The common cold and your pain experience

Myotherapy as a profession has evolved considerably, even since I qualified in 2013. Myotherapy is sometimes still thought of as “targeted massage”; in reality this couldn’t be further from the truth. These days, as myotherapists, we take into consideration the person as a whole. Including lifestyle choices, in order to make well-informed decisions on how best to assist the person in front of us.

Something my wife said the other day really made me think about how we perceive pain in our own bodies. We were talking about how she was starting to feel sick and that it was probably because our nine-month-old hadn’t been sleeping well and also that she (my wife) was feeling a bit stressed.

In thinking this through it was immediately obvious that we weren’t only thinking about the problem (my wife feeling ill) but also attempting to figure out the underlying cause too. That night she decided to go to bed a bit earlier to catch up on sleep.  She also made plans to do some yoga once she was feeling better to help reduce her stress levels.

Rather than thinking, “oh I have a bug, I’ll deal with it” she automatically went through a thought process of working out what might be influencing her cold.  She then went one step further and changed her routine to address the lack of sleep and put measures in place to lower her stress levels, thereby actively influencing her health and function.

This made me wonder why, when we’re in pain, do we rarely consider what other factors might be at play either directly contributing to, or amplifying, what we feel?

One of my colleagues, Matt Jeffers from Muscle & Move Myotherapy in Melbourne, often likens  back pain to catching a common cold. This is his way of reducing the fear associated with back pain. In doing so, putting the experience into common ‘everyday’ terms. Incidentally, we now know that the immune system and the nervous system (which is responsible for the pain we feel) are physically linked (in our brains). So why not take that analogy one step further and turn our minds to those factors we know make colds worse,  and relate them to our experience of pain.

One of the great things about educating myself on pain is finding out how many different influences there are on pain: sleep, emotions, stress, past experiences, beliefs, to name but a few.  Moving away from a completely biomechanical model (where pain = tissue damage) really threw a spanner in the works for me as a practitioner and it still makes my head spin at times. So if it’s hard for us practitioners to get our heads around this new way of thinking (which the scientific journals refer to as the biopsychosocial (BPS) model of health), then we have to expect that it’s going to be challenging for the general public to understand too. Especially when treatments in past days focused so heavily on physical fixes, many of which have now been shown to be far less effective than we’d previously thought, much like medicine and it’s general lack of effectiveness with the common cold.

These ideas, whilst challenging, are now being discussed in the regular media, eg on TV programs like Catalyst on ABC, on radio and at special events in our local community. (eg in association with the ‘Pain Revolution’ which made its way through Geelong and the Surfcoast in 2017.)  All in all I think these new understandings are slowly taking hold, via what we see in the media, from education in the clinic, and from evidence-based posts and links in social media.

Maybe one day it’ll be second nature to consider what’s going on in your life generally when you start to feel pain (or perhaps even now if you’re currently experiencing persistent pain). Much in the way that my wife realised that her lack of sleep and increased stress levels had probably jeopardised her immune system. Maybe (hopefully) persistent pain will be less of an issue, if we can think of it in this way too .

What did you think of when you last felt pain? I bet it wasn’t how many hours you slept last night. Maybe it’s time this thought process becomes the norm.

A different way to get your fix of strength and conditioning. Kinetic Link Training (KLT) is a unique full body workout that is highly effective.

KLT is a functional strength and conditioning system using resistance bands,/cable machines and different types of weights. The system has been designed so your whole body is being challenged with each exercise. No benches, no seats, no supports are used. Forcing you to use your core as it was intended. Challenging and improving your dynamic stability whilst targeting the area being rehabbed.

Using KLT’s 22 essential movement patterns to train whole body movements. Exercise in a way that you have never done before. Single muscle exercises are still needed during early stages of rehab. But once the hard work is done, KLT is used to retrain the movement pattern/s that have changed from adaptation to the injury or pain.

Here is a sample of some of the exercises that might be used in a session. The KLT system has been designed with variation in mind. There are 100’s of combinations of movements and equipment to keep sessions focused and interesting.

“It’s Fun To Be Fit”

A great quote from Wayne Rodgers. When people come into the clinic, it is usually because they have something going on that is affecting their lifestyle or stopping them from doing something they love. Our goal is to get you back to what you love and have fun doing. KLT is a fantastic vehicle to make that happen.

Can I use my Private Health Insurance with KLT?

Yes, but only if it is a part of your Myotherapy appointment and treatment plan. If you are wanting to use it to purely enhance performance then it isn’t.

Book a Myotherapy appointment today to get back your pain free life.

5 Easy and Effective Neck Stretches

Myotherapist: “Why did you make today’s appointment?”

