Author: Carmen Satre

Neck & Shoulder Pain: Why Won’t It Go Away?

first ribThere are those of you suffering from chronic pain or spasms in your neck, shoulder(s), or mid-back. You’re beyond frustration. You’ve tried several healthcare providers, including chiropractors and physical therapists, all issuing different treatment plans but nothing has helped. You’ve even tried massage but that provided nothing more than temporary relaxation. X-rays and MRI results are normal. What is going on and why can’t you find relief? The answer could be First Rib Fixation Syndrome. A lot of people haven’t heard of this and don’t realize they have it.

What Is First Rib Fixation Syndrome?

Doctors tend to overlook this syndrome as part of their first examination and diagnosis. It’s easy to miss, which is too bad because an elevated first rib can cause a plethora of symptoms and complications, leaving someone to suffer unnecessarily for years. This syndrome can be a long-held issue developed over time. Common causes include bad posture, long hours at the desk, over exercising, moving heavy objects, having a physical job, or possibly sustaining an injury.

Fix upper cross posture issues with massage therapy in Des Moines, IA.Over time, a muscular imbalance occurs known as The Upper Crossed Syndrome which elevates the first rib. When this happens, shoulder muscles (the subscapularis and infraspinatus) load up with trigger points, resulting in weakness and pain. With muscles now compromised, the shoulder is unable to move normally. People then tend to compensate for the pain by rounding the shoulders forward and jutting the head out further from the neck. The neck muscles (scalenes, serratus anterior, and sternocleidomastoid) overcompensate and develop more active trigger points. Referred pain from these new trigger points manifests as what may seem like random, erratic symptoms. Since these muscles attach to the first rib, even more elevation occurs. The trapezius muscle in the back then goes into immediate self-protection mode, resulting in tightness and spasm. This has a tendency to compress the brachial plexus and subclavian artery to eventually throw the person into a possible state of Thoracic Outlet Syndrome. Vicious, isn’t it?!

Sleeping habits play a large part in the development and treatment of this syndrome. Elevated first ribs typically occur in stomach sleepers. Some sleep with one arm tucked under their head, or sleep with minimal or multiple pillows. These now compromised muscles work extra hard if the person spends long hours working in front of computers using a mouse or has an intense job with repetitive movements. Changes in sleep style post treatment speed recovery and help prevent trigger points from reforming.

Also, all athletes should be evaluated as an elevated first rib is common in that type of lifestyle, particularly tennis players and weight lifters.

Symptoms

  • Shoulder pain
  • Neck pain
  • A heavy hurting feeling or throbbing in the arm
  • Dull achy pain and tightness in upper back and shoulders
  • Headaches
  • Trapezius spasm
  • Radiculopathy (a neuropathy)
  • Jaw pain
  • Mid-back pain
  • Paraesthesia (tingling, prickling, or burning)
  • Chest & sternal pain

Treatment: Can It Go Away?

Whiplash and thoracic outlet massage Des Moines, IA.So what do I do that’s different than others? When someone presents a certain set of physical complaints that resemble this syndrome, I palpate effected areas for tenderness, spasm, and edema. A person will automatically jump or pull away when an elevated first rib is touched. Through various soft tissue mobilization techniques (MFR, PNF, ART, TPT, Gua ShaMassage Cupping) active and latent trigger points in almost all of the muscles listed above are manipulated until pain ceases. This can take as little as one treatment for someone to experience immediate relief but can take up to a handful of sessions for more aggressive cases (those with repetitive work-related movements that reform trigger points). These sessions are different than “typical” massages as the entire time can be spent on removing and breaking up the trigger points. This is aggressive and intense so I am sure to only work within the person’s tolerance level.

If this sounds familiar, please contact me. Again, this is a great example of the kind of pain you don’t have to live with. Let’s knock it out so you can feel good in your skin again.

Carmen Satre
Carmen Satre

See you on the table!

