Massage Therapy and Professional Athletes

The main focus of a professional athlete should be on the condition of his or her body.  Why?  Because to be at the pinnacle of the sport, the athlete is often required to push the boundaries of human performance.  Their body generates, and is subjected to, forces and stress that the average person will likely never experience.  For the elite athlete, decreased muscle function and power during rigorous, high intensity events compound the chance for injury.

A proper analogy would be to liken the athlete to a formula one race car.  To be competitive, the man, as well as the machine, is ideally operating at or near peak levels.  In order for the car to reach that potential, it requires a savvy mechanic that understands the workings of the particular vehicle and how to tweak it for performance gains.  It would only make sense that the athlete would need a similar ‘mechanic’, but one that works on the human body. This person is the massage therapist and if integrated into an athletic training program, can help the professional stave off injuries, recover quickly from painful trauma, and prolong his or her athletic career.

In the realm of competitive sport, the licensed massage therapist (LMT) is part of the medical staff.  The role of the LMT covers preventive care, maintenance, and mild trauma/injury.  The therapist will also be involved in any regimen of pain management and rehabilitation.  But, the truth of the matter is that massage is not as integrated a part of the medical team as it should be.  There are still pro teams that do not staff an LMT.

Correctly utilized, massage therapy assists the professional athlete in three distinct ways:

  1. Preventive Care – If not taken care of, little aches and pains can compound and contribute to serious injury.  Muscular micro-tears, tendinopathies, radiculopathies, joint pain, minor bone subluxations, and soft tissue swelling and inflammation, can be addressed with massage therapy to prevent further, more severe complications.
  2. Functional Maintenance – When operating at or near 100%, massage can be used to keep the body balanced and healthy.
  3. Injury Rehabilitation – The body’s natural method of protection after injury, is to tense up the surrounding local muscles.  It is an innate safety mechanism that creates a shield against further external trauma, as well as forms a stable, less mobile structure.  The downside is that the tight, tense muscles slow blood circulation and lymphatic drainage.  Therapeutic massage can be an impressive assistant to relax the injured soft tissue and allow the fluids to circulate smoothly and speed the healing process.  For these reasons, every rehabilitation program should have some form of Massage therapy included.

One elite athlete that regularly uses massage therapy is James Harrison, a professional football linebacker for the Cincinnati Bengals.  It is estimated that he spends upwards of a half-million dollars a year on total bodywork.  Is it necessary?  For Harrison, his salary literally pays for him to stay healthy and injury free.  Most of his compensation and bonuses depend on whether he is on the field.  Needless to say, Harrison understands that massage therapy is an asset to his football career and is a key component in keeping his body strong and free from injury.

The articles linked below are about James Harrison and the costs associated with his bodywork over the course of the year.  But what is really brought to light is that the idea of pro sports athletes using therapeutic massage for a performance edge is still a relatively new and surprising thing.  Though if Mr. Harrison continues his long and fruitful football career, a lot more players will agree and seek out the benefits of massage therapy for themselves.  And when enough pros are asking for massage, maybe then, more sports organizations will see the value of adding a few licensed massage therapists to the medical staff.

NOTE:  At August Point Wellness, we treat athletes from the novice to the professional.  We can assist and work with your training schedule to ensure that you get the care you need.

Related Articles

James Harrison Spends up to $600,000 a Year on Massages

Cincinnati Bengals Linebacker James Harrison is a ‘Massage Whore’

NFL.com – Bengals Linebacker James Harrison’s Expensive Body Maintenance Plan (video)

Forbes Article on If James Harrison Can Deduct Massage Therapy on his Tax Return

5 Common Running Injuries, 1 Treatment Tool (Part 1 of 5)

Rectus femoris - Muscles of the Lower Extremit...

Rectus femoris plays a large part in PFPS, or runner’s knee syndrom

Running brings joy to many people.  But, it can also bring pain.  Poor gait, muscular imbalance, repetitive stress, improper shoes, etc., can all contribute to a less than blissful experience.  The constant pounding on the joints from the pavement can take its toll on the body when unmanaged.  The good news is that appropriate maintenance of the body can key in to long-lasting enjoyment of this healthy exercise.