Client: “I have been getting a tight neck and shoulders for the last few
months. Headaches are becoming more frequent. I think it is from sitting
at my desk all day. My workload has been crazy recently.”

This is one of the more common conversations that I have with people in
the clinic. When you get busy in front of a computer it is like you get
sucked into a time warp and all of a sudden you have been sitting there
for 6hrs straight!

I have, without a doubt, been guilty of being in this same situation in my
previous career. Even though we know we should be having movement breaks
intermittently sometimes it just doesn’t happen. So I thought I would
share with you the 5 stretches that I not only prescribe to clients but
also use myself. These are very beneficial for people working at a desk for long
periods.

THESE STRETCHES ARE COMPLIMENTARY TO THE MOVEMENT YOU ARE DOING THROUGHOUT THE DAY, NOT A SUBSTITUTE!

Front Of Neck

To stretch the right muscle, turn your head to the left. Put the heel of
your left thumb (thenar eminence) at the attachment of your right sternocleidomastoid (SCM). This is where your collar bone and sternum meet.
Put your right hand on top of your left to apply extra pressure. Keeping
your head turned to the left lean your head back. You should then feel a
nice strong stretch in your SCM. Turn your head to the right and repeat the process for your left one.

Side Bend

Move your right ear towards your right shoulder. With your right hand, pull your head further gently into the side bend. Hold for 20 seconds and repeat for the other side.

Forward Bend

Put your chin towards your chest. With either hand, pull your head gently further down creating a stronger stretch. Hold for 20secs.

Forward Angle Bend

Turn your head to the right. Put your right hand over the back left hand side of your head and gently pull your head down towards the ground. Hold for 20secs. Turn your head to the left and repeat the process.

Inbetween Shoulder Blades

Interlock your fingers (palm facing in) at chest height.
Move your hands away from your chest trying to create as much space between your chest and palms as possible.
Put your chin on your chest and turn your head from left to right with your chin down.

As a Myotherapist, these are simple and effective neck stretches that I give to clients almost daily. Whether you are an office worker or you just woke up with a stiff neck, stretches like these can be a safe and easy way to ease neck tension.

Take note of the text in bold above, these neck stretches are in addition to any other movement you are doing through out the day. Always consult a health professional to make sure you these stretches are suitable for your situation.

If you are having issues with headaches or your neck, BOOK AN APPOINTMENT to see if we can help.

Sternocleidomastoid

Sternocleidomastoid (SCM) is an unusual muscle. It has the ability to create movements in many directions. It has two bellys the anterior and posterior, with each performing a slightly different role in terms of movement. The posterior portion performing more of the side bending movement and the anterior more of the head rotation/protraction. The muscle is easy to find by turning your head to one side, the muscle engage and you will see it run from behind your ear to your collarbone.

Action: Unilaterally: head rotation to opposite side of muscle, side bending to same side as muscle

Bilaterally: Forward bending of neck, elevation of sternum and assists in forced inhalation

Origin: Manubrium and medial portion of the clavicle

Insertion: Mastoid process of the temporal bone, superior nuchal line

Accessory nerve: cranial nerve XII and ventral rami of the (C2, C3)

Anectdotally it has been a problem for people suffering from headaches. Most commonly I have seen office workers and people that clench or grind their teeth come into the clinic with discomfort being referred from their SCM. Especially people with a deskbound job that are leaning forward, looking at the computer screen. Typically clients have presented with headaches around the temple or forehead.

Often overlooked during treatment, tightness in your SCM can refer pain and discomfort in many areas of the head. It is a relatively simple muscle to treat. Easy to access to self treat but if you are at all unsure then seek treatment from a health professional.

As you can see from the below picture there are up to seven common points that can refer discomfort around the neck and head. There are 3 in the posterior belly and 4 in the anterior belly. The red areas indicating the common referral patterns with a problematic SCM.

Ways to ease tension in your SCM:

Strenghtening: Unilateral: Using a theraband around your head and anchored to something, turn your head to the right. Keep on the same side until finished the change sides.

Using a theraband around one side of your head and anchored to something, side bend your head away from the anchor point.

Bilateral: Using a theraband around the front of your head and anchored to something, push your head and bend your neck slightly forward at the same time.

Stretching: To stretch the right muscle, turn your head to the left. Put the heel of your left thumb (thenar eminence) at the attachment of your right SCM. Put your right hand on top of your left to apply extra pressure. Keeping your head turned to the left lean your head back. You should then feel a nice strong stretch in your SCM.

Self Massage: Lying with your head on a pillow turn your head to the right. Put your hand on your left SCM as you are turning your head to make sure you are on the correct muscle. You will feel it pop up or tighten. Gently massage the muscle with the pads of your fingers in small circular motions. Turn your head to the left and repeat the steps again but on your right SCM.

