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Soaking Away Your Aches and Pains
Do Epsom Salts Work?

For many people, soaking in a relaxing bath at the end of a busy day is a great way to reduce stress and relieve any muscular aches and pains. Some people claim that the benefits can be enhanced by adding Epsom salts to the bath but others have questioned whether there is any real health benefits that are provided by including salts whilst you soak.

epsom salts in the bath

The proponents and supporters of Epsom salts can that the benefits have been known for hundreds of years and that bathing in Epsom salts is one of the easiest ways to reduce stress and ease muscular pains. Other specific claims are that it relaxes the nervous system, provides benefit for the skin (such as treating Athlete’s foot), helps prevention of hardening of the arteries, makes insulin more effective and that it eliminates toxins from the body.

However, the amount of rigorous research that would support these claims varies and, if you pardon the pun, they should be taken with a pinch of salt (particularly any claims associated with removal of toxins and heavy metals from the body as these are likely to be particularly spurious in nature).

It should be mentioned at this point that if you are pregnant then you should always talk to your doctor before considering an Epsom salt soak. If you have any other diseases, conditions or concerns then it might be a good idea to raise the use of Epsom salt baths the next time you speak to them.

Chemically Epsom salts are hydrated magnesium sulphate and there is no doubt that magnesium is important mineral for many health functions in the body. For example, some cramps have been attributed to lack of magnesium in the diet and when cramp sufferers begin to take magnesium supplements then the pain and intensity of their cramps may drop within a relatively short time. (For more information about the importance of magnesium as a mineral check out this article).

Despite all the benefits and claims that you may find if you research Epsom salts, a recent online article has questioned whether or not they do actually deliver. The article itself is a fairly lengthy piece discussing this topic in some details (click here if you wish to read it).

The jist of the argument is that for many years we have “known” that a soak in a Epsom salt bath is good for relieving muscular stress, pain and tension. However, when you look at the science and research that has been carried out then there is very little supporting evidence. In particular, the claim that the body absorbs the magnesium sulphate through the skin is in doubt and the author questions whether there is a plausible mechanism how Epsom salts can have an impact on muscle tissue and function. Osmosis can be ruled out as osmosis, by definition, is the movement of water molecules through a semi-permeable membrane.

  
However, the author does refer to a study performed by Dr R Waring from University of Birmingham in UK who found that people who soaked in an Epsom salt bath had raised levels of magnesium and sulphate in their blood after the bath, although the mechanism of transfer was not determined.

Despite the scepticism about whether a soak in an Epsom salt bath is effective, there are many who frequently resort to a lengthy soak at the end of a stressful or physical day. And as a recent facebook contributor wrote:
“Works great for me, if Epsom doesn’t work for you then it sucks to be you. ;-)”

TMJ Pain?
Try Massaging your Pterygoids

You may be surprised if you were told that the hardest working joint in the body is the jaw or the temporomandibular joint (TMJ). It is virtually constantly working when talking, chewing, grinding and clenching and there are estimates that it moves more than a couple of thousand times every day. It is no surprise then that some of the muscles used to move the joint can become a little overworked and sore.
Often the result can be what is referred to as TMJ dysfunction which can manifest itself in a number of different ways. These include
Massage for TMJ dysfunction

  • headaches
  • dizziness
  • soreness and irritation of the eyes
  • difficulties with chewing
  • clicking/grinding jaw
  • problems with the ears including Tinnitus

The outcome is often that the TMJ dysfunction sufferer has poor quality sleep, is constantly in pain or discomfort and a general degradation of their quality of life.
It is not uncommon that these problems can be related to trigger points in the muscles that move the jaw and, although there are a number that can be affected including the masseter and the temporalis, one of the main culprits is often the pterygoid muscles. The good news is though that it is relatively easy to massage these muscles yourself so long as you know where to work.

The origin of the term pterygoid is Greek and the root of the word, pter-, refers to wing like (as in pterodactal) which is considered to reflect the shape of the muscles.

The group consists of the medial and lateral pterygoids each of which have their own recognised trigger point referral pattern.