Beat The Heat

OLYMPUS DIGITAL CAMERAThose of us living in four season states have a comedic annual ritual. The long winter drones on day after day… A break in the cold finally happens… The shorts and flip-flops come out of the closet and we take full advantage of the first weeks of hot weather and full on sun! It’s a fun tradition. What’s not so fun is overdoing it and feeling the awful effects of heat exhaustion, or worse, heat stroke. Whether you spend long hours in the garden or run more miles outside than you’ve been used to during the Winter there are a few tips to survive the heat wave outside.  The key is to analyze the symptoms and then learn how to respond or better yet, prevent.

Heat Syncope

Symptoms include fainting and light-headedness that usually occurs at the end of exercise.

  1. If you begin to feel faint, get out of the heat and rest in a cool place drinking cold water.
  2. Elevate your legs.
  3. Most likely you will experience “heat cramps” – tight muscles or spasms after intense exercise. To relieve these, massage and stretch the cramped muscle and drink more cold water.

Heat Exhaustion

Heat exhaustion is similar to heat syncope but accompanied with nausea, vomiting, headache, fast breathing, and poor coordination. Most people in this state still try to get through their current activity but Don’t!

  1. Find a cool, shaded place to cool down.
  2. Remove as much of your sweat-soaked clothing as possible and use cold, wet towels to cool the skin.
  3. Elevate your legs and drink water or a sports drink to replenish lost electrolytes.
  4. DON’T jump into an icy bath as this cooling method is too rapid for the body to adjust.

Heat Stroke

Heat stroke is the second leading cause of death in athletes yet totally preventable. It’s a small step from heat exhaustion to full-blown heat stroke with symptoms being hysterical behavior, delirium, blacking out, and weakness. It’s a myth that dry skin signals heat stroke – the sweating mechanism is still working. If you see someone displaying this behavior do the following to help them:

  1. Cool the body as quickly as possible and call 911.
  2. While waiting for EMS, move the person to a cooler place and swap their clothing with ice packs, cold towels, etc.
  3. Massage in this instance is very effective in increasing circulation in the extremities.
  4. If the person starts to shiver, remove all cooling devices as shivering is our natural way to increase core temperature, which needs lowering in this moment.

Follow good prevention during the hot Summer by staying well hydrated, increasing consumption of good food made up of mostly fruits and vegetables, and exercising in moderation.

Carmen Satre

See you on the table!

Blog written by Carmen Satre of Massaveda

Is it good to get a massage when sick?

blow your noseIt used to seem like cold and flu season only hit in the winter time. Lately people are suffering from viruses year-round. A great question I hear regularly is, “I’m sick. Should I come in to have you push it out faster?” While it’s true that massage has wonderfully detoxing effects and enhances the immune system, getting a massage while in the throes of fever and sickness could be too taxing on the body. So what are some pro’s and con’s of receiving massage while sick?

Massage releases stored toxins in the system and flushes them out quickly. Sounds great, right? Absolutely, however during sickness, the body is already overloaded waging war on the virus. If the body then has to continue that war yet wage a new battle to remove newly released toxins, you could not only feel much worse in the short-term, but experience a longer recovery time. Based on whatever your work schedule is, the best thing could be to cancel the appointment, stay home and rest.

Each person is different depending on their history of how they handle being sick, the preventative healthy lifestyle being lived out, and the natural state of their immune system. The difference between a nasty head cold and full-blown flu symptoms are two different things. If a massage occurs at the onset of a bad cold, hang on – the cold’s intensity will happen in 3-4 days vs. spread out over 7-14 days. If your schedule can handle that then definitely have the massage quickly detox you. Massage works wonders clearing out the lungs and sinuses from all the mucus and drains the body of bacteria and virus. Massage brings relief to sore rib and back muscles fatigued with excessive coughing. Massage relieves sinus pressure and headaches.  Illness can quickly feel isolating too. Massage instantly helps the body AND mind feel safe and protected as it engages in serious battle.

In massage sessions, I regularly use essential oils containing anti-viral and anti-bacterial properties. Applying these oils provide relief from symptoms as well.

On the con side, the other thing to consider is the spread of infection. Massage typically takes place in a small enclosed room running at a warmer temperature than usual. Viruses love that! Aside from small fans and the possibility of an air purifier, there are no open windows for ventilation. An hour session is a long time for a virus to spread not only to the therapist, but all the objects housed in the room. Clients coming in right after are then susceptible for being contaminated by the spreading of that same virus. Having said that, I regularly use anti-bacterial and anti-viral cleaning agents and oils after EVERY client to quickly minimize the spread of infection before the next session begins.