Always consult a health professional before performing any of these suggestions to see if they are correct for your situation.

Book an appointment now!

Happy Silly Season to you all!

We are taking some time off this year in between Christmas and the New Year to recharge our batteries and hit the ground running in 2018. We hope you all have a safe and fun holiday season! Please see our opening hours below for the impending Christmas period. If you are planning on making your health a priority in 2018, jump online to book a Myotherapy appointment. We would love to help you in the new year!

22nd Dec: OPEN 10.00am – 7.00pm

23rd Dec 2017 – Monday 1st Jan 2018: CLOSED

2nd Jan 2018: OPEN FOR BUSINESS AS USUAL

I hope your Christmas cracker jokes are as bad as these ones!

Why does Santa have three gardens?

So he can ‘ho ho ho’.

What do vampires sing on New Year’s Eve?

Auld Fang Syne

What happened to the man who stole an advent calendar?

He got 25 days.

What kind of motorbike does Santa ride?

A Holly Davidson.

What do you get if you cross Santa with a duck?

A Christmas quacker.

What is the best Christmas present in the world?

A broken drum – you just can’t beat it.

How did Scrooge win the football game?

The ghost of Christmas passed.

Who delivers presents to baby sharks at Christmas?

Santa Jaws.

Who is Santa’s favorite singer?

Elf-is Presley.

What do Santa’s little helpers learn at school?

The elf-abet.

What did Santa say to the smoker?

Please don’t smoke, it’s bad for my elf.

What do reindeer hang on their Christmas trees?

Horn-aments.

Why are Christmas trees so bad at sewing?

They always drop their needles.

Did Rudolph go to school?

No. He was Elf-taught.

Why did the turkey join the band?

Because it had the drumsticks.

What do you get when you cross a snowman with a vampire?

Frostbite.

What do snowmen wear on their heads?

Ice caps.

How do snowmen get around?

They ride an icicle.

Serratus Anterior

Action: – Abducts/Protracts scapula

– Upwardly rotates scapula whilst abducting arm

– Stabilises scapula by holding it to chest wall

Origin: Anterior surfaces of the first 8 or 9 ribs

Insertion: Anterior surface of medial border of scapula

Nerve: Long thoracic nerve C5-C7

Serratus Anterior is one of those muscles that you only really notice on the ripped Calvin Klein models getting around in nothing but underwear. Tucked away underneath your scapula and reaching around to the front of your rib cage with finger like attachments. Giving the muscles its serrated shaped, hence the name. It plays an important role in scapula movement and stability.

Dysfunction in this muscle can refer pain or discomfort around the obliques, medial border of the scapula and down the arm (see above picture). Symptoms may need to be differentiated from dysfunction of the rhomboid, lastissimus dorsi, upper arm muscles and nerve entrapment.

It is considered the punching muscle because of the action it assists with (check out the great boxer Manny Pacquiao below). Muscle fibers are activated mostly at the end range of the punching motion. Exercises like push ups and bench press help to strengthen this muscle but to get the most effect you will need to push out as far as possible.

The other action that it performs is stabilising the scapula by holding it to the chest wall. If you have a winged scapula (like in the picture) this could suggest that weak/inhibited serratus anterior has some involvement and may need to be addressed.

Strengthening

Using a theraband make a loop at each end to hold onto. Put the body of the theraband behind your back keeping it at shoulder blade height. One arm at a time, do a controlled punching motion extending your arm as far out as possible. If you are feeling strong you can do two arms at a time. Remember to punch out as far as you can, the muscle activates the most at the end of this movement.

Stretching

Standing beside a wall, place the hand of the side you want to stretch on your hip with your thumb facing forward. Use the wall to push your elbow towards your body. The harder you push the stronger the stretch. Turning your hips away from the wall will add more tension as well. You can turn it into a PNF stretch by pushing your elbow into the wall for 5 seconds, take a deep breath in and on the exhale relax the movement and move closer to the wall. Bringing on a stronger stretch.

Self Massage

Pin a spikey massage ball in between your serratus anterior and a wall. There are a couple of ways to do this. 1. Move the ball along the muscle fibers  2. Find a tender spot and move your arm up, down, forward and back.

Does any of the above sound familiar to you or someone you know. Myotherapy can help in assessing and treating problems with the serratus anterior. Always consult a health professional before trying any of the above recommendations.

Tensor Fasciae Latae (TFL) has been a common problem in the clinic this week. I have had two cyclists that have stepped up their kilometers now the weather has warmed up. The increase has resulted in some tightness through the front of the hip, including the TFL. Not quite resulting in ITB friction syndrome but a possibility if left untreated. There has been a mix of techniques used to help these clients, massage, dry needling, stretching and strengthening. After 1-2 sessions and some education on self management, they are back riding pain free.