Trigger Points and Self-Massage for Medial Pterygoid
If there are trigger points present in the medial pterygoids then the person will often have pain in the TMJ and also around the ear. It can also be difficult to swallow with pain referred to the back of the mouth. If you have restrictions in how far you can open your mouth then there is likelihood that you will have trigger points in this muscle, normally present on both sides of the head.

In order to self-massage the trigger points then you simply press up on the inside of the lower edge of the jaw using your thumb. As with any massage, then it is advisable to go gently at first as often the jaw can be extremely sensitive at these points.
The most effective way to reach the upper fibres of the medial pterygoid is through the mouth. With clean hands, reach into the very back of the mouth beyond the final molar. Work on the muscle just beyond the bony edge of the jaw (open and close the mouth to locate the muscle if required).

pterygoid sketch

Trigger Points and Self-Massage for Lateral Pterygoid
This muscle is considered by many to be the leading culprit for pain and TMJ dysfunction. For example, if you have clicking and discomfort on opening and closing the mouth then you may have trigger points in the lateral pterygoid. Constant tension in these muscles can lead to the jaw being disarticulated.
To locate this muscle, then commence just in front of the ear on the cheekbone. Press on the underside of the cheekbone whilst opening and closing your mouth. A couple of centimetres from the ear you will often hit pay dirt with a tight tender band going up under the cheek bone. This is the lateral pterygoid and gently massage this muscle until the pain and tension has reduced.

  
Any time you massage trigger points in muscle groups it is a good idea to stretch them out afterwards to enhance the relaxation of the muscle. One recommended stretch for these muscles is to open your mouth against resistance by placing your hand under your chin while you slowly open the mouth against the resistance.

Often you will need to repeat this self-massaging a couple of times a day for a number of days to completely eliminate the trigger points in the group. If you are a TMJ dysfunction sufferer though, the time taken to do this will be well worth the effort as the pain relief can be significant.

More info on pterygoid trigger point massage is available on the video below.

Massage Strokes Using Active and Passive Movement

We have previously written about static massage strokes where there is no movement of the body part being massaged, http://www.innerwestmassage.com.au/blog/static-massage-strokes. For this post we will be introducing some techniques which incorporate either passive or active movement of a joint using similar compression and stripping strokes. Whilst these strokes are effective within a remedial, sports or deep tissue massage, it must be mentioned that not every technique will be useful for each massage recipient. Typically these strokes will require more pressure and can lead to some discomfort, although therapists should only ever work within the pain tolerance of the client.

Massage with active and passive joint movement
For many of the following techniques, whether the movement is active or passive makes little difference to the actual physical action of the therapist. The difference is more that a passive movement will bring about mostly physiological changes to the soft tissue whereas an active movement can introduce some neurological impact as excessive muscle spindle activity is reduced when a muscle is contracted. Another difference may be that an active movement may cause the client pain so from a comfort level a passive stroke may be more appropriate.

Shortening Strokes
Shortening strokes can be effective in dealing with trigger points, myofascial tension and some joint restrictions. They are performed by applying some static compression to the part of the muscle that requires bodywork and then the tissues are shortened/contracted either by moving the joint actively or passively. Generally for the start of the stroke the muscle will be in an elongated and lengthened state.
The philosophy behind shortening strokes is that by deliberately reducing the tension in the muscle through shortening then it may decrease trigger point activity and neuromuscular dysfuncationality within the muscle. If there is less tension on the muscle fibres while compression is applied then it may lessen the amount of neurological activity.
Often the end position of the joint and muscle after a shortening stroke will be held for an extended period of time as a form of positional release.

Lengthening Strokes
Often the primary intention of a massage therapist is to lengthen muscles that have been hypertonic through overuse or through a constant state of contraction due to poor posture. Active or passage lengthening strokes are a great way to achieve this objective as the mobilise connective tissue, reduce tension in the muscle and encourage elongation and lengthening of the muscle.
There a number of different ways to perform these strokes. A popular approach is referred to as “pin and stretch”. Static compression is applied to a particular point using a massage tool that is strong enough and specific enough to be able to hold the muscle in place as the muscle extends either actively or passively. The sharper the massage tool then the more intense the sensation for the client.

As an example of a pin and stretch technique for pectoralis minor then have a look at the video below.

