when neglected), the body changes with what we habitually do.

If you sleep on your stomach with your head turned to the right, when standing you will find you head does not turn as easily to the left.
When you prop a phone under your neck while talking on the phone your neck twists to that side.

When driving or sitting in front of a computer, day after day, the body folds forward in a slump.

Our good and bad habits shape our bodies, our posture, and our patterns of motion. We adapt to doing whatever we do repeatedly.

5th Posture Principle
The Body Will Adapt To Posture & Motion Changes

Over time, the stress of unbalanced adaptive posture and motion results in muscle imbalance and joint wear. This begins a vicious cycle of unbalanced motion – causing breakdown – causing more unbalanced motion.

Chronic poor posture results in posture adaptation and constant muscle and joint stress. Poor posture and excessive sitting over-strengthens the over-used Standing muscles and weakens the underused Shifting muscles. Because the body must balance, and because loose joint moves before a stiff joint, the chain of the body’s motion follows the path of least resistance. This is why, over time, posture worsens and body stress increases as the body gets better at moving with adaptive posture & body motion patterns. Poor posture and motion patterns cause muscle imbalance, joint stress and more poor motion.

Changes in posture & motion cause real physical change and breakdown in the body. Muscles become chronically tight. Ligaments stretch. Joints wear. Ultimately, the chronic muscle spasm, joint damage (arthritis/DJD) and recurring injuries result from years of constant muscle and joint stress.

Try These:

Up Against The Wall
1. Stand up straight next to a wall placing your left shoulder against the wall.
2. Try and lift your right leg.
You can’t!
Here’s why:
You can’t shift to the left in order to balance.

Mirror Mirror
1. Stand in front of a full-length mirror.
2. Lift your left leg and slowly count to 12.
3. Stop the first time you have to put your foot down to balance.
4. Repeat with your right leg.

How long can you balance on your left leg? On your right one? If you can’t balance for 10 seconds on each side, your body is not evenly balanced.

Unbalanced stress causes the body to adapt and change over time, ultimately causing problems and pain.

Digital Motion
1. Slowly raise your hand above your head.
2. Put it back down, and lift it again, even slower (as slowly as you can).

Can you lift your hand slowly and smoothly? If you lift as slowly as possible, most people notice that the hand jumps slightly. Individual muscle fibers contract fully or not at all. You cannot move your hand smoothly and slowly because the individual muscle fibers contract in unison to create the appearance of smooth motion. When you slow down the motion, you can see the “gaps” in the motion from less or unused muscle fibers. A ballet dancer or athlete moves with grace and control because the motion is smooth. This is why an elderly person who cannot control their muscles moves with a jerky walk.

Don’t Be Cross!
1. Cross your arms in front of you.
2. Is your left forearm or right forearm on top?
3. Now, cross your arms with the opposite forearm on top. (Be sure you have a different arm on top this time!)

This feels awkward to most people. Your “normal” or habitual pattern of motion is with one forearm on top. Reversing the top forearm makes your arms, shoulder girdle, and neck work opposite your habit pattern. As a very general rule of thumb, the more stuck in a pattern of motion (and therefore out of balance) one is, the more imbalanced one feels on doing a reverse arm cross. Some people are so fixed in their pattern of motion they are physically unable to cross their arms backwards.

Another observation of fixed patterns of motion is noting if your hands are above or tucked under your arms. Then, try to do the opposite of your normal pattern.

Sole Searching
1. Look at the bottoms and sides of your shoes.
2. Are they worn the same on both sides?

If not, it is because they have worn to adapt to the stress of your walking unevenly on them. When the leather on the bottom of your shoes wears out unevenly you can buy new shoes. Where are you going to live when you wear out your body?

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