There are a handful of running injuries that continue to be among the most frequent.  Here, we outline the top five painful jogging issues along with one simple tool to treat and relieve them all.  It’s called the Sciaticare Ball and once understood, this trigger point, acupressure and physical therapy tool can be used to relieve many body aches and pains.  The importance of resolving injuries immediately cannot be understated.  If one continues to push through the pain and the irritation, compound and chronic problems can arise to deter a quick recovery.

The top five running issues are:

  1. Patellofemoral pain syndrome – also known as PFPS or runner’s knee
  2. Iliotibial band syndrome – also known as IT band syndrome
  3. Plantar fasciitis/Achilles tendonitis – these two are typically interrelated
  4. Ankle sprain – along with ankle instability
  5. Hamstring tightness/pull – an important, and often neglected muscle in running

Below, we will address the first of the five pain conditions that runners often suffer.  The other parts will come in later segments.

1.  PATELLOFEMORAL PAIN SYNDROME (Runner’s Knee, PFPS) –  This has been defined as knee pain at or under the patella or knee cap.

Problem — The quadriceps muscle does the bulk of the work in the upper leg during the runner’s gait.  In general, the quadriceps muscle is more powerful than its antagonist, the hamstring muscle group.  Due to the nature of running, this imbalance can grow out of control.  The result is an overly powerful knee extension muscle group (when compared to the antagonist group).  Without going into the complexities of muscle control, spasm, reciprocal inhibition, etc., the quadriceps muscle continues to pull on the knee strongly without much oppositional vector force reaction from the hamstring group.  This repeated unilateral force can wreak havoc on the knee cap.  Pain directly over the kneecap (or a feeling like the pain is underneath the patella) is typically due to the rectus femoris and/or vastus lateralis.

Solution —  This is a two-part treatment.  The first part is treating the rectus femoris (RF) and underlying vastus intermedius (VI) for muscle spasm and tightness.  The second part is strengthening the hamstring group.  This second part is outside the scope of this article and will only be briefly touched upon in part 5 of this series.

Treatment –  Lie prone on a firm, flat, level surface.  Find the midpoint of the line connecting the ASIS and the patella.  This is the trigger point for the rectus femoris and vastus intermedius.  Place the Sciaticare Ball between this location and the floor.  The weight of the thigh should provide enough pressure to stimulate the trigger points found here.  Reach back and grab the ankle on the same side you wish to treat, and pull the foot towards the buttock to stretch the quadriceps.  Rock the leg back and forth over the tendermost areas.  Treat any other tender spots nearby in similar fashion.

A PDF of one simple exercise utilizing the Sciaticare Ball (complete with pictures) can be found here:

http://www.augustpoint.com/articles/sciaticare_quicksheet_rectus_femoris.pdf

The combined effect of stretching the quadriceps and massaging the trigger points in the quadriceps will keep muscles limber and loose.  It is possible to treat the quadriceps daily, as this large muscle group can quickly adapt and benefit.

Although it is possible that the runner’s knee is caused by weak quadriceps muscles, it is rarely the cause.  In many cases, the quadriceps tend to be either:  overpowering to the hamstrings, or inflexible.  It is not recommended to increase strength training for the quadriceps group until the trigger point is worked out and the muscles made more flexible.

This concludes part 1 of 5.

4 Points For Big Toe Pain (Part 1)

Big toe (hallux) pain occurs in a significant number of people at some point in their lives.  Not only affecting athletes, hallux pain also includes the sedentary population to a significant degree.  Early assessment and treatment of big toe pain is important in preventing long-term damage and chronic reinjury.

Although hallux pain triggers are various, this article will be focused on pain due to stress and strain on the joint due to the surrounding musculature.  If hallux pain is mainly located on the plantar (bottom) side of the foot, the four points found here may help provide significant relief.  These simple points can be manipulated oneself or treated by a skilled massage therapist or licensed acupuncturist.

