Skin on Skin
Touch is obligatory in a massage & has an effect on the nervous system by stimulating the mechano-receptors in the body that respond to sensory feelings, releasing an emotional effect on the client’s well-being. Massage stimulates the nerve receptors in the tissues which in turn control muscle tension. When these are released this relax's the client both physically & mentally & can affect the para-sympathetic nervous system controlling other vital body functions, for example the digestive system. I will explain the areas I plan to massage ahead of any treatment to make sure you are comfortable at all times
You might attend my clinic seeking treatment thinking you have a specific injury caused through an over-stretch through playing sport causing restricted movement or general immobility. Sometimes the obvious cause is not always the ‘root’ cause of the problem. For example, someone complaining of pain in the calf 10 minutes from the onset of a run might also have a job operating a sewing machine with a foot pedal all day. The repetitive movement of their working pattern is more likely to be the root cause of the problem. By understanding the whole picture of your lifestyle I can appropriately treat and advise
How Muscles work
When a muscle contracts, it consumes glycogen stored in the microfibers of the muscles to create energy to create the contraction of muscle bundles shortening the muscle. There are thousands of muscle contractions within the body every second & the by-product of this energy consumption leaves ADP waste. If the muscle has been working to its maximum or over-used there will be small fibres of torn muscle which the body needs to flush away to allow repair. The body is an amazing machine, it repairs automatically, but by massaging we are increasing the micro-circulation of the blood to a specific area & therefore speeding up the process of repair, allowing the patient to return to normal activities more quickly. An added benefit may be that by stimulating the stretching of the capillaries, it can help increase their functionality & make them more robust for on-going circulation.
Using long massage strokes on the lower limbs, where the body part is furthest away from the heart and gravity at its greatest, the therapist can assist de-oxygenated blood to be carried back towards the heart. Massage assists with the circulation of blood around the body, contributing to the pumping effect of circulation
Massage works to assist the body’s lymphatic drainage system. Lymph vessels run throughout the body, parallel to the circulatory system & act as the waste collection system for the body. Lymph flows towards the heart absorbing any excess interstitial fluid & returning it via the lymph nodes (which filter out any toxins) into the veins. Interstitial fluid is most prominent where there has been damage or injury of tissue, this could be because of a medical condition or through sporting activity. As there is no pump action stimulating the return of lymph to the heart, the flow of lymph relies on the action of muscles to pump it back. If muscles are damaged or ‘stuck’ and static, lymph flow will be restricted. This is often common where gravity is at its greatest, again in the lower limbs, typically the legs.
When using a specific muscle group, whether through repetitive movements or sport, muscles are put under stress, increasing the risk of tearing muscle fibre. When the muscle fibres tear they bleed & lay down waste matter which results in scar tissue. Scar tissue can build up if the blood leaks outside of the muscle cavity, disabling the muscles from contracting & lengthening. As scar tissue is laid down it hardens the tissues surrounding it. By massaging the affected area enables the adhesions & scar tissue to be broken down & speed up the process of healing allowing a quicker return to normal function.
Scar tissue creates adhesions & stops the interface between the skin and muscle, known as fascia moving freely. Scar tissue sticks muscles together so they are unable to lengthen or contract forming hard knots of muscle fibres. Fibrous tissue forming scar tissue makes the muscles thick and less pliable & this can also apply to areas between the bone, ligament & tendon leading to restriction of movement. By using transverse strokes & friction techniques the therapist can break the fibrous bonds apart to allow functionality to be restored & allow blood (that might have been restricted to this area because of the fibrous build up) to flow through the area once more, aiding recovery.
Common Musculo-skeletal conditions - including common causes, tissue damage signs, typical symptoms & healing times
Sprains occur when there is an injury to a ligament, so where the connective tissue is between bone & bone. Resulting injuries are normally either direct, where the bone surrounding the ligament is struck directly, for example in boxing or in-direct, where the rip or tear is a result of a non-direct blow & is normally as a result of being over-stretched. Typically this might be landing on the side of your foot (inversion or eversion of the foot) & turning over the ankle or a twist of a knee from a firm foot plant on the floor. Initial signs of complete or partial sprains would be the area will swell and bruise & cause pain when weight bearing activities are carried out causing loss of ability to move the joint, depending on the severity
A strain is an injury to either a muscle or tendon which connects muscles to bones. It can be the case of an over-stretch or a partial or complete tear & can be caused by long term repetitive movement of the muscle or tendon as well as injury caused through athletic activity. When the muscle or tendon is being stretched, if it is over stretched this can result in a strain to the muscle & tendon. Generally a strain will take a lot longer time to heal than a sprain. Examples would be Tennis Elbow or Achilles tendon partial or complete ruptures
A stress fracture is caused by repeated stress or heavy consistent weight bearing, normally on weight bearing bones such as the leg & ankle. It is the fracture of tiny particles of bone away slicing away from the main bone. Examples of where stress fractures might occur would be the repeated jumping while enthusiastic dancing, which could involve bouncing up & down continually throughout a gig, causing repeated stress on the long bones of the leg, the Tibia. It is also a common injury among athletes, especially runners
Pain and tenderness is presented in the area that is affected when the bone is weight bearing. In a runner, this might present as severe pain when first starting to run, moderate pain during the middle of the run & severe pain at the end & in recovery again. An x-ray will often not show up stress fractures, an MRI scan might diagnose it but this would be expensive
The term Tendonitis describes inflammation of the tendons. Tendonitis is normally due to over-use & therefore is most common in the back of the heel, calf, elbow & hip. Tendons should glide & move smoothly in normal use, moving the joint to bring the bones closer together, when the movement becomes jerky & irritated, this is normally due to inflammation of the tendon which results in pain when moving the joint
There are hundreds of tendons throughout the body; the ones that appear to cause the most problems are a small number, such as used in the elbow or ankle. As tendons have a poorer blood supply than muscles, they are prone to tissue damage & their poor blood supply means that healing is longer than in a muscle where the blood supply is good. Often the weakest area in a tendon where it is prone to the most injury is called the watershed zone & this area is where the blood supply is at its weakest. The body struggles to deliver the right nutrients & blood supply providing oxygen & lymphatic drainage to clear down waste products. along with supplying the right nutrition to the tendon to counteract the stress the tendon is being put under & heal it when damaged
Tendonitis usually occurs within older adults, where the tendon is less flexible & elastic than in youth & is therefore more prone to over-use. It is often seen in people that have taken up a new exercise regime or are training hard on a specific area of the body. Tendonitis is characterised by pain over the tendon, some swelling might be present & there will be pain when moving the joint. It is not appropriate to x-ray for Tendonitis, although this will rule out any other broken bones or hairline fractures whose symptoms could represent similarly
When performing massage, the therapist is looking to stimulate well-being in the client & reduce stress. The concept of a specific injury caused through sporting activity is less common so the whole of the person’s lifestyle must be taken into account when deciding what area to treat.
In amateur and professional athletes, the therapist can identify areas that are sore (not injured at this stage), or have been heavily worked. Concentrating massage in those areas promotes a quicker recovery & reduces injury time
Soreness may indicate areas that have the potential to cause injury in the future so by identifying them early then we prevent injury occurring & extend the ‘up’ time for an athlete.
As well as the effect of massage on the reduction of pain from sore muscles, as the therapist massages the affected areas & surrounding tissues, athletes, competitive or otherwise, gain different benefits from a sports massage