Online massage booking        Find us on Facebook    Google+    twitter RSS

Massage and Nausea

Unfortunately an occasional side effect of massage is that you can occasionally feel a little nauseous after the massage. Whilst you will hopefully feel relaxed, looser with less muscle and joint pain, it is possible that you may just feel a little off colour for a while.

For most people, this side effect of massage only last for a relatively short period. Some people will need to have a lie down and sleep. Others will drink plenty of water to feel as though they are giving their system a flush. Regardless, in the vast majority of cases, the nausea is only a transient hindrance.

Dizziness and nausea post massage
There is much discussion regarding the cause of the nausea and dizziness after a massage and it may well be the case that there are a number of different causes. One theory which is discounted by most therapists is that the nausea is caused by toxins that are release by the massage. For a discussion of this fallacy then please check out www.innerwestmassage.com.au/massage-toxins.php.
A recent hypothesis is that “Post Massage Soreness and Malaise” is the result of a mild case of Rhabdomyolysis which occurs when muscle cells are damaged and it interferes with the blood chemistry.

Personally whilst there may be some evidence to support this theory, if you follow this theory then you would agree that the deeper the massage, then the more likely you would be affected. Although this is a personal viewpoint, it doesn’t tally with my experiences.

For me nausea is more likely if I haven’t had a massage for a while and I have never noticed any correlation between the pressure/intensity of the massage and the degree of nausea experienced. I tend to subscribe to the theory of Dr Keith Eric Grant who considers that massage is about returning the body towards homeostasis and that the nausea may be the result of giving the lymphatic system a bit of a kick-along. Other therapists may argue differently to this but regardless this type of nausea post massage is very normal and not a cause for concern.

However, if you start vomiting and feel extremely dizzy post massage then that is a different kettle of fish. This happen whilst I was massaging someone a while ago and we had to stop the massage after about 20 minutes as the client was unable to continue. Although massage had only been carried out to the back, just the act of lying prone was too much for the client. Although she recovered and started to feel better once she rose from the table, this was not a normal state of affairs and seeing her doctor was the next step.

Although uncommon, one possible explanation for the extreme nausea in this case is atlantoaxial instability.

Atlantoaxial instability can be considered as a loose upper spine and is the loss of the integrity of the joint between the top two vertebrae, the atlas and the axis. For some people who may have had a neck injury or trauma, then when they move their head or neck then a bone projection (the “dens”) from the axis may effectively make contact with their brain stem. The result of this can range from mildly unpleasant through to downright dangerous.

  
Whilst massage is not necessarily precluded for people who suffer from atlantoaxial instability, extreme caution would be required. The neck can be considered vulnerable and only relatively gentle strokes should be attempted with the approval of a suitably trained diagnostic therapist. Most doctors would strongly recommend that there be no manipulation such as a chiropractic adjustment.

Although there may not have been a formal diagnosis of the condition then a massage therapist should be alert to the possibility. A client may be particularly tight high in the neck or be very guarded and protective of the way they hold their head. If any alarm bells are rung for the therapist then they back off with the intensity of their work and use the adage “too little is better than too much”.

By Richard Lane

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.

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

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


Tweet