Point 1 –  Abductor hallucis muscle.  This muscle is responsible for plantar flexion of the hallux and some medial deviation (hallux varus) of the proximal phalanx (big toe points away from other toes).  The abductor hallucis gives structure to the medial arch of the foot as well.  Tight abductor hallucis muscles can be easily mistaken for plantar fasciitis pain.  A notable distinction is that this pain is typically concentrated along the medial arch of the foot between the 1st metatarsophalangeal joint and the calcaneous (heel).  [See Figure 1 for treatment location.]

Point 2 –  Adductor hallucis muscle.  Compared to abductor hallucis, this muscle similarly plantar flexes the big toe, but laterally deviates (hallux valgus) the proximal phalanx (big toe points toward other toes).  The opposing forces of the adductor hallucis and abductor hallucis provide stabilization of the hallux in the transverse plane.  Severe lateral deviation of the proximal phalanx is sometimes referred to as a bunion. The adductor hallucis pain is typically concentrated on the lateral edge of the 1st metatarsophalangeal joint and can spread to an area beneath the 2nd through 5th metatasophalangeal joints. This muscle is considered a deep foot muscle and will require adequate pressure for stimulation.  [See Figure 1 for treatment location.]

Point 3 –  Flexor Hallucis Brevis muscle.  The flexor hallucis brevis shares some of the function of both the abductor and adductor hallucis muscles.  Pain caused by the flexor hallucis brevis is mainly located around the 1st metatarsophalangeal joint.  This muscle is considered a deep foot muscle and will require adequate pressure for stimulation. [See Figure 1 for treatment location.]

1 - Abductor hallucis; 2 - adductor hallucis; 3 - flexor hallucis brevis

(Figure 1)  1 – Abductor hallucis; 2 – Adductor hallucis; 3 – Flexor hallucis brevis

Point 4 –  Flexor Hallucis Longus muscle.  This muscle is located outside the foot and is thus known as an extrinsic foot muscle.  It resides in the lower leg behind the soleus muscle and attaches to the fibula.  The flexor hallucis longus is a comparably large plantar flexor of the hallux and is thus responsible for strong plantar flexion of the big toe, especially during walking and running.  This muscle is one of the most important muscles to treat in big toe pain and due to its remote location, one of the least addressed.  Since this muscle is deep to the soleus, adequate pressure is necessary for proper treatment of the flexor hallucis longus.  [See Figure 2 for treatment location.]

Figure 2 - Flexor Hallucis Longus

(Figure 2) 4 – Flexor hallucis longus

In any painful foot condition, treat the musculature and soft tissue first.  Tight muscles will continuously pull on joints and elicit pain.  This common occurrance is often overlooked in sourcing joint pain.  Intolerance to orthotics may be a sign that the muscles in the foot are causing pain or problems associated with the big toe and foot.  Before seeking out orthotics, one should have the surrounding musculature checked for tender trigger points and sensitivity.  Orthotics typically solve structural problems of the foot and should not be used until all of the functional components (i.e. muscles, tendons, fascia) have been treated for some length of time.  Calf cramps, foot cramps, poor circulation in the lower extremities are other signs that muscular problems in the feet are occuring.  This functional approach to medicine can save hundreds to thousands of dollars in expenses and can circumvent more invasive procedures, such as surgery.

A simple, effective tool in maintaining the functional ability of the hallux is a rubber ball.  Roll each foot over a ball for 5 minutes a day, spending a minute or more on each of the points listed above.  Sit on the floor with legs straight out and place the ball under #4.  The weight of the lower leg may provide enough pressure to stimulate the flexor hallucis longus.  If not, cross the other leg over top of the leg being treated to increase the weight.  This procedure should be followed 4-5 days a week for a couple of months to allow the muscle spasms and tightness to abate.  This is an excellent way to promote good blood circulation, massage intrinsic foot muscles, stimulate nerve endings, and refresh tired, worn out feet.

August Point Wellness offers a self-massage tool called the Sciaticare Ball that is quite a bit more useful than the rubber ball stated previously.  The Sciaticare Ball can be used on feet, calves, back, hips, and much more.  With an easy to place handle, it allows better control in massaging those hard to reach places.  Visit www.augustpoint.com or Amazon to purchase.  As always, for best results, seek out the guidance of a licensed massage therapist or acupuncturist and combine professional treatment with self-treatment for optimal health.