A Few Rules:

  1. If you have a fever – stay home.
  2. If you know you’re contagious – stay home.
  3. If you’re already nauseas, even slightly – stay home. Massage will only increase this feeling with the release of new toxins in the system.

So What’s The Answer?

The best rule of thumb is be cognizant of what you have and decide accordingly. If your body is aching for touch and the schedule allows you for the possibility of being down in bed for a day or two afterwards, keep the appointment. If your skin is already sensitive to touch and fever is involved, a nice hot bath and bed rest may be the better option. I encourage both decisions because we all handle illnesses differently. I’ll be available, either way, because we’re all in this together.

Carmen Satre

See you on the table!

Blog by Carmen Satre with Massaveda

Heat or Ice – Which Is It?

I hear a lot of confusion in the massage room about when to use heat over ice. Of course heat feels amazing but sometimes icing an injury feels good too. The use of heat and ice are equally important in the self-care process of muscle management. They each have specific uses but need applied at the right time or they could exacerbate an issue.

Heat Vs. Ice

Icing, or cryotherapy – is for injuries except for low back pain
Heat, or thermotherapy – is for muscles

Cryotherapy and massage in Des Moines, IA.Choosing ice over heat for injuries is very important as icing calms damaged and inflamed tissues. These tissues are already swollen and carrying heat, a normal process for the body, although painful. Adding heat during this time feels great initially but only creates increased pain and swelling. Not what you need in a time of trying to resume daily activities.

Choosing heat for muscles is great for muscle spasms or pain from knots and trigger points. Icing muscle spasms or trigger points can actually make them worse. Picture being surprised with someone splashing cold water on you or someone coming in from the cold outside and putting their hands directly on your skin – the entire body contracts. This is what happens when icing trigger points and spasms, both already in a state of contraction. Severe spasms and trigger points can feel like knife blades and it’s a common mistake to run for an ice pack. But icing these tissue issues causes the muscles to contract even harder, and the trigger points to burn more intensely. Trigger points and muscle spasms calm down with heat.

Heat also relieves psychological stress, which is a major factor in pain issues. At the end of a hard day’s work it’s a great idea to throw heat on tight neck and shoulder muscles or on leg muscles after a work-out.

What About A Muscle Strain or Tear?

This one is debatable but ice is generally preferred. If the muscle is truly injured, ice only for the first few days. Use ice to bring down the initial inflammation and help numb the severe pain. Once this phase is over replace with heat.

Always Cold or Over Heated?

Heat therapy and massage in Des Moines, IA.It’s not a good idea to use heat if you’re already sweating or overheated. And ice will only make you feel worse if you’re shivering. The brain may misinterpret these situations as an excess and a threat. Shake things up to help out the brain. If you experience an injury but you’re already freezing, warm up in a hot shower and then throw an ice pack on the injury afterward. Or bundle up in a robe and blankets during cryotherapy. Same with heat. If your legs are cramping and you’re overheated from the work-out, jump in a cool shower then slowly turn up the heat to help relax the muscles.

Do Not Ice Low Back Pain!

Except for a direct injury from whiplash or a muscle tear where inflammation is definitely present, do not ice a low back injury. This is a common point of confusion even within the healthcare industry. Common low back pain, the feeling as if the back “is out”, is not from an injury or trauma causing inflammation. Painful trigger points, knots/adhesions, and the low back muscles being weak are the common causes of low back pain. When the low back feels like it’s out, icing will only make that feeling worse. Always Heat.

Hopefully this clears up some confusion. Using the above information as a guideline, choose the therapy that feels right for your body at the time and help speed up the healing process.

Carmen SatreSee you on the table!

Blog written by Carmen Satre with Massaveda

Skin Brushing

skin brushingAwhile back a client recommended I look into skin brushing. The first thing I thought was, “That’s all I need, another process in my life!” I heard great things about skin brushing but didn’t think it necessary to add to my already busy schedule. Then another client recommended it – I began to take the hint. My rule of thumb is if more than one person recommends something it’s worth checking out. So I jumped online to order reasonable brush to try this long-held procedure (dating back to the athletes in Greece).

