Body in Balance MN

Best Therapeutic Massage and Bodywork: injury treatment and prevention with relaxing massage for stress release


The Key to Foam Rolling (self massage) for Trigger Points

Posted by Katrina Koller on January 23, 2012 at 9:40 PM Comments comments (1)

A common topic among my clients is foam rolling.  What is it?  Should I do it?  Will it help?  For those of you new to foam rolling, it is a hard peice of styrofoam shaped like a giant rolling pin or cigar designed to allow one to self massage unhealthy tissue (knotted or painful tissue) using the weight of your own body balanced on the foam roller. They cost around $15-30 and can be purchased at any sporting goods, running, Physical Therapy, Relax the Back or larger discount stores.

I often see clients after they have foam rolled themselves into more pain, so perhaps I speak with some bias here but here's what I see: If used sparingly and mindfully for cases of mild muscle tension - foam rolling can be a life saver - especially if you can't always get in to see a good massage therapist when you are in pain.   That said, one must consider the root cause and severity before going at it too hard with a foam roller (or a tennis ball for that matter). 

Trigger points often form in weakened overstretched tissue (for example in upper back posterior shoulder, where tissue is weak and overstretched due to tight chest and bicep muscles and rounded shoulders) and when trigger points become chronic, they begin to cause fascial adhesions and unhealthy or "stuck" tight tendons near neighboring joints.  Foam rolling will address the muscle belly while leaving the surrounding tendons and ligaments near the joint yearning for attention.  This can leave your muscles feeling more irritated and painful in the end. The truth is, getting into the nooks and cranies of the joint structures (structural or deep tissue massage) will usually provide the lasting relief you need for moderate to serious muscle tension and trigger points.

Typical scenario: rolling feels great!! Yipee, I'm gonna roll the crap out of this trigger point! Ahhhh. That hurts sooooo goood!  (Yes, I've been there!) 10 minutes later, pain returns with a vengeance. Now this is NOT always the case, but if you rely on foam rolling repeatedly rather than addressing the root cause of your pain, you may end up worsening your pain and really feeling desparate.

Here are some good rules to follow when using a Foam Roller:

1) GO SLOW!  knotted tissue and trigger points hate to be pushed too fast - they like to be coaxed.  You are not tenderizing a steak here...

2) Don't overdo it.  Less is more.

3) Be mindful of how you can balance to moderate pressure before you tackle a really sensative trigger point and if you need instruction on foam rolling - click on the video below.

4) If pain persists, don't wait until you grow a huge "farm" of trigger points.  Address the pain and get at the root cause.  Try ice/heat therapy (click on the blog post here about ice and heat to learn more) and book a session with a skilled massage therapist.   One session could end several weeks or months of needless pain and rolling.

One more word about trigger points: many of my clients come to me after getting multiple injections to address trigger point pain.  Injections may or may not treat the symptoms, and even your physician will tell you they won't treat the root cause.  They will SOMETIMES treat inflammation (a symptom) - when inflammation is the cuase of the pain.  More commonly the cause of pain is not inflammation but unhealthy soft tissue (tight muscles, tendons, fascia, and ligaments) which can cause nerve impingement, numbness and severe pain or pressure on your spine and joints. 

Click on the  link below for foam a foam rolling demonstration on youtube:

What are these knots (trigger points) and why do I get them??

Posted by Katrina Koller on January 21, 2012 at 1:25 PM Comments comments (0)

A common question I get from massage clients is "what are these knots (also called "trigger points") and why do I get them?"  Here are answers from some experts:

Janet Travell and David Simons are two physicians who, amongst others, have assisted in our understanding and treatment of trigger points.  “In the core of the trigger point lies a muscle spindle that is in trouble for some reason. Visualize a spindle like a strand of yarn in a knitted sweater….. a metabolic crisis takes place, which increases the temperature locally in the trigger point, shortens a minute part of the muscle (sarcomere) – like a snag in a sweater – and reduces the supply of oxygen and nutrients into the trigger point". Lack of blood flow and nutrients over time produces pain and tension in the area.

Here are factors that can contribute to or enhance trigger point activity:

1. Nutritional deficiency, especially vitamin C, B-complex and iron;

2. Hormonal imbalances (low thyroid, menopausal or premenstrual situations, for example);

3. Infections (bacteria, viruses or yeast);

4. Allergies (wheat and dairy in particular);

5. Low oxygenation of tissues (aggravated by tension, stress, inactivity, poor respiration).

My own experience in the treatment of trigger points has helped  me understand that it can be tricky.  Since most trigger points occur in musclesor tissues that are overstretched, weak, overworked or injured, a therapist must use care when applying pressure so as not to further injure the area.  Pressure can be productive if used on the right soft tissue structures and without putting the body into further spasm.  The area must also be prepared or "primed" for best results.  Muslces and other soft tissue structures like to be coaxed with variable pressure but not bullied into submission (that means beating on your body with tennis balls or foam rollers won't likely get you out of pain for more than a few minutes).

Ice or Heat - which is best?

