|Remedial massage to relieve pain
"Tendon and Ligament Healing : A New Approach Through Manual Therapy ", William Weintraub.
Weintraub aims to show how manual therapy can heal tendon and ligament injuries non-surgically. The book is extremely informative in its clear, accessible descriptions of the cellular, neural, electrical and biomechanical levels of injury and healing and how manual therapy can assist complete recovery. It provides the professional bodyworker with specific explanations of how to work precisely with the microstructure of the tissue and will be of particular help for dealing with people who suffer from sports, overuse, or accident injuries.
"Spinal Manipulation Made Simple: A Manual of Soft Tissue Techniques", Jeffrey Maitland, Kelley Kirkpatrick.
This book focuses on the problem of joint fixations which often lie at the root of common soft-tissue pain syndromes. Jeffrey Maitland presents techniques for manipulating the soft tissues of the back in a safe, simple manner, focusing special attention on issues of back pain. He shows how to release joint fixations in the spine, sacrum, pelvis and ribcage using a gentle type of soft tissue manipulation, starting with extremely easy, safe techniques to help develop palpatory skills and leading on to further techniques which will release 'stuck' vertebral facets gently and effectively. (NO CRACKING OR SNAPPING!) Excellent drawings and photographs accompany the text for even further clarity. This book has been described as 'The most accessible book on this subject yet' and is highly recommended.
"Orthopedic Massage: Theory and Technique ", Whitney W. Lowe.
'Orthopedic Massage: Theory and Technique' is an excellent resource for those using massage to treat pain resulting from soft tissue injuries and disorders.
"Soft Tissue Release: A Practical Handbook for Physical Therapists", Mary Sanderson.
Mary Sanderson presents the techniques and rationale of STR, developed originally by Taws and Young, in a concise, easy-to-read way. Photos and diagrams show exactly how the technique is applied and the book is well organised making quick reference easy. 'Soft Tissue Release: A Practical Handbook for Physical Therapists' is recommended as a good introduction to a highly effective technique.
"The Whartons' Stretch Book
", Jim Wharton, Phil Wharton, Bev Browning.
'The Whartons' Stretch Book' Presents active isolated stretching in a clear, concise and eminently readable way. Practitioners will find this book invaluable in teaching clients short sequences of stretches. They really do make the difference between short-term and long-term relief from muscular imbalance and resulting pain. Not just for sports massage.
"Handbook of Osteopathic Technique ", Laurie Hartman. An essential guide for osteopathic techniques.
Modern osteophathic techniques, including indirect technique are featured with the use of photographs and detailed descriptions. In addition this text shows which techniques might be considered for different body types, and how to adjust for individual cases. This text aims to assist the practitioner in refining skills and directing further learning. The book is designed for students of osteopathy, but is also considered suitable for physiotherapists, chiropractors and manipulative therapists who wish to expand their knowledge of effective, modern, gentle osteopathic methods. Highly recommended.
Remedial massage is primarily used in the treatment of painful conditions or injuries involving soft tissue (muscles, tendons, joints) and ligaments.
Tense muscles or muscles in spasm cause pain and discomfort, for instance in the back and shoulders. Excessive stress can increase pain and tension in the muscles, resulting in general aching pain and headaches. Remedial massage will ease tension out of muscle tissue, speed the elimination of waste products associated with tense muscles and restore proper functioning.
Micro-tears in muscle fibres and fascia can bring intense pain. Scar tissue from old injuries causes shortening of muscles and fascia and accompanying immobility and pain syndromes. Remedial massage uses specific techniques to break down scar tissue, restore mobility and support the body's own repair process. See below for more information about micro-tears and remedial massage.
Trigger points are one of the main causes of chronic soft tissue pain, yet remain undetected (and ignored) by many in the medical profession. Myofascial pain syndrome, general, undiagnosed pain, as well as joint pain and muscle aches are often due to trigger points, which can be easily treated by a remedial massage practitioner. See below for more information about trigger points.
Muscular weaknesses and imbalances can occur, which lead to over-use of specific muscles and overload of particular joints. This in turn leads to damage and pain. Remedial massage is used to treat the injuries which cause imbalances and help restore properly balanced functioning of the musculoskeletal system.
Back pain, shoulder pain, neck pain, knee pain, headaches and joint pain are often caused by soft tissue injuries or disorders which are treated by remedial massage.