I’ve been skin brushing DAILY for 44 days now and yup – definitely hooked! I skin brush every morning before showering (yes, you skin brush on dry skin) and from day one have found it an immediately invigorating experience. It’s as if every part of my body truly wakes up for the day and is ready to take on anything. It seems like something just for the ladies but is extremely effective for men as well.

What Exactly Is Skin Brushing?

Skin brushing is the daily jump-start to your lymphatic system! Remember from the Massage Biology 101 entry that this system is our body-guard. It does the following to keep us going in our lives:

  • Strengthens the immune system overall
  • Increases the number of natural killer cells and their activity
  • Relieves stress
  • Waste removal for our circulatory system
  • Eliminates toxins
  • Improves blood circulation and removes sweat (great for athletes)
  • Diminishes spider veins over time

What’s this mean and why am I writing about it? We can get over the bad stuff quicker and with more energy: colds, viruses, flu, Candida, cancers, etc. This is a fantastic self-care routine to aid regular massage. As massage flushes the lymphatic system as well, daily skin brushing will keep the body clean going into the appointment, which means even more effective massage sessions with quicker benefits!

Skin brushing is so easy it’s a bit embarrassing I haven’t been doing this and promoting it from the beginning of my massage career. It fits easily into the daily routine and only takes 5-10 minutes before a shower to do.

Ok, But Why Skin Brushing?

Our skin is the largest organ in our bodies. We overlook it as a rule but it’s actually responsible for 15% of our toxin elimination. Skin brushing removes the top layer of our skin, the dead cells, to encourage new cells to grow. By unclogging pores, toxins are eliminated with more efficiency. What else does skin brushing do for us:

  • Improves lymph drainage
  • Releases toxins
  • Encourages new cell renewal
  • Promotes tighter skin
  • Boosts circulation
  • Exfoliates
  • Reduces cellulite

Choosing A Brush

Skin brushing helps your massage in Des Moines, IA.The type of brush used does make a big difference, and it doesn’t have to be pricey. Natural bristles are a must as synthetic bristles scratch and contain toxic chemicals, which defeats the purpose of skin brushing. The bristles should be fairly stiff as firmer bristles with have a greater effect on your circulation. I purchased the Yerba Prima Tampico Skin Brush off Amazon. Buy-in is only $10 and it does a great job. It has a removable handle which makes for easier access around the body. There are more expensive ones for serious “brushers” and one day I may graduate up to the big leagues. But for now, this one treats me well.

How To Do It

There is a very specific routine for skin brushing. To help boost the lymphatic system a rigid order and natural flow need to occur. For the beginning routine I use feel free to email me and I’ll send it your way. Remember, every bit helps in getting us all feeling good in our skin again.

Carmen Satre
Carmen Satre

See you on the table!

Blog written by Carmen Satre with Massaveda

What About Me?

I hear this question quite often: “Do you work on my issue?”  It’s a valid question and yet makes me smile every time I hear it asked.  The answer: most probably yes!  Any issue stemming from a muscular irritation, pain or annoyance is most likely treatable by massage therapy.  So this month I thought I would list different issues as well as occupational hazards I actively work on with clients.  Hopefully this selected list will help if you have found yourself asking the same questions.

  • Workman’s compensation issues (construction accidents, etc.)
  • Sports training
  • Sports injuries
  • Repetitive work injuries such as carpal tunnel, stiff neck, frozen shoulder, etc.
  • Depression
  • Numbness and tingling down the arms and into the fingers
  • The feeling that the low back “just went out”
  • Pre-natal comfort
  • Infertility
  • Recovery from a miscarriage
  • Whiplash, even from accidents occurring years in the past
  • Recovery from surgeries in reducing scar tissue and restoring muscle tone
  • Military issues stemming from training and daily maneuvering
  • Multiple sclerosis
  • Age related issues to keep muscles supple into the golden years
  • Panic attacks
  • Balancing muscle tone in neurologically related issues
  • Sciatica
  • Fibromyalgia
  • Relief from Ehlers-Danlos symptoms
  • General stress relief
Carmen Satre
Carmen Satre

See you on the table!