Related links:

Big Toe Pain…And Gout is NOT the Diagnosis

Joint Pain is Not Always Arthritis

Over 50 million Americans have been doctor-diagnosed with some form of arthritis.  Most of these cases have chronic joint pain associated with them, which is the typical reason for the doctor visit.  There is a correlation between arthritis and chronic joint pain, but not all chronic joint pain is arthritis.  Yet, the general public has been led to believe that arthritis is the primary reason for joint pain.  Although sometimes true, not all joint pain should be equated to arthritis.  In fact, a significant portion of joint related pain is not due to the joint at all.

Joint movement occurs because of muscle contraction.  For instance, quadriceps muscles on the front of the thigh extend the knee, while hamstring muscles in the back of the thigh flex the knee.  When the quadriceps muscles are activated, the hamstring muscles deactivate to allow for reduced resistance during motion of knee extension.  The opposite holds true such that hamstrings activate and quadriceps deactivate in knee flexion.  This is Sherrington’s law of reciprocal inhibition.

Muscular Forces From Quadriceps Can Cause Knee Joint Pain

When muscles are tight, the connected joint can get pulled in multiple directions.  (See image for example of quadriceps muscle forces pulling on the knee joint.)  The line of force on the joint is always along the length of the muscle.  When severe enough, the unbalanced muscular forces can actually alter the movement of the joint and cause repetitive joint stress to the point of pain.  This pain can mimic a plethora of arthritic conditions.  The interesting feature of muscular-related joint pain is that the muscles don’t often exhibit pain themselves.  Hence, the muscular spasm or tightness tends to escape detection as the true source of the joint problem.

Muscular-induced joint pain is the most common reason for joint pain.  It is also the most-missed cause of joint pain for the reason stated earlier, in that a muscle will often cause joint pain before the muscle elicits pain itself.  Differentiating arthritis from muscular-induced joint pain is key in determining the proper treatment solution for the patient.  Otherwise, joint pain that can be fixed through non-invasive methods will either persist or worse, lead the patient towards an unnecessary surgical procedure.

The moral of the story here is that arthritis is just one component of joint pain.  Muscles that are tight, overused, and/or imbalanced with its antagonist muscles cause joint pain as well and can resemble arthritis pain and other degenerative joint disease.  Any doctor or medical professional who claims joint pain is completely due to arthritis or other rheumatic joint disease has missed a compelling piece of the diagnostic puzzle, the role of the muscle.

If one is looking for a natural muscle rub to help in treatment of muscular induced joint pain and arthritis, August Point Wellness carries the Sciaticare Brand Penetrating Muscle Rub.  It is an all natural alternative to Ben-Gay, Tiger Balm, Icy Hot, and others.

Related articles

 

The Burden of the Brachialis

Brachialis - Muscles of the Upper Extremity Vi...

Brachialis – Muscles of the Upper Extremity Visual Atlas, page 48 (Photo credit: robswatski)

The brachialis is the underappreciated workhorse of elbow flexion.  When one is asked to show their muscle, usually the biceps brachii takes the spotlight.  Both the brachialis and biceps flex the elbow, so why isn’t the brachialis muscle as popular?  The answer is because much of the brachialis is hidden underneath the biceps and cannot be seen.  The brachialis is surprisingly strong and doesn’t get the credit it deserves.  Many times, it doesn’t get the care it deserves either.

The main function of the brachialis muscle is to flex the elbow.  It works with the biceps brachii, brachioradialis and supinator.  Certain positions engage the brachialis more or less during elbow flexion yet there is variability in contraction of the muscle in each position.  Therefore, assessment of brachialis pain requires some skill and good technique.

Pain and spasm in the brachialis muscle can come about from activity such as lifting heavy objects or holding the arm in flexion for long periods of time.  Playing instruments such as a saxophone or guitar can trigger brachialis pain over time.  Other activities, such as typing on a computer while arms are unsupported, or carrying groceries can elicit a tight brachialis.

