Is it Carpal Tunnel Syndrome?

     With all the work we do on our smart phones, tablets, and computers, it's not surprising that many of us suffer from pain in our arms, hands, and fingers.  It's easy to write off the swelling, numbness, tingling, and general discomfort as carpal tunnel syndrome.  However, I've worked with several clients who had surgery for such a diagnosis with little to no relief.  So if it's not CTS, what's the problem?

First, let's clarify what Carpal Tunnel Syndrome is:
     The carpal tunnel is an opening in the wrist made up of the carpal bones, ligaments, and other fibrous tissues.  With Carpal Tunnel Syndrome, the median nerve and tendons traveling through this passageway become compressed when the carpal tunnel is swollen or restricted.  This compression causes numbness and tingling of the wrists, hands, and fingers.

     More commonly though, the impingement of the thoracic outlet (the opening between your collarbone and upper ribs where the nerves and blood vessels pass through to supply the arms and hands) is actually the root of all these symptoms.  When the muscles (i.e. the scalenes) around this opening become tight and shortened, they pull the first rib up against the collarbone, restricting blood, lymph, and nerve supply to the arms, which ultimately causes all the same symptoms as carpal tunnel syndrome.  (The pectoralis minor, triceps, brachialis, and some of the forearm muscles can also become tight and impinge nerves of the arms and hands.)

If it is truly CTS, where most of the restriction is at the wrist, maintaining proper body mechanics, stretching your hands and forearms throughout the day, and avoiding poor sleep habits (like bending your wrists or tucking them under your pillow all night) should alleviate many of the symptoms.

I also use contrast bathes frequently for my forearms and hands.  Ice water submersion for 1-2 minutes, then hot water for the same - just go back and forth about 3 to 5 times, always ending with the ice water!  This basically creates a forced circulation, pushing blood out with the ice water then opening up the blood vessels and tissue to new oxygenated blood with the hot.  It works wonders.

If your symptoms seem to be stemming from further up the arm - maybe even into the shoulder and neck - your scalenes (anterior, medial, and posterior) and pectoralis minor are most likely the main culprits. 

Check out my previous post - Shoulder Pain - for stretches and exercises to alleviate tightness and pain in the shoulders and neck.

On a semi-side note, POSTURE is everything!  Check in with your posture throughout the day; you'll probably be amazed by how curved forward and curled up you can get while engrossing yourself in work (or a Netflix binge).  Sit up straight, lift the crown of your head to the ceiling, and let those shoulders fall back.  This might seem easier said than done, but with massage, self care, and stretching, you can absolutely work your way to less pain with better posture.

And I'll leave you with this.  :)

IT Band Syndrome

     I got this awesome (and incredibly relevant) topic choice from one of my FB followers!  With this amazing cool(er) weather, I've starting to run again, which means  - you guessed it! -  lots of foam rolling and stretching!  Unfortunately, that doesn't always cut it.  I have several of cyclist and runner clients who have chronically tight legs and hips, but more specifically, TIGHT I.T. BANDS!

The Iliotibial Tract (IT Band) is a fibrous strip of thick connective tissue (a reinforcement of the fascia latte: the deep connective tissue of the thigh).  It originates at the iliac crest (the curve of your hip bone) and runs aloing the lateral side of the thigh, insterting at the top of the tibia (the shin).  It encases the Tensor Fascia Latte (TFL) and also recieves most of the gluteus maximus tendon.

Actions: stabilizes the knee in extension and in partial flexion (i.e. walking/running, squatting, cycling, etc.)

Iliotibial band syndrome (ITBS or ITBFS, for iliotibial band friction syndrome, Runner's Knee) is the chronic inflammation of the IT Band; it is one of the most common causes of lateral knee pain.

   

There are several different things that can cause ITBS, such as overuse, leg length discrepancies, and improper form when exercising/running. 

So what can we do for ITBS?

As far as massage goes, trigger point and myofascial techniques would be the way to go to alleviate some tightness throughout the entire thigh, with a focus on the knee attachment points of the IT Band and hamstring tendons (just behind the IT Band insertion point).  The TFL and the Gluteus Maximus would be the next section to address because of their direct relation to the IT Band.

Your Homework:

For prevention and management, stretching and proper strengthening exercises for the lateral thigh will take strain off the IT Band.

4 Exercises to Prevent Runner's Knee

For more exercises/stretches for the legs, follow me on Pinterest.

And if you have a flair up, always R.I.C.E. (Rest, Ice, Compress, Elevate).  

Really.  Do NOT power through it.  

Take care of yourself.  :)

Book your next appointment online now!

Neck Pain

Hey guys!

I hope you are all doing well, and have had an amazing summer!

     With all the rain happening off and on, everyone’s allergies have been miserable, including mine.  I’d had a horrible headache for almost a week, with NetiPot, Epsom salt baths, and my usual allergy arsenal barely touching it.

     So! I poured over all my reference books for a good while before I turned to YouTube to look for cervical spine stretches (I know I talked about TMJ and Forward Head Posture in one of my previous posts, but I couldn’t even get comfortable enough to do those stretches!)  I finally found this video by Dr. Paula Moore:

     It has worked WONDERS for not only my neck pain, but even pain I was unaware of in my mid back and arms!  After three days of doing her exercise/stretch every time I thought about it or found myself leaning my chin on my hand at the computer, I was loose enough to do these amazing neck stretches.