Blog written by Carmen Satre of Massaveda.

TMJ Disorder – Do You Have It?

Countless people suffer from chronic pain stemming from TMJ Disorder. The symptoms are nagging and constant. But TMJ Disorder is a condition easily confused with muscle tightness in the jaw. Fortunately there is lasting relief from both types of pain with massage therapy. So what’s the difference between the two and how does someone know which they have?

TMJWhat Is TMJ?

TMJ stands for the temporomandibular joint, which everybody has. This is the hinge joint that connects the lower jaw (mandible) to the temporal bone of the skull, in front of each ear. These joints are flexible and allow the jaw to move smoothly up and down and side to side, allowing us to chew, talk, yawn, etc. The muscles attached and around the joint are what control the position and movement of the jaw.

What’s TMJ Disorder and Its Symptoms?

Temporomandibular joint disorder (TMD for short, thankfully) occurs as a result of problems in the joint (and disc) where the jawbone meets the skull. One of the common symptoms is clicking, popping, or grating sounds in the jaw joint when talking or chewing. Pain could be involved but not necessarily. Other symptoms include:

    • Pain or tenderness in the face, jaw joint, neck and shoulders. Pain could also occur in or around the ear when chewing, talking, or opening the mouth wide.
    • Inability to open the mouth wide.
    • Jaw becoming “stuck” or “locked” in either the open- or closed-mouth positions.
    • A feeling as if the upper and lower teeth are not fitting together properly.
    • Swelling on the side of the face.
    • Possible toothaches, headaches, neck aches, dizziness, earaches, hearing problems, upper shoulder pain, and tinnitis (ringing in the ears).

How is TMD Diagnosed?

There are many other conditions causing similar symptoms to TMD, therefore it is very important to have a dentist conduct a careful examination of the entire area. The dentist will look for specific limitations in range of motion or jaw locking as well as a wearing away of the joint. X-rays may be involved as well as CT scans or MRI.

What Causes TMD?

There are many causes of TMD such as injury causing whiplash, jaw abnormalities, and poor posture. Other causes include:

    • Constant teeth grinding or clenching, which puts pressure on the TMJ.
    • Dislocation of the soft cushion or disc between the ball and socket of the joint.
    • Osteoarthritis or rheumatoid arthritis in the TMJ.
    • Stress resulting in a constant tightening of the facial and jaw muscles.

What’s the Fix?

Some medical professionals may recommend surgery and orthodontics to correct the problem, however more natural solutions have been found to be long-lasting and much less invasive and expensive. The National Institute of Dental and Craniofacial Research recommends gentle stretching and relaxation exercises to increase jaw movement. Massage therapy mixed with stretching and exercise of the muscles involved significantly loosen up the entire area, freeing the jaw of pain and discomfort. After only one or two sessions people find such relief that many have put away their mouth guards and report a better quality of life. 

Masseter muscle of the jaw
Masseter muscle of the jaw

What If It’s Only Muscle Tightness?

Outside of TMJ issues, the main muscles involved in everyday jaw tightness or discomfort are the masseter muscles. The masseter muscle is the primary chewing muscle. With regular talking, chewing, and stress these muscles develop “knots” (or adhesions) and trigger points  just like any other muscle in the body. Most people don’t realize these muscles are involved with headaches, neck aches, and shoulder tension. These can be flattened out and removed to loosen the muscle so it can return to its natural resting length. It’s so fun to loosen these during a session and hear people say, “Wow I didn’t realize how tight I was in there. I feel so much better!”

I work on both conditions of muscle tightness and TMD daily with high success. With a specific combination of modalities for each, the jaw area immediately loosens up, decreasing stress and tension in the head and neck. After a session, I provide daily exercises and stretches for the jaw to keep the area from tightening.

Another wonderful sigh of relief that you don’t have to live with the pain, even if it’s only nagging. Feel good in your skin again today.

Carmen Satre
Carmen Satre

See you on the table!

