Myofascial Compartment Syndrome

 Increased interstitial pressure in a closed, nonexpanding, myofascial compartment that compromises the function of  the blood vessels, muscle and nerves.

  •  Acute Compartment Syndrome – Causes includes, but not limited to fractures and crush injuries. Results in ischemia and     eventual necrosis of muscles and/or nerves. It is medical emergency
  • Chronic/Exertional Compartment Syndrome – Can occurs in distance runners or those involved in major changes in activities levels. Leads to ischemia, pain, and rarely neurological signs and symptoms can be present. Symptoms are less sever, and tend to improve with rest, but may proceed to acute compartment syndrome if the exercise continues, because fascia cannot accommodate the hypertrophy in the specific area.

Soft Tissue Injury Con’

Today we will talk about the Severity of Tissue Injury!

To properly treat the tissue after the injury first we need to understand the severity of the damage.

Grade 1-

  • Mild pain at time of the injury or within 24 hours.
  • Mild swelling, local tenderness, and pain when the tissue is stressed.  

Grade 2-

  • Moderate pain that requires stopping the activity (possible able to resume after some interruption with lower grade injury).
  • Stress and palpation of the tissue greatly increase the pain.
  • When injury occurs to a ligament, some of the fibres are torn which will result in increased joint mobility.

Grade 3-

  • Near-complete or complete tear or avulsion of the tissue (tendon/ligament) with severe pain.
  • Stress to the tissue is usually painless.
  • Palpation may reveal the defect.
  • Torn ligament results in instability of the joint.

Follow us in our next blog at our Massage Therapy Clinic in Oakville; we will discuss the difference between the Sprain and Strain type injury.

 

 

Soft Tissue Injury Con’

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Today we will talk about Inflammation and tissue healing!

Irritability of tissue is depends on the stages of inflammation and repairs. After any connective tissue damage whether it is from mechanical injury (including surgery) or chemical irritant, the vascular and cellular response is similar.

In regards the following stages the time fames might be affected if there is any other medical condition that the patient may have and medication intake due to those medical conditions, all of that will affect the healing process.

Acute stage- Usually lasts 4-6 days but might be longer or shorter and unless the injury is not aggravated.

Sign of inflammation are presents:

  1. Swelling
  2. Redness
  3. Heat
  4. Pain at rest
  5. Loss of function

Range of motion testing- movement is painful and patient usually guards against motion before completion of range. It is body’s way of immobilizing the painful area.

Sub-acute stage- Usually lasts 10-17 days (14-21 days after the onset of the injury), but might be longer or shorter.

Sign of inflammation progressively decrease and eventually disappear.

Soft Tissue Injury

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What is new in our massage therapy clinic in Oakville?

Today we discuss what a soft tissue injury is:

  1. Severity of the injury
  2. Musculoskeletal structures that are involved
  3. Stage of inflammation
  4. Recovery time.

When a client has experienced a trauma it is important that therapist consider the severity of the injury, identify all the musculoskeletal structures that are involved, identify the stage of inflammation and recovery of the involved tissues.

For all of that we as therapist we must perform orthopaedic and palpation assessment, so we can identify all the impairment and functional limitations present. We can then determine for which of the findings massage therapy is appropriate.

But before we talk about the treatment let’s have a look on some definitions-

  • Contusion – A crushing injury from a direct blow that results in capillary rupture.
  • Strain- Trauma to a muscle and/or its tendon from overstretching or violent contraction, and usually will happen with sprain.
  • Sprain- Overstretching, partial tearing or complete tearing of a ligament (or joint capsule) due to trauma.
  • Repetitive Strain Injury aka overuse- Repeated, submaximal overload and/or friction wear to a muscle or tendon resulting in inflammation and pain.
  • Dislocation- An injury to a joint in which the articulating surfaces are no longer in contact.
  • Avulsion- Is a fracture that occurs as the result of the pulling of soft tissue attached to the bone from trauma.
  • Subluxation- An incomplete disruption of boney continuity that often involves soft tissue injury.
  • Dislocations and Subluxation are often will happen along with strain type injury.