The second common use of lengthening strokes is to perform a stripping stroke along the length of the muscle as the muscle is lengthened via active or passive joint movement. The muscle is put into a shortened state and then slowly stretched as the therapist strips the muscle. This can be referred to as facilitated lengthening. Often for larger muscle groups this stroke is repeated a number of times in parallel so that the entire muscle is treated.
The overall effect of lengthening during a stripping stroke is to magnify the intensity and the effect on the soft tissue. The trick to performing it effectively is to work slowly. The slower you work then the deeper you can penetrate without causing undue discomfort to the recipient.

By Richard Lane

Couples Massage in Sydney

As a Sydney mobile massage service one of the advantages we have over clinic based remedial and relaxation massage is that we can arrive with two therapists and provide massage to couples at the same time. For busy people this can be a great way to relax and receive quality bodywork without it eating into too much free time.

 

Sydney Couples MassageIf you were to go to a clinic to see a therapist separately then by the time you and your partner travel and each have your massage then you can be looking at around 3 hours that you would spend apart for just an hour’s massage each. By having two therapists come to your home then you can relax side-by-side and the total time will be only the set-up and pack-up time for the therapists along with the massage.

 

Generally it is easier for you to organise an appointment with one company so that they can coordinate that the therapists arrive at the same time but if you have a particular preference for a specific therapist (or therapists) that offers mobile massage then there is nothing stopping you from effectively arranging the couple massage with two different companies (or therapists working as sole traders).

Couples Massage Training
In many cities in Australia and the world there are therapists that will offer massage training specifically for couples. However, to my knowledge there is no-one offering this service in Sydney. There are probably WEA type courses that will offer classroom training to multiple groups of couples but I’m talking about one therapist assisting one couple in their home for relaxation (if anyone does offer this service then feel free to email us using contact details on main website).

  
Occasionally we are asked if we will provide couples massage training in Sydney. Normally the request is for a therapist to provide instruction/demonstration for the couple but at present we are not really set up to formally offer this service. However, it is not uncommon for us to demonstrate a specific stroke for providing relief for a specific muscle or muscle group so that someone can help their partner (between massages) with a particular problem.

Massage Techniques – Static Strokes

Check out any massage teaching website or text book on massage techniques and you will come across a myriad of different massage strokes. For many newcomers, this can be confusing and daunting although once you realise that much of the confusion is the result of using different terms for the same strokes then you will begin to feel more comfortable with understanding and practising the various strokes. For example, one therapist may refer to trigger point therapy, another to acupressure and another to shiatsu. Yet they are all effectively talking about the same physical technique of applying static pressure to a specific point.
This article will just introduce some of the possible static massage strokes that are available. It is suggested, however, that if you do wish to learn and use them that you should enrol at a suitable massage teaching establishment so that you can understand in a safe and proper learning environment.
When we use the term static massage strokes, we are referring to the fact that the body part that is being massaged is stationary. We will discuss technique where passive and active movement is incorporated into the strokes in a later blog.

Effleurage
Effleurage strokes are the most common technique used by massage therapists and they are simply the flowing, gliding stroke along the length of body. It is used to spread lubricant (either oil or lotion), to warm up the muscles and to relax the recipient. The pressure applied and the speed of the stroke can vary considerably although it is rarely the case that effleurage strokes should be painful for the recipient. Generally the massage therapist will use their palms to perform the stroke although fingers, thumbs and forearms can be used depending on the particular body part being massaged. The strokes are performed along the length of the muscles, parallel to the muscle fibres.

Petrissage
Petrissage strokes are kneading techniques whereby a therapist will pick up, squeeze or wring soft tissue. For example, Petrissage of the calf muscle at the back of the lower leg is often used to warm up and relax the muscle. The therapists will use two hands and gently knead the calf with flowing action.

Compression
Static compression is simply the action of applying pressure at a particular point on the body without any movement from the therapist. Any massage “tool” (fingers, thumbs, knuckles, forearms or elbows) can be used to apply the pressure depending upon the specific body part and the amount of pressure required. Generally this stroke is performed to deactivate myofascial trigger points and pressure can be applied for as little as a few seconds or for as long as a couple of minutes depending upon how long it takes to achieve the desired therapeutic response.