References:

http://www.webmd.com/oral-health/guide/temporomandibular-disorders

http://www.livestrong.com/article/305729-tmj-exercises-for-jaw-popping/

http://www.mayoclinic.com/health/tmj-disorders/DS00355

Thoracic Outlet Syndrome

Thoracic Outlet Syndrome (TOS) is a painful medical issue with painful medical procedures, but certain techniques of massage can bring pain relief, reduce inflammation, and decrease healing time. There is much controversy among physicians and diagnosing this syndrome is very difficult. It is often confused with carpal tunnel syndrome, brachial plexus syndrome, rotator cuff syndrome, and bursitis.

What Is the Thoracic Outlet?

TOSThe term “thoracic outlet” refers to the entire area defined by scalenes and the first rib, or to the passage between the anterior and middle scalenes. On their way to the arm, the axillary (subclavian) artery and brachial plexus pass between these two muscles, then between the first rib and the clavicle. They can become entrapped at some point in this area by tightness in the anterior and middle scalenes. It is sometimes difficult to distinguish pain referred by the scalenes from pain resulting from entrapment of the brachial plexus.

How Do I Know if I Have Thoracic Outlet Syndrome?

TOS is impingement of the brachial plexus nerve bundle and the blood vessels going to and from the arm. As a reminder, a syndrome is a collection of specific symptoms that is not a true pathological condition.

Symptoms include:

  • Edema
  • Numbness
  • Tingling sensations
  • Weakness of the upper limbs
  • Paresthesia (pins and needles)
  • Shooting pain
  • Feeling of fullness
  • Possible discoloration in the area due to diminished circulation

To diagnose this problem, a doctor or therapist will have you move your neck and shoulders in specific directions, which may result in a nerve entrapment or pinching sensation. They will also ask you to lift your hands above your head and open and close them for a few minutes. If you feel pain, numbness, or heaviness, you may have this disorder.

What Causes TOS?

There are various causes that produce symptoms of pressure on structures such as nerves (in the brachial plexus) and blood vessels that exit from the thorax (posterior to the clavicle) to enter the limbs:

  • Cervical or rib misalignmentTOS anatomy
  • Tight muscles
  • Spasm of neck muscles (scalenes) or other muscles such as the pectoralis minor lying close to the structures passing through the outlet
  • Atrophied muscles, muscle degeneration
  • Herniated intervertebral disk
  • Spondylosis (a bone spur at the nerve root)
  • Whiplash
  • Postural changes during pregnancy
  • Any activity that causes enlargement (weight lifting or weight gain) or movement (exercise or injuries) of the muscles in this area

So Can Massage Help?

Massage IS indicated for TOS if muscle tightness or spasm causes the impingement. If there are any causes other than muscular tension, massage is contraindicated for that local problem area.

Massage helps by:massaging

  • Relaxing the area
  • Increasing circulation
  • Reducing inflammation
  • Speeding up the healing time

During a session, focus is on the muscles of the neck, shoulders, arms, and upper back. The upper chest and arm area is also a focus. Overall treatment for TOS includes specialized exercise routines, massage therapy techniques, possible physical therapy, and in some severe cases, surgery.

If symptoms do not diminish with massage, impingement may be due to another cause and such clients should be referred to their healthcare professional to get a diagnosis and treatment plan. While the condition is present, avoid being in prolonged positions with the shoulders and arms, such as sleeping on arms, changing desk orientations to increase ergonomics, and so on.

Again, you don’t have to live with the pain. Choose to start the healing process today.

Carmen Satre
Carmen Satre

See you on the table!

Blog written by Carmen Satre with Massaveda

Reference:
Introduction to Massage Therapy, 
second edition, Mary Beth Braun, BA, MT, NCTMB & Stephanie J. Simonson, BS, MT

The Massage Connection: Anatomy & Physiology, second edition, Kalyani Premkumar, MBBS, MD, MSc (Med Ed), CMT, PhD

Thoracic Outlet Syndrome & Massage, http://www.massage-education.com/thoracic-outlet-syndrome.html

Trigger Points: What Are They?

Massage Therapy is a very confusing field now. Not being covered under insurance leaves the door wide open to what falls under the heading. A given massage therapist practices anything from spa relaxation to physical therapy type work.