An injured or tight brachialis commonly causes pain in one or more of four locations.  Local pain may be felt on the outer portion of the humerus where the brachialis can be palpated.  Pain may also be felt near the muscular point of attachment on the proximal part of the ulna.  Referred pain may be felt at the base of the thumb on the same side as the affected brachialis.  The ipsilateral anterior shoulder or deltoid may also show tenderness from referred brachialis pain.

A muscle spasm or just plain tightness in the brachialis can impinge the radial nerve.  Symptoms of this nerve irritation affect the thumb and give the person a feeling of tingling or numbness in the thumb.  Since only the sensory portion of the nerve is affected, loss of strength in the thumb is not seen.

Much of the treatment for the brachialis can be done at home using the thumb of the opposite hand.  A massage tool could also be helpful for stubborn trigger points or muscle spasm.  Your alternative health practitioner can also be of great help, especially if one is searching for a natural healing therapy.

At August Point Wellness, we believe that many of the brachialis muscle issues can be addressed through acupuncture, massage therapy, and self-care.

An example treatment that we would use to address tight brachialis:

The Soleus Muscle, The Second Heart

Deep and superficial layers of posterior leg m...

Soleus

The heart is an amazing organ that pumps between 5 and 7 thousand liters of blood a day.  Yet, it is not the only pump in the body.  While the heart pumps blood out towards the extremities, deep muscles assist in pumping blood back towards the heart.  One of the most important muscles for assisting blood flow back to the heart is the soleus muscle of the calf.

The soleus muscle is a large flat muscle in the lower leg.  Part of the soleus can be palpated directly, while the rest lies underneath the gastrocnemius muscle.  The location of the soleus muscles are important.  They are on the extreme distal end of the body and furthest away from the heart.  When standing upright, the soleus resides at the body’s lowest gravitational point.  These two factors put the soleus in an ideal position to work synergistically with the heart as an efficient pumping system.  The heart pumps arterial blood, while the soleus pumps venous blood.  But, this occurs best when the soleus muscle is healthy and supple.

Problems with the soleus are a frequent cause of pain and suffering.  Athletes and inactive people can both be affected.  This happens because the soleus is used in many activities, such as walking, running, and cycling.  It is a hardworking muscle that tends to get heavy use and very little care.  Most people don’t take enough time to stretch and treat the soleus.  Hence muscle tightness and trigger points can form, causing the soleus to hinder circulation rather than help.

Tight, stiff soleus muscles can radiate pain to the heel, ankle, and as far away as the lower back.  Complications from soleus tightness include:  ankle instability, calf cramps, varicose veins, phlebitis, lower leg edema, low blood pressure, orthostatic hypotension (postural hypotension), and hypersensitivity of lower back.  Pain that is mimicked by tight soleus muscle include:  plantar fasciitis, heel spurs, stress fracture, shin splints, Achilles tendonitis, and thrombosis.

Treatment for the soleus muscle should begin with natural therapy.  Home treatments such as strength training, stretching and self massage should be done regularly to maintain the muscle’s pliability, density, range of motion, and function.

At August Point Wellness, we believe that many of the soleus muscle issues can be addressed through acupuncture, massage therapy, and stretching.

An example treatment that we would use to address tight soleus:

Treating a Stubbed Toe with Alternative Medicine

A stubbed toe can be a very painful event.  If you have stubbed your toe on something, it’s possible that you may have either fractured it or damaged soft tissue surrounding the toe.  If you’re really lucky, you may not even bruise.  If you’re not so lucky, your toe could be broken.  When in doubt, visit your primary care physician or urgent care and get x-rays.  (A broken toe does not have to look disfigured in order to be broken.)

Take a close look at the injured toe.  Look for ruptured skin or a damaged nail.  If the skin is broken, clean the area with soap and water and apply an anti-bacterial ointment.  (It’s not necessary.  It’s a precaution for preventing local infection.)

Injured Toe, 3rd one. Swelling and redness on medial side.