Compression Broadening
Healthy muscles need to fully elongate and contract. With contraction, comes a broadening of the muscles as the sarcomeres within the muscle fibres overlap. A compression broadening strokes attempts to mimic this action (on a macroscopic level). To perform this stroke then you apply pressure to the relevant muscle using two massage tools and then slowly move the tools apart as you simultaneously stretch and compress the muscle. It is important not to have too much lubricant for this stroke as the objective is not to slide over the muscle.
As an example, the flat of the fists are often used on hamstrings muscles to perform a compression broadening stroke. The therapist will apply pressure with both fists side-by-side on the belly of the hamstring and then slowly move the fists apart across the muscle fibres.

Longitudinal stripping
This technique utilises a slow long gliding stroke parallel to muscle fibres in an effort to increase the length and elasticity of the muscle fibres. The pressure required should be sufficient to grip the muscle rather than glide along the superficial layers and can be bordering on the uncomfortable for the client. Any massage tool can be used to perform longitudinal stripping strokes and if you require more pressure then the tool chosen will use a smaller contact area.
The critical factor is the speed of the stroke. If the therapist works too quickly then the bodywork will be more painful and less effective.

Friction
Friction strokes can be a little confusing for the new massage therapist but once mastered then generally easy to perform and most remedial massage therapists would incorporate them at some stage during a session. A friction massage stroke moves adjacent superficial tissues in relation to the underlying soft tissue with a repeated forward and back or circular action. Any massage tool, fingers, knuckles, thumbs, elbows, etc can be used to perform the stroke and the important factor for the therapist to be aware of is that there is no movement of the massage tool relative to the skin. There is no gliding and the tool used maintains contact with the skin and moves it as the stroke is applied.
These strokes are typically used by massage therapists and physiotherapists for treating soft tissue injuries particularly where there may be scar tissue. The intention is to break cross-fibre bonds with the shearing nature of the stroke. However, it should be mentioned that research supporting the effectiveness of friction strokes is limited and some question whether it does achieve this goal.

By Richard Lane

Spondylolisthesis and Massage Therapy

Many people book in for remedial and therapeutic massage because of lower back pain. However, the causes of lower back pain can vary considerably and they are poorly understood. Massage therapy can be appropriate for a significant proportion of those who present with lower back pain due to muscular tightness and/or trigger points. However, massage therapists are not permitted to diagnose conditions and there are some patients for whom massage is contraindicated or for whom massage should only be performed under the direction of a suitable physician.

One such condition for which massage therapists should be extremely cautious is spondylolisthesis. If you think or suspect that a client may be presenting with spondylolisthesis then you should consider that the massage is contraindicated.
Spondylolisthesis arises from a stress fracture in the vertebrae, most typically in the L5-S1 region and occurs when one vertebra actually slides forward relative to another because of the fracture.
Activities that cause repeated flexion and extension of the spine are considered to be risk factors for the development of spondylolisthesis. Gymnasts, butterfly swimmers, weightlifters, for example, are particularly susceptible. In addition excessive lumbar lordosis is often considered to be a contributing factor as the greater curvature of the spine can place increase loads and the tilt angles at various parts of the spine.
Clients who present with spondylolisthesis will likely complain of dull pain in the lower lumbar or upper sacral areas and this pain will normally occur after the person has been performing the repeated flexion/extension activities. If a therapist tries to palpate the area then pain levels can increase if there is anterior forces being applied to the spine that can further contribute to forward slipping. X-rays or MRI scans may be required to confirm the presence of an anterior slipped vertebra.
Treatment for spondylolisthesis will normally begin with rest and refraining from carrying out any activities that flex/extend the spine. Some physical therapists may suggest bracing of the back to prevent further movement. It is likely that some strengthening and flexibility training may be incorporated into a rehab programme and it is at this point that a massage therapist is most likely to become involved. Under direction, the therapist may target muscles that have become hypertonic in response to compensating for pain.
However, a word of caution is that hamstrings will often tighten in those who are suffering from the condition. The reason for this is that they are effectively trying to rotate the pelvis posteriorly and minimise further vertebral slipping. Releasing tight hamstrings in spondylolisthesis patients would generally not be recommended, particularly in the early stages of rehabilitation.