To clarify what I do, the type of massage therapy modality I specialize in is “Neuromuscular Therapy” or “Trigger Point Myotherapy.”

What’s a Trigger Point & Why Work It?

“Trigger points” (TrPs) are tender points in soft tissue that radiate or refer pain to distant areas. These are found all over the human body usually in the belly of a muscle. Once formed, they radiate pain out from the belly similar to a wrinkle in a sheet or a ripple on the water, this is the referred pain felt. Trigger points are produced by muscle stress, such as overwork, repetitive motion, or sudden excessive stretch.

There are four types of trigger points:

  1. Active TrP – one that is spontaneously producing referred pain.
  2. Latent TrP – one that produces pain when pressure is applied during palpation.
  3. Primary TrP – one that is caused by muscle stress.
  4. Satellite TrP – one that is produced secondarily by a primary trigger point.

carmen massageHow Do They Go Away?

Trigger points generally stay inside the muscle until manipulated away. In layman’s terms, when a muscle is over-stressed it feels compromised and immediately protects itself. This tightening process forms TrPs within the muscle. Muscles are very stubborn and don’t forget experiences easily, hence the term “muscle memory”. Muscles will hold on to this protection until a manual process occurs which tells the brain to send a signal to the muscle that it’s safe to relax and return to a normal resting length. This is what I do.

Pressure is placed directly into a tight or sensitive trigger point area, which often causes radiating pain, and held until the tenderness disappears. This process repeats running along the rippled path of the TrPs. There is a delicate balance between applying enough pressure to release it and applying so much pressure that the TrP worsens. Releasing the points encourages increased circulation to the area allowing the underlying tissue to soften. This is the point when clients say, “I didn’t even know that hurt until you found it! How did you know that was there?”

What Is Neuromuscular Therapy?

Neuromuscular Therapy is also called Trigger Point Myotherapy. This technique alters the length muscles to teach them how to operate correctly. Muscles are manipulated back into the shape originally intended. Less is more during this treatment session to avoid bruising and soreness. This type of therapy consists of alternating levels of concentrated pressure on the areas of muscle spasm to release the lactic acid from the muscle, resulting in increased blood flow and oxygen. Fascia is also stretched to keep the body loose. If the shell of the body is loose, the muscles can loosen and relax back into their natural form.

Causes of Trigger Points 

The common cause of trigger points results from various forms of trauma, ranging from a direct injury, excessive stretching, heavy lifting and twisting, or even emotional stress. These sensitive regions will often activate pain in referring areas. Once we eliminate the trigger point, massage aids in removing the waste products and restore circulation to the area.

Some trigger points will be more severe than others and patience is the key factor during the session. Less severe TrPs will release almost immediatley. More severe ones need worked longer. The reason the experience is so worth it, however, is that there is animmediate relief as soon as the TrP dissipates. There’s no waiting 3-5 days to see if the session was a success. You know right away.

Some severe trigger points can reform after a session. I always recommend icing the area worked after a session. The ice will increase circulation to the area and decrease inflammation, minimizing the odds of the TrP reforming.

Dr. Janet Travell is the person most often associated with trigger point therapy. She’s quoted as saying, “Active trigger points cause pain. Normal muscles do not contain trigger points. Individuals of either gender and of any age can develop trigger points.” Simple enough. Another great reminder that you don’t have to live with the pain. Come in and get those stinkers gone so you can feel good in your skin again.

Carmen Satre
Carmen Satre

See you on the table!

Blog written by Carmen Satre with Massaveda

Say No To Scar Tissue

I admit it, not everyone is as excited about scars as I am. I collect and count them as badges of honor. Much like tattoos, scars are visual stories leaving their marks on our physical bodies reminding us how we survive and strengthen. However, some scare are viewed as unsightly and distracting and some might not want the reminder of the experience. Good news! Scars can easily be broken up and minimized.

Scar Tissue Overview:

What is it?
Scar tissue is the growth of new tissue: skin or fascia, after injury.

How is it recognized?
Scar tissue on the skin often lacks pigmentation and hair follicles.