What may result from a trauma-?

Dysfunction, joint dysfunction, adhesion, contracture, spasm, muscle weakness and even myofascial compartment syndrome.

Follow our blogs at our massage therapy clinic in Oakville, next blog will be about Inflammation and tissue healing.

Treatment for constipation

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In this blog I will introduce to you how Massage Therapists are approaching constipation.

Treatment for constipation.

In the context of a massage using general and specific Swedish and Non Swedish techniques treat specific impairments such as

  • Increased resting muscle tone
  • Stress
  • Trigger points

Abdomen : ( direction of techniques in bold are specific to the large intestine are always done in a clockwise direction )

Position in supine with knees bent or elevated onto pillows:

  • General and specific massage to the abdomen diaphragm, abdominals and the psoas if indicated.
  • Vibrations over the four corners ( iliocecal region, hepatic flexure, splenic flexure, sigmoid region )
  • Fascial release: gently applied, “stretch” the haustra, diaphragm
  • NMT: vibrations over 4 corners ( iliocecal region, hepatic flexure, splenic flexure, sigmoid region ), Be sure to work clockwise.

Self care

  • Hydrotherapy
  • Diaphragmatic breathing
  • Aerobic exercise
  • Increase hip flexion while defecating ( elevated feet on books or stool while sitting on the toilet )
  • Referrals

Some common Trigger Points and Referred Pain

Abdominal muscle trigger points can cause “pseudo “visceral pain

Adductor longus : General pain inside the pelvis, possible shooting pain in the pelvis

External Obliques – Refers pain into the abdomen , possible source of chronic diarrhea

Lower Abdominals : Source of abdominal discomfort

Pyramidalis : Feeling of abdominal fullness

Somatovisceral Pain

Myofascial TrP’s can induce visceral disturbances and dysfunction.

For instance Lower Rectus Abdominus TrP’s can induce diarrhea.

Viscerosomatic Pain

A reciprocal influence of visceral structures on somatic regions including muscles can be equally important. Example being the reflex spasm of the abdominal wall in response to the inflammation of acute appendicitis.

Contraindications

  • Deep head over the abdomen on clients with cardiovascular concerns
  • Recent abdominal surgery
  • This treatment can significantly increase motility ( CI’d if client has diarrhea)
  • Crohn disease
  • Ulceration colitis

Pelvic floor dysfunction as a cause or result of constipation:

Pelvic floor dysfunction is caused by a weakness of the muscles in the pelvis surrounding the anus and rectum. However, because this group of muscles is voluntarily controlled to some extent, biofeedback training is somewhat successful in retraining the muscles to function normally and improving the ability to have a bowel movement.

Follow us at our Massage Therapy clinic in Oakville, there is more blogs to come!

Constipation, Part II

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In this blog we will continue discussing the Constipation topic and we will see more in details how our digestive system works and what can effect it

Retention of hard or putty like stool in the rectum which interferes with the normal passage of feces. It can be masked by watery diarrhea pushing past it. It is usually accompanied by pain and abdominal distension.

Actions of the digestive system

  1. Peristalsis : wavelike contractions of the gastrointestinal tract that move the contents through the system.
  2. Mass movements: in the large intestine, contractions are larger and less frequent – called mass movements – they help eliminate feces.

Transit time

From ingestion to elimination, it should take anywhere from 24-48 hours it can vary anywhere from 3/d to 1/3 days

  • Increased transit time – if the food remains in the system for longer duration then more water is absorbed by the large intestine – this results in hard, usually smaller stool.
  • Decreased transit time- if the food remains in the system for shorter duration then there is less opportunity for the large intestine to absorb water – this results in loose, watery stool.