By Richard Lane

Pregnancy Massage in the First Trimester

Massage for pregnancy

If you ring to book for a pregnancy massage and mention that you are in the first trimester then there are many therapists who will refuse to accept your booking. Day spas often will include on brochures and promotional materials that you should not come in for a massage if you are in the early stages of pregnancy.

So it appears as though the massage industry supports the view that massage during the first trimester is not safe.

However, for many women this is just not the case and there are no scientific reasons for healthy women not to get a massage during the first trimester. Indeed often women will receive bodywork without even knowing that they are pregnant.

The reasons for the varying positions on first trimester pregnancy massage stem from a misconception that massage can, in some cases, lead to miscarriage. This view is inaccurate and there is no causal link between massage and miscarriage. Whilst the prevalence of miscarriage is greatest in the few months of pregnancy, in general, the actions and the activities of the women will have no bearing on the likelihood of her suffering from an unfortunate miscarriage. Basically if it is going to happen then it will happen as the miscarrying embryo is typically chromosomally abnormal and not viable. Infections and diseases may be other causal factors. Exercising, stretching or having a massage, however, does not contribute any risk towards a miscarriage.

If a miscarriage does happen within a short period of having a massage, assuming that the massage therapist has not acted outside of their scope of training, then it is fair and reasonable to declare that having the massage was not the reason for the miscarriage. Whilst a woman may very well question what she did and didn’t do in the days before the miscarriage, in the long run hopefully she will be able to understand that what happened was going to happen regardless and she should not assign any blame to her (or others) actions.

Most massage therapists do understand this point, yet a significant proportion are still reluctant to perform a first trimester pregnancy massage. Their position is that they do not wish to be put into a position of the woman associating a miscarriage with any massage. This is very much a personal choice of an individual therapist and no therapist should ever be put into a position of providing massage services when they are not entirely comfortable to do so. Some clinics may make a similar decision on behalf of all therapists, more out of a misguided fear of litigation.

  
Whether a woman actually feels like having a massage during the first trimester though is a separate question. Nausea, morning sickness lethargy, breast tenderness, etc may act as negative influences and make her not want to get a massage anyway. However, this is a separate issue to whether she can get a massage or not.

Before booking in for a massage with a suitably trained therapist, we would also suggest that you discuss your intentions with your doctor just to ensure that there are no issues which may mean that pregnancy massage (at any stage of the pregnancy) is contraindicated.

By Richard Lane

Why Does My Neck Hurt?

Regardless of where a problem may originate in the body, the neck and shoulders are very often the manifestation of the issue.  This is true of both physical and emotional dysfunctions.

On top of the cervical vertebrae is a large roundish object which is virtually always in motion in an attempt to stay balanced and to keep the eyes horizontal.   If this object, also known as the head, is well balanced on the vertebrae then the loads on the muscles of the neck and shoulders are relatively low.   However, physical disturbances all down the body to the feet can interfere with this dynamic leading to greater loads on and tension in the muscles.  For example, a shortening of calf muscles from, say, wearing high heels, tilts the pelvis forward which alters the curvature of the spine which will impact on how the head sits.

In addition, our necks are always adjusting to any imbalances in our body.  If we sidebend to one side then there is a tendency for our neck to counteract this movement in order to keep our eyes level with the ground.

Chickens are often used to demonstrate this to great effect!

Our emotions often arise in our stomachs and we are all familiar with the sensation of butterflies or tightening in our bellies.  From there they will wind up again to our necks where the emotions can often be expressed in the form of tightening of the muscles of the neck and shoulders.  If this becomes a near constant state of tension then we can lose a degree of flexibility in our spine to create a bottleneck in the area.

  
Furthermore the complicated movements and requirements on the cervical spine and muscles can lead to problems more easily than elsewhere in the body where there is more protection and less mobility demands.

For these reasons, whenever you book in for a massage, then your therapist is likely to find restrictions and painful areas in your neck that you may not even have been aware of.  However, if you do present with a neck problem then it may very well be the case that your therapist could spend significant time working on parts of the body other than the neck if they consider that the root cause of the neck issues may not actually be with the neck.

By Richard Lane


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