Posted by Katrina Koller on January 3, 2012 at 3:05 PM Comments comments (0)

Ice is best for accute injuries and reducing inflammation. Heat works well for relaxing tense muscles.  This article spells it all out:

Hip Strengthening Exercises Reduces Knee Pain

Posted by Katrina Koller on December 29, 2011 at 7:25 PM Comments comments (0)

Hip strengthening exercises performed by female runners not only significantly reduced patellofemoral pain — a common knee pain experienced by runners — but they also improved the runners’ gaits, according to Indiana University motion analysis expert Tracy Dierks.

“The results indicate that the strengthening intervention was successful in reducing pain, which corresponded to improved mechanics,” said Dierks. “The leg was going through more motion, suggesting that the (pain) guarding mechanism was reduced, and coordination or control of many of these peak or maximum angles in the leg were improved in that they were getting closer to occurring at the same time.”

Only in recent years have researchers begun studying the hips as a possible contributor to patellofemoral pain (PFP). This study is the first to focus on hip strength and gait changes during prolonged running.

Before starting a hip strengthening regime, it is best to begin with healthy soft tissue.  I often recommend a one hour deep tissue massage followed by a strength training routine to improve balance/gate and prevent  "guarding" and bi-lateral (one-sided) pain or stiffness in the hip, outer thigh and knee.  Most bodyworkers agree that nearly all mild to moderate chronic knee issues can be addressed with proper structural massage (deep tissue massage) and strenth training.


What to do about a torn muscle or tendon

Posted by Katrina Koller on December 29, 2011 at 3:20 PM Comments comments (0)

Injury Prevention Pulled Muscles, Scar Tissue and Re-injury

The reknowned Athletic Trainer Brad Walker explains how scar tissue affects recovery and re-injury of pulled muscles:

Have you ever had an injury that just will not heal? And then when you think it has healed, you go and re-injure it again. You may have a problem with scar tissue.

So you have pulled a muscle. Over-stretched it, torn it, strained it or sprained it. Call it what you want. From an injury point of view, the initial healing process is all the same.

Sprains (ligament) and strains (muscle or tendon) are the most common type of soft tissue sports injury and are often caused by activities that require the muscles to stretch and contract at the same time. A lack of conditioning, flexibility and warm up can also contribute.

While most people are well aware of the importance of applying the R.I.C.E. regime to a sprain or strain in the first 48 to 72 hours, it is after this that most people get stuck. Let us start by having a look at what happens during those first 72 hours and then move onto what is needed for a full recovery.

The First 72 Hours Without a doubt, the most effective, initial treatment for soft tissue injury is the R.I.C.E.R. regime. This involves the application of (R) rest, (I) ice, (C) compression, (E) elevation and obtaining a (R) referral for appropriate medical treatment.

Where the R.I.C.E.R. regime has been used immediately after the occurrence of an injury, it has been shown to significantly reduce recovery time. R.I.C.E.R. forms the first, and perhaps most important stage of injury rehabilitation, providing the early base for the complete recovery of injury.

24 hours after soft tissue injury, when R.I.C.E.R. has not been used, there is a large amount of uncontrolled bleeding and swelling. However the application of rest, ice, compression and elevation will significantly reduced the amount of bleeding and swelling.

The Problem with Scar Tissue When a muscle is torn, you would expect that the body would repair that tear with new muscle. In reality, this does not happen. The tear, or rupture, is repaired with scar tissue. When the R.I.C.E.R. regime is used, this limits the formation of scar tissue.

Now this might not sound like a big deal, but if you have ever suffered a soft tissue injury, you will know how annoying it is to keep re-injuring that same old injury, over and over again. Untreated scar tissue is the major cause of re-injury, usually months after you thought that injury had fully healed.

Scar tissue is made from a very brittle, inflexible fibrous material. This fibrous material binds itself to the damaged soft tissue fibres in an effort to draw the damaged fibres back together. What results is a bulky mass of fibrous scar tissue completely surrounding the injury site. In some cases it is even possible to see and feel this bulky mass under the skin.

When scar tissue forms around an injury site, it is never as strong as the tissue it replaces. It also has a tendency to contract and deform the surrounding tissues, so not only is the strength of the tissue diminished, but flexibility of the tissue is also compromised.

So what does this mean for the athlete? Firstly, it means a shortening of the soft tissues which results in a loss of flexibility. Secondly, it means a weak spot has formed within the soft tissues, which could easily result in further damage.

Lastly, the formation of scar tissue will result in a loss of strength and power. For a muscle to attain full power it must be fully stretched before contraction. Both the shortening effect and weakening of the tissues means that a full stretch and optimum contraction is not possible.

Getting rid of the scar tissue To remove the unwanted scar tissue it is vital that you start a course of deep tissue sports massage. While ultrasound and heat will help the injured area, they will not remove the scar tissue. Only massage will do that.

 About the Author Brad Walker is a prominent Australian sports trainer with more than 15 years experience in the health and fitness industry. Brad is a Health Science graduate of the University of New England and has postgraduate accreditations in athletics, swimming and triathlon coaching. He also works with elite level and world champion athletes and lectures for Sports Medicine Australia on injury prevention.