Causes/Factors that influence transit time:

  • Failure to respond to the defecation reflex
  • Stress: increases activity of the sympathetic nervous system
  • Diet: fibre decreases transit time, fat increases transit time, dehydration increases transit time
  • Dehydration
  • Postural faults: hyperlordosis scoliosis, tension through certain muscles or muscle groups can affect digestion ( iliopsoas, abdominals, diaphragm…) – look at work (prolonged positions )
  • Increased age and weakness of the smooth muscle in the intestines Muscle weakness and inactivity, which impede defecation ( especially in the elderly)
  • Scar tissue in the abdomen will affect GI function – draws everything towards it
  • Post – surgery : the body is in a state of flux and the GI system tends to decrease its function
  • Pregnancy
  • Obstruction caused by tumors
  • Medications, narcotics CNS depressants slow peristalsis. Diuretics, calcium, and iron.

Neurological disorders that might affect our digestive system:

  • Multiple sclerosis
  • Parkinson’s disease
  • Stroke
  • Spinal cord injuries

Metabolic and endocrine conditions that might affect our digestive system:

  • Diabetes
  • Uremia
  • Hypercalcemia
  • Poor glycemic control
  • Hypothyroidism

Systemic disorders that might affect our digestive system:

  • Lupus
  • Scleroderma

What are the Signs and symptoms of constipation:

  • Changes in ‘normal’ pattern of bowel movements
  • Straining when defecating ( unproductive urges )
  • Hard / pellet – like stool
  • Abdominal or low back pain
  • Bloating / flatulence
  • Headaches, malaise, halitosis, nausea, lack of appetite
  • Hemorrhoids
  • Abdominal pail / distension ( a sense of incomplete emptying )
  • Hard feces can irritate the psoas and cause trigger points and low back pain

Follow us at our massage therapy clinic blogs in Oakville and find out how massage and self-care might assists in decreasing the symptoms of constipating

Constipation

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In the next couple blogs we will discuss what Constipation is and how Massage therapist can play a very important role in it.

What is exactly Constipation?

Constipation is a slow, difficult, or infrequent movement of feces through the bowel. Bowel patterns differ among individuals, abnormalities are relative to the individual’s normal pattern. Constipation is a condition where are less frequent bowel movements than normal and hard stools results.

Functional constipation – there is no underlying medical condition that can usually be managed with self-help measures. The bowel is healthy but not working properly.

  • Colonic inertia, delayed transit.

Chronic constipation – can be caused by several conditions

  • Colonic disorders IBS
  • Pelvic floor dysfunction
  • Symptoms present for more, approximately 3 months.

Secondary constipation – causes of secondary constipation include:

  • Colon cancer
  • Endocrine condition
  • Medication
  • Neurological disease

Follow our Massage Therapist clinic in Oakville for further information about Constipation.

Ginger Poultice

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Modern science now confirms that ginger has over 100 distinct health benefits. Ginger easily penetrates into the body. Ginger compress can exert its influence even within solid organs such as the kidneys and liver, or within the lungs.

What are the properties of Ginger?

  • Increase circulation
  • Detoxification
  • Digestion ( may decrease intestinal gas)
  • Stimulant
  • Sedative
  • Anti-inflammatory
  • Antiseptic
  • Increases Immune system function
  • Diaphoretic – induces sweating
  • Diuretic – increase the amount or frequency of urination
  • Analgesic – relieve pain
  • Strengthens kidney function

How are we going to prepare our poultices?

Apply grated ginger to cheesecloth or paper towel and apply to the area or simmer ginger root in the water, or add powdered ginger to boiling water. Soak a folded cloth in the water and apply to relieve pain, or to bring blood to surface of congested area. Ginger may also be used for a foot soak or bath to reduce pain.

What is the common Indication?