There are numerous treatments styles and many of them recommend ice as a treatment for injured toes.  At August Point Wellness, we do not recommend ice on a stubbed toe.  Why? Because the toes are at a circulatory disadvantage being located at the most distal (and likely inferior) end of the body.  Circulation is imperative for the healing process and icing an injury improperly will constrict blood vessels and actually slow the healing process.  Sure, it could reduce swelling of the toe, but a reduction in swelling does NOT equate to increased rate of healing.

Here is an alternative treatment plan if you wish to take care of a minor stubbed toe injury naturally:

  1. Take arnica internally.  Arnica contains plant-derived anti-inflammatory compounds.  It is an alternative to ibuprofen.
  2. Warm the foot and toe in a footsoak bucket or a bath.  Use epsom salt and peppermint oil to reduce swelling.
  3. Massage the injured area.
  4. Apply a pain relieving topical ointment or bruise liniment to the injured area.  We recommend our own Sciaticare Penetrating Muscle Rub.  It’s based on traditional dit da jow herbal bruise and fracture formulas of China.  It’s 100% natural, safe, and effective.
  5. Elevate the injured toe and foot as much as possible until injury is healed.
  6. If very painful, splint the toe with the one next to it for the first week or two of the healing process.
  7. Wear stiff-soled shoes until injury is fully healed.  This is to reduce the excessive motion of the toe.

As you can see from the image above, the founder of August Point Wellness has suffered a stubbed toe injury.  Above is the actual protocol he is currently using for this injury.  Please note that the information in this article can be used to treat a jammed finger as well.

Mountain Biking (Cycling) and Numbness in Hands

English: From Image:Gray411subclavius.png, for...

Subclavius

Gray's anatomy
Pectoralis Major

Riding a bike is great exercise.  There’s no doubt about that.  But, there are some parts of riding that aren’t so great.  Some of the common complaints from cyclists are low back pain, neck pain, and knee pain.  These complaints typically come from poor riding position, muscular imbalance, and/or extended amounts of time spent on the bike.  Other, less common bike injuries that I see in my clinic have to do with anterior shoulder pain and numbness or tingling in the hands and fingers.  As you will soon find out, these two issues tend to go hand-in-hand.

The bike position of the rider is dependent on a couple of variables: body shape, bike geometry, and bike setup.  For the purposes of this discussion, let’s assume that the rider is on a standard mountain bike.  Mountain bikes, in general, place the rider in a forward leaning position.  The rider’s body is sitting on a saddle and the torso of the man or woman is bent over the top tube, where the hands of the rider stabilize the torso by gripping the handlebar.  In this position, the upper body is performing a number of positional adjustments to provide comfort:  (lumbar and thoracic) spine is flexed, (cervical) spine is extended, shoulders are horizontally adducted, and arms are outstretched.  To keep the torso stabilized, your muscles grip the handlebar and apply force directed along your arms towards your shoulder joint.

The muscles that contribute to stabilizing your upper body on the bike are manyfold.  They all work synergistically to keep you fairly upright on the bicycle.  Since this article is about shoulder pain and numbness and tingling in the hands, we will narrow down the discussion to two common culprits of these problems.  Both of these muscles, pectoralis major and subclavius, are heavily involved in cycling and can be stressed to injury.

When riding a bike, the pectoralis muscles are in a shortened, flexed state.  They are large muscles that expend tremendous energy during cycling.  For most fit riders, the pectoralis muscles are strong enough to handle the load placed on them.  But, the problem arises when the pecs don’t get stretched between rides and remain in a shortened state, even when off the bike.  (Stand in the mirror and look for the shoulders to be rolled or hunched forward.  This could be a sign of tight pectoralis muscles.)

The same situation goes for the subclavius.  On the bike, the subclavius muscle is also in a shortened state.  Albeit a small muscle, the subclavius is within close proximity to some major nerves and vessels that traverse underneath the clavicle and down the arm.  When this muscle shortens, the clavicle gets pulled downward onto the subclavian artery and vein.