Is massage indicated or contraindicated?
Massage is contraindicated during the acute stage of any injury in which the skin has been damaged. In the subacute stage massage may improve the quality of the healing process.

What Is Scar Tissue?

Scar tissue is a special kind of fibrous connective tissue that forms when tissues are injured. It is unique because, unlike those in tendons and ligaments, the collagen fibers are not arranged in a parallel pattern. Because of the abundance of dense and irregular collagen fibers, scar tissue is strong but not as pliable as normal, healthy tissue. Serving as a replacement for other injured tissue, it cannot perform the functions of tissue it replaces, and its blood supply is minimal.

Extensive scarring can restrict normal movement, reduce or prevent normal circulation of blood and lymph, and impede or even prevent injured tissue from functioning properly. The structure of scar tissue depends upon where the injury occurs, but it usually has the same components as the original tissue, accompanied by an abundance of extra collagen fibers.

Types of Scar Tissue

There are two types of scar tissue, internal and external.

When soft tissues are compromised or injured, the body automatically responds to repair the damage. In phase II of the healing mechanism, collagen fibers are produced to splint the area and prevent further damage. New collagen fibers are relatively easy to align with the fibers of the original tissue, given gentle movement throughout phase III. Collagen fibers continue to be produced during phase III, and without enough movement, they become sticky and hard. As a result, the collagen fibers are difficult to realign and they easily develop into connective tissue adhesions, or scars, with far-reaching effects.

  1. External – the scars are visible when the integument (skin) is injured,
  2. Internal – but tissues beneath the surface of the skin can also develop scars. Invisible scars are equally capable of affecting structures in other areas of the body.

 What Does Massage Do?

Once a scar or adhesion is created in one area, it begins to pull on the fascia throughout the body. Remember – it’s all connected!

In the subacute and chronic stages of a skin injury, massage is indicated and can be very beneficial. Soft tissue work is the recommended treatment for superficial scar tissue and may be initially applied.

The quicker the adhesion is treated, the less likely it is to affect the rest of the body. Because of its patchlike nature, there is a tendency for all other tissues to pull in the direction of the scar, which can lead to more compensation patterns and fascial restrictions.

Once the scar has formed, massage on and around the scar tissue can increase the speed of healing by increasing circulation to the area, which prevents fascial restriction and increases mobility of the tissue. Scar tissue may have reduced sensation, so providing the therapist with regular feedback throughout the session is extremely helpful.

Methods to Release Scar Tissue

Releasing scar tissue is a very specific technique, both for internal and external scarring. I use a few methods to breakup both kinds of tissues including cross fiber friction, massage cupping, and Gua Sha tools.

Client Study: LH, External Scar

Last year LH had skin cancer removed just under her right nostril. Obviously she wanted that scarring diminished. The raw, untouched before/after photos below shows our progress in only 3 sessions of 15 minutes within a five-day period.

Scar tissue release at Massaveda massage therapy in Des Moines, IA.

LH’s scar tissue before session 2.

Scar tissue release at Massaveda massage therapy in Des Moines, IA.

LH’s scar tissue after 3 sessions.

Testimonial: Kim W., Internal Scarring

“Carmen is fantastic! After years of going to whatever massage therapist had an opening and always feeling underwhelmed I’ve finally found a keeper! Carmen believes in treating the cause of the problem rather than providing short-term relief and thank goodness she does. I have scar tissue and knots that have been around for half my life and have always caused me problems. Carmen worked with me to create a treatment plan that would address my problem areas and ultimately lead to an overall reduction in my scar tissue and muscle congestion. After only a handful of visits I’m already feeling relief where I’ve never felt relief before and am feeling better overall. Also, she doesn’t ask that you come in for an hour each time. She can spot treat your problem areas in 15-30 min if that’s all that’s necessary. The flexibility is key. I still have a long ways to go in my treatment but I feel I’m making great progress.”

Scars are just like pain, you don’t have to live with it and their effects can be greatly minimized.

See you on the table!

Carmen Satre
Carmen Satre

Blog written by Carmen Satre with Massaveda

Reference:
Introduction to Massage Therapy, 
second edition, Mary Beth Braun, BA, MT, NCTMB & Stephanie J. Simonson, BS, MT