Injuries, weaknesses and imbalances rarely occur in isolation, and the whole pattern needs to be assessed and treated. A remedial massage practitioner will trace a problem back to its causes so that there is a chance for true healing to occur (rather than just the relief of symptoms) and so that recurrence can be minimised.
The causes of pain
Micro-tears, scar tissue, fascial shortening and biomechanical compensation
Damage to soft tissue (muscle, fascia and tendon) in over-use injuries and repetitive strain injuries, causes micro-tears in the fibres. If the affected area continues to be stressed through repetitive activities or incorrect posture, secondary tension develops around the tiny tears, to protect them from further use or stress. Repair takes place with the formation of scar tissue which can form hard, inelastic lumps. This process can continue virtually unnoticed for weeks, months and even years. However, as the same tissues are continuously over-used, the tension around the area of the scar tissue increases, and micro-tears form around the original injury in an ever-increasing radius. The fascia (muscle fibre wrapping) also becomes shortened and movement becomes increasingly painful. Sometimes continuous overload of the area can lead to a complete breakdown in which movement is impossible without severe pain. At the same time, the body has gradually adapted to the worsening injury, compensating for muscles which are not functioning well. Posture and balance are compromised, causing further problems.
A massage practitioner will trace pain or injury back to the originally affected area, and use specialised massage techniques to break down the scar tissue and encourage it to reform in a way that encourages mobility. Massage will also encourage and support the body's own healing and repair mechanisms. Secondary damage will be treated in the same way, in order to restore biomechanical balance and to prevent recurrence of the problem. The practitioner will also need to find out which particular activity, trauma or posture brought about the injury in the first place, and advise on what to do to prevent recurrence.
Remedial massage can help to repair the damage, stop secondary damage occuring, and release the soft tissue so that the same damage does not occur again in the future.
Trigger points: frequent cause of soft tissue pain
Trigger points cause symptoms such as pain (often referred pain, which can be as intense as pain from any other cause), muscle stiffness, weakness, nausea and dizzyness. Trigger points are tiny contractions of muscle fibres in a very small band of muscle tissue. Contraction takes place within the microscopic sarcomere of a muscle fibre, and a trigger point exists when overstimulated sarcomeres become unable to release their contracted state. To a practitioner it feels like a knot or a small lump ranging in size from a pinhead to a pea, lying along a taut band of muscle fibres. They are caused by accidents, falls, strains, postural stress and muscle over-use. They can lie latent within the muscle indefinitely (and don't actively refer pain), but they can also be activated by very little stress or strain. They are extremely painful when pressed upon. As they are soft tissue, trigger points cannot be seen on an X-ray. They occur at various points along individual muscles, often in predictable places, and are easily treated once found.
Often trigger points coexist with scar tissue and mysofascial adhesions (bits of soft tissue that get torn, leak and then stick together, causing pain when they are pulled apart by movement). A remedial massage practitioner will treat all three problems in different ways including soft tissue release, neuro-muscular release, deep tissue work, trigger point therapy and active and passive stretching exercises. Trigger points are painful when treated, but the pain goes within 15 - 20 seconds, and relief from the referred pain is often immediate. Trigger points can often return, so your practitioner will show you exactly how to treat them yourself.
What kind of diagnosed conditions can remedial massage help?
Remedial massage can help with over-use injuries and repetitive strain injuries. Tendon injuries such as tendinitis, tenosynovitis and peritendinitis benefit from massage. "Tennis elbow","frozen shoulder" and "runner's knee" are conditions which are often caused and exacerbated by trigger points in the muscles, which are treated with specific massage techniques. Major injuries resulting from a direct trauma from an external force or ultimately from repeated micro-tears (over-use) will benefit greatly from specific massage techniques at the various stages of repair in order for tissues to return to optimum functioning. Injuries to ligaments (sprains) involve secondary damage to surrounding soft tissue, and therefore massage is important to enhance repair of the whole area. Tears and injuries to fascia causing muscular and joint pain are treated with remedial massage. Fibrositis, fibromyalgia and myofascial pain syndromes, along with chronic fatigue syndrome are accompanied by soft tissue disorders, trigger points and fascial congestion which contribute to a vicious circle of pain and exhaustion. Sports injuries of all kinds need specialised massage treatment and rehabilitation programmes.