Tight, shortened pectoralis major and subclavius can contribute to thoracic outlet syndrome and impede lymphatic drainage of the breast.  Breast tenderness and edema are symptoms of muscle tension as well as numbness, tingling, and/or weakness in biceps, radial portion of the forearm and fingers.  Treat the pecs and subclavius by stretching.  Opposing muscles, or antagonists, such as the rhomboids, latissimus dorsi, and trapezius should be strengthened through exercise.  This balancing of strength on the shoulder joint provides stability through the entire range of motion.

I highly recommend acupuncture and massage therapy as the first line of treatment for numbness and tingling in the arm and fingers from cycling.  These are natural, drug-free therapies that can assist you in your recovery process.  See your alternative health provider and learn more about what they can do for you.  Implementing a stretching routine to lengthen the pecs and subclavius muscles and offset extended periods of time on the bike.

An example treatment at my clinic would be:

 

Pain Trying to Undo Your Bra Strap? It Could Be This Pair of Muscles…

Infraspinatus - Muscles of the Upper Extremity...Infraspinatus Muscle

“It hurts when I try to undo my bra.” Or “Taking off my shirt is painful.” Or “Combing my hair hurts my shoulder.” Or “I have problems reaching behind my back.” These are common complaints for trigger points in the rotator cuff muscles, infraspinatus and subscapularis.

There are 4 rotator cuff (RC) muscles that assist in movement at the shoulder (supraspinatus, infraspinatus, teres minor, and subscapularis). These muscles hold the head of the humerus in the glenoid cavity, as well as provide mobility. An imbalance in rotator cuff muscles can be painful, as well as severely limit the joint range of motion (ROM). That imbalance can also lead to trigger points that are painful when touched.

Two muscles that tend to get stress and overwork injuries are the infraspinatus and subscapularis. These are two of the four rotator cuff muscles in your shoulder. When there is difficulty raising the arm above the head or behind the back, doctors
typically diagnose frozen shoulder. Frequently enough, I hear other diagnoses such as bursitis, adhesive capsulitis, neuritis, etc. attached to the one for frozen shoulder. Muscle relaxants and anti-inflammatory meds are sometimes prescribed without regard
for more effective, natural methods of relief.

The function of the infraspinatus is to externally rotate the humerus. (It’s the kind of motion that allows you to bring your arm back to throw a ball.) The function of the subscapularis is to internally rotate the humerus. (This is the forward and downward motion of throwing a ball.)  As you may know, these muscles are antagonists to one another. Each opposes the function of the other. This concept is important, because the health of one muscle will usually affect the health of the other. (It’s a yin-yang theory of balance.)  Therefore, treatment of both the infraspinatus and subscapularis are imperative in a complete healing plan.

The infraspinatus is located on the shoulder blade itself. The muscle above the spine of the scapula is called the supraspinatus (‘above the spine’), while the muscle below the scapula is called the infraspinatus (‘below the spine’). If one is flexible enough, he or she may be able to reach over their shoulder with the opposite hand and palpate the infraspinatus muscle.  One of the key causes for tight infraspinatus muscle is holding the arms out in front for extended periods of time.

Acupuncture and massage are two extremely effective methods for treating the infraspinatus trigger points. Stretching after each therapeutic treatment is important to help relax musculature and improve circulation.  To treat the infraspinatus at home, while you are between your physical therapy, acupuncture, or massage treatments, invest in a tool to help you work out trigger points in the infraspinatus.  August Point Wellness carries the Sciaticare Ball, an effective trigger point relieving tool for many different musculoskeletal trigger points.  Instructions on how to use the Sciaticare Ball for infraspinatus can also be found on our website here.

The subscapularis is a slightly more difficult muscle to address.  Located under the scapula, this muscle is the largest and strongest of the rotator cuff muscles.  Along with acupuncture and massage therapy treatments, the sufferer should also learn to stretch the subscapularis muscle.  (Sometimes stretching alone is NOT enough to release the muscle spasm.)  The most effective method that I have found to stretch the subscapularis is the broomstick stretch.  If you do not have a broomstick handy, you can try the subscapularis doorway stretch.  (For now, Google these stretches for images and videos on particular stretches.  I hope to add images to this post soon!)