Tensor Fasciae Latae (TFL)
The tensor fasciae latae is a muscle that starts at the anterior iliac crest and joins onto the lateral condyle of the tibia via the iliotibial band (as seen in the picture above). The type of actions that it helps with is abduction and flexion of the thigh at the hip joint. It is innervated from the L4, L5, and S1 area of the spine. Tightness in this muscle can have an affect on the iliotibial band (ITB). Eventually causing Ilitibial Band Friction Syndrome (pain on the outside of the knee 10mins into exercise). The type of people that are more susceptible to TFL overuse problems are runners, cyclists, endurance athletes and anyone flexing at the hip a lot.

Stretching

The second stance in the below picture gives you an idea of how to perform this stretch. Stand about 50cm away from a wall with your left side to it. Put your left hand on the wall to balance you. Cross your left foot behind you right and lean your left hip into the wall. You should then feel a stretch through your TFL and down your ITB. Swap to your right to stretch the other side.

Soleus

Your Soleus muscle sits underneath your gastrocnemius and tightness can often present as calf/gastrocnemius problems. Recently I had a client come to me in the clinic complaining of calf tightness and discomfort in at the back of his heel. He plays football and pre-season has just started. Like a lot of amateur atheletes, he stopped nearly all exercise when the season finished. When pre-season started there was a huge jump in training load. After talking through what he had been (not been) doing in the past few months it was pretty clear that the increase in training load was probably the cause of his discomfort and tightness in his soleus.

We have created a plan for managing the tightness with treatment and stepping back the training load a bit to something more progressive. In the end, a simple problem which can be easily avoided.

Two things that can be taken out of this case study:

1. Exercise needs to be graded when getting back into physical activity. After having a break from physical activity, is when you are in a high risk category of injuring or reinjuring yourself. (A study done by Ausdance showed 14% of injuries occur within 3 weeks of a break from dancing)
2. Early intervention is best. Potentially the client could have had a lot of different issues through the 2017 football season if the problem wasn’t rectified early. Knee, glut, hip, lower back problems can all occur from tightness in the lower limb.

More details on the Soleus muscle

Action: Plantar Flexes Foot

Origin: – Proximal half of posterior surface of tibia along soleal line

– Proximal 1/3 of posterior fibula

Insertion: Posterior calcaneus via calcaneal tendon

Innervated from S1, S2 via tibial nerve.

Strengthening

Calf raises are a great way to strengthen this muscle. To target the soleus, have your knee/s bent when performing the exercise. It is important to make sure your knee stays in line with your second toe as you progress through the exercise. You can view a great tutorial, by The Australian Ballet, for this strengthening exercise here.

Stretching

Lean against a wall with one leg back. Bend your front knee and keep your back one bent as well keeping your back heel on the ground. The more you bend your back knee and lean forward the greater the stretch.

The Soleus is located underneath the Gastrocnemius. The movements it helps with are standing, running, walking and jumping. Mostly made up of type II, slow twitch muscles fibers, which makes it more equipped for posture control. It is important to have a reasonable amount of flexibility in your soleus to perform walking, jumping and running effectively. Reducing the risk of injury and dysfunction. A tight soleus can reduce dorsiflexion in the ankle. The types of problems our Myotherapist sees in the Geelong Clinic are shin pain (shin splints), glute pain and lower back pain. All the way up the the lower back, causing the hip to fold in.

1. Brukner & Khan’s Clinical Sports Medicine,  4th ed. Peter Brukner, Karim Khan Sydney:  McGraw-Hill Australia;  2012
2. http://ausdance.org.au/

Being primarily a Myotherapy clinic, a 1hr Myotherapy appointment is the most common service clients select.  However, if you have been referred to the clinic by someone or wanting to try any of our services for the first time and aren’t quite sure which service or length of appointment to choose this is a little guide to help you out.

Which Service?

As a sole owner operator, the service you choose to book isn’t a major issue. That is something that we can talk about and decide on once you are in the clinic. If you are in doubt pick Myotherapy. It is more important to pick the correct length of appointment to reserve your time.

Appointment Length?

Ideally if it is your first visit to the clinic then a 1hr appointment is needed for your initial consultation. This gives us time to take a detailed history and go through a thorough assessment. If you do not have time for a 1hr appointment or there isn’t a 1hr slot available then choose whatever length of appointment is available. In the initial consult we will talk about how long the follow up appointments should be.

Pregnant ladies, can you please indicate how far along you are in the provided notes section.

You can book your appointment online here or call 03 5248 7321 if you would prefer to speak to someone over the phone.