  • Acute or chronic pain (rheumatism, arthritis, backaches, cramps(intestinal, menstrual cramps etc..), kidney stones attacks, toothaches)
  • Digestive system: colic, diarrhea, flatulence, heartburn, loss of appetite, dyspepsia, stomach cramps, ulcerative colitis.
  • Respiratory system: used as an expectorant, chills and allergic rhinitis, sinusitis, chronic bronchitis.
  • Speed recovery from inflammation conditions and injuries
  • Kidney stones, gallbladder stones, cysts(breast, ovarian) and benign tumors such as uterine fibroids

But there are some contra indications as well ( we would stay away of those specific application areas)

  • Ginger compresses over the brain
  • Elderly or very young people
  • Pregnancy
  • Appendicitis or pneumonia
  • Fever

Follow our blogs at our Massage Therapy clinic in Oakville.

Application of Cabbage

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Let’s discuss the effect of Cabbage on our body, and why it can help us?

For areas of inflammation, cabbage leaves can be applied cold. Cabbage has anti-inflammatory properties that can reduce inflammation. For chronic conditions, it is applied with heat Break ridges or veins.

It is most useful in the treatment of arthritis, chest infection, laryngitis, tonsillitis and mastitis.

Indications/Effects:

  • Warms, Detoxifies, Stimulates
  • Ulcers
  • Varicose veins
  • Shingles
  • Eczema
  • Gout
  • Infection, Mastitis, Breast Congestion
  • Premenstrual breast tenderness
  • Lymphedema
  • Sprains

Making a cabbage poultice:

Lazy Man’s Version – Raw scoured or blanched whole cabbage leaves are layered on to a wet tea towel/cheesecloth and applied over an area. In condition presenting without inflammation, a warm or hot pack can be placed on top of the poultice. Saran wrap may be used if the pack is staying on the area overnight. Apply over liver for very powerful detoxification (10 minutes only). For conditions presenting with inflammation, scour a cabbage leaf and freeze before applying it to the area.

OR

  1. Finely chop green cabbage sufficient for the area to be treated
  2. Place the cabbage in a blender with just enough water to make a thick paste
  3. Spread the cabbage paste 1’’ thick over a piece of cheesecloth, muslin or a clean tea towel. The size should be sufficient to cover onto the Desire part of the body
  4. Place the cloth, cabbage side onto the skin, over the area to be treated
  5. Cover with a clean, dry cloth then wrap the whole area in a thick towel or wool flannel cloth.
  6. Leave the cabbage poultice in place for 15-60 minutes depending on the severity of the condition and the reactions of the person.
  7. After removing the poultice wash the area with tepid water.

Follow up our Massage clinic in Oakville to get more information in a next blogs for additional types of Poultices & Packs.

Mustard Poultice

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Mustard Poultice

Let’s discuss why Mustard can be helpful for us and what the indications to use Mustard are.

Indications:

  • Arthritis (more caution should be used for people with Rheumatoid Arthritis)
  • Poor circulation
  • Head/Chest colds and congestion
  • Pain relief (through counterirritant)
  • Bronchitis

Method:

  1. Mix 1tbsp mustard powder with 4-8 tbsp flour. Double or triple the amounts according to the size of the poultice required. Moisten the mixture with tepid water until a paste-like consistency is achieved.
  2. Place the Mustard mixture on paper towelling and fold to make a packet or wrap in muslin/cotton. Reminder – Some herbs like mustard can be irritating to the skin. Potentially irritating additive should be put between two pieces of cloth before applying.
  3. Warm the pack for 5 minutes by placing it on a heat source.
  4. Oil the skin lightly and place a thin cloth on the area to be treated. Apply the mustard pack and cover with a blanket. At first, the pack will seem very hot, so as passive hyperaemia occurs, the pack can be moved from area to area. Apply the pack to each area for 2-10 minutes. The entire treatment should last 15-30 minutes.
  5. Mustard foot bath – 1tbsp of powered mustard to 1 or 2 gallons of water in a foot bath for 15-20 minutes. Use a cold compress around the neck. Indication/Effect – Cold, Flu, Headaches, Dysmenorrhea, Sore throat, Pelvic and Prostatic Condition (decrease internal congestion and pain).

Follow up our Massage clinic in Oakville to get more information in a next blogs for additional types of Poultices & Packs.

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