With the way most people use their shoulder, a strength imbalance causes the subscapularis to be strong, while the other three RC muscles are weak.  Therefore, after the trigger points have been worked out of the RC group, one should begin strength training on these muscles.  Exercises that isolate the individual RC muscles are a great start.  Pair it up with exercises that stabilize the scapula and regain strength and flexibility in your shoulder!

A sample treatment that I may use in my clinic would be:

  • Acupuncture – SI9-SI12, GB21, Rhomboid Motor Points (MP), UB10, Subscapularis MP, LI16
  • Massage Therapy – Entire Rotator Cuff Set, Pectoralis Minor, Serratus Anterior, Upper Trapezius
  • External Liniment/Rub –  Sciaticare Penetrating Muscle Rub applied over  muscles for faster healing and improved blood flow.  Patient would apply Sciaticare PMR daily and massage into area to promote circulation and healing.  Application of Sciaticare PMR before any rehabilitation exercises would be recommended as well.

This type of frozen shoulder pain usually requires 4-6 treatments to really improve ROM and show results.  Obviously, your results may differ.  You may need to modify your posture, work ergonomics, and lifestyle as well.

Barefoot Running? Refresh Your Feet With the Sciaticare Ball!

English: Vibram FiveFingers Bikila shoes, top ...

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There’s somewhat of a craze going on right now about barefoot running and how great it is for the feet.  Barefoot running is somewhat of a misnomer (thanks in part to the loose interpretation of the term by marketing and advertising execs) in that some of the so-called “barefoot runners” are not really barefoot.  The better terms used for barefoot running is minimalist running, or natural running.  The runner wears minimal cushion beneath the soles of their feet, but only to protect from road debris and small particles that can damage skin.  Some benefits of barefoot running show persons experiencing lower magnitude impact thus erasing back pain and knee pain after just a few months of exercise.

There is no doubt that running barefoot can build foot and lower leg strength.  But, it can also be hard on the feet for the first few weeks of adaptation.  To ease the transition from standard shoes to the minimalist style of footwear, we have some tools that are sure to help you maintain your foot health with any type of footwear.

The foot is a complex structure built to withstand enormous forces from impact on a multitude of surfaces.  The muscles, tendons, and ligaments that hold and support the dynamic shape of the foot allow for weight distribution, balance, and propulsion.  Since the plantar side of the foot is the part that strikes the ground in most activities, it  is important to keep this impact zone healthy and supple.  One excellent way to do this is to schedule regular foot treatments, such as massage, acupuncture, and/or foot reflexology.  (As you may already know, there are plenty of nerve endings in the foot that can be stimulated and balanced through these types of therapies.)

Benefits of having regular treatments to you feet are:

  • early detection of structural problems
  • stimulate nerve endings and “wake” them up
  • improve balance and proprioception
  • prevent/treat tendinitis
  • prevent/treat ligament strain
  • improve circulation
  • reduce edema and swelling

To help you make the transition from standard running shoes to minimalist shoes (or barefoot), August Point Wellness offers the Sciaticare Ball.  The Sciaticare Ball is our multipurpose therapy tool created by a massage therapist and acupuncturist.  It can be used as a standalone treatment or in conjunction with your current health care.  Use the Sciaticare Ball to massage the plantar side of the foot.  Roll your feet over the Sciaticare Ball to firmly massage the deep musculature under the entire foot.  Use it every day after you run.  Spend just 5 minutes rolling the Ball under the three arches of the foot and enhance your foot health and recovery.  Feel your feet rejuvenate themselves.  

August Point Wellness also offers another great product, the Sciaticare Penetrating Muscle Rub.  The Sciaticare Penetrating Muscle Rub is a unique formula based on traditional herbal Chinese Medicine.  Great for muscle strains, tendon sprains, bone bruises, and fractures, this warming rub can work wonders for your feet as well as your entire body.  For those aching, sore feet and calves, rub the Sciaticare PMR into the skin and allow the natural herbs and oils to deeply penetrate into the skin without any harsh chemicals or artificial ingredients.  Another benefit of the Sciaticare Penetrating Muscle Rub is the herbal formula’s antifungal and antibacterial properties.

For more information about the Sciaticare brand, please visit the August Point Wellness website.