Do them.  Every time you find yourself craning your neck forward or propping it way too high when watching tv; straighten up, stretch the crown of your head as if you are trying to touch the ceiling, and do.these.stretches.

They will change your cervical spine’s life. :)

You can follow my Relief: Shoulder, Neck, and Head Aches board on Pinterest for more upper back pain solutions!

TMJ & Forward Head Posture

     Hey guys!  The month of May has been a fabulous, crazy, fast month for me, hence my lack of posts the previous couple of weeks.  I want to thank everyone who helped with the grand opening party and came out to support us.  You are all amazing, and I am so grateful to have you in my life!  For future reference, if I ever take off and leave you guys without prompts, you can always visit my Pinterest for stretches, exercises, health tips, etc.
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     This week I'm going to cover a bit about the TMJ (temporomandibular joint), TMD (temporomandibular disorders), and what role forward head posture has in the mix.

Temporomandibular joint and muscle disorders (TMJ/TMD) are the symptoms of tension or injury to the chewing muscles and joints connecting your jaw (mandible) to your skull.

Here you can see the superficial muscles (the masseter and temporalis), a cut away to view the deep muscles (the pterygoids), and where the muscles insert on the mandible (jaw bone).

(You can view a larger version of this picture here!)

Elevation of the Mandible                                                     Muscles Responsible
 Masseter, Temporalis, Medial Pterygoid
Retraction of the Mandible
Temporalis
Protraction of the Mandible
Medial & Lateral Pterygoid
Lateral Deviation of the Mandible
Medial & Lateral Pterygoid

And here is how forward head posture can pull your entire spine out of alignment:

Watch this video- It's a great link on how to work with TMJ pain with Erik Dalton.  He explains a few different muscles I haven't covered yet, but goes into greater detail with forward head posture and TMJ/neck pain.

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To put it simply, when your head moves forward from slumping over your desk all day, the muscles attaching to your jaw become shortened, retracting your jaw (see the yellow circle above.)  Clenching/grinding your teeth tightens these muscles as well.  Your jaw gets pulled into this area, creating tension and pain due to limited range of motion in your temporomandibular joint.  You can perform self massage in or outside of your mouth to release some of these muscles, as well as along your temples and behind your ears.

Here are some TMJ trigger points and pain patterns.  You can apply pressure to the black X areas while gently, slowly opening and closing your mouth.  Repeat 10 times.

Masseter:                                                            Temporalis:

You can also use a wine cork to relax your jaw by placing it between your teeth.  Relax and hold for 20 seconds. Repeat 3 to 5 times.

To relieve forward head posture, you can turn your head to the left and feel your right SCM pop up.  Gently pinch it between your pointer and thumb on these black X areas and slowly tilt your head back as far as you are comfortable with.  Hold each for 10 seconds and release.

SCM:

You can also place the tips of your fingers on the insertions (at the inside edge of your collarbones) and gently tilt your head backwards to stretch these guys!

And I'll leave you with this.  Have a wonderful weekend!!!

Shoulder Pain

     With all the advances in technology, we, as a society, spend a lot of our time on computers, smart phones, and tablets.  That's all fine, until our bodies start protesting. The human body needs movement.  It seems simple enough, but unfortunately, most jobs these days lend themselves to eye strain, poor posture, and long hours of sitting, which leads to stagnation throughout muscle fibers and the fascial, circulatory, and digestive systems.

I gave you guys a couple of low back/hip flexor stretches in my previous post: Fascia & Myofascial Release, so today, I'm going to address shoulder pain.

Most people's area of complaints involve these muscles:

And here are some great ways to stretch them all out!

This stretch helps re-align the cervical spine, improves breathing, and aids in good posture.  You can do it five or six times a day, and people that carry bags over one shoulder or work at a computer all day should do this stretch daily.

- Place your right hand on the left side of your head.

- Tilt your head to the right.

- Gently push down with your right hand until you feel a maximum stretch.

- Slowly rotate your head to look up at the ceiling.

- Hold for five deep breaths.

- Repeat on opposite side.

This stretch is a great chest/shoulder opener.  It reduces shoulder and neck pain by stretching the short, tight anterior muscles of the shoulder, and giving the tired, overextended posterior muscles a break.

Wall pectoral stretch:

- Place your hand and forearm flat on the wall at a 90 degree angle.

- Turn your entire torso away from your arm to stretch your shoulder joint/chest.

- Hold for two counts. Repeat 10 times.

- Switch sides.

Doorway pectoral stretch:

(You can either do both shoulders at the same time, but I personally feel like I get a deeper stretch doing one at a time.  REMEMBER! If you do one at a time, turn your ENTIRE torso away from your arm.)

- Place one foot forward and your forearms flat on the door frame.

- Let your weight shift to the forward foot to stretch across your chest.

- The higher your place your arms on the doorway, the deeper the stretch.

Time to stretch those triceps! (And also, a little bit of your teres major/minor, latissimus dorsi, and posterior deltoid fibers.)  So many of my clients suffer from tight posterior upper arms, and this is a great way to open up the back of your shoulder joint.

Please note: If you can't reach your hands together, don't fret!  A LOT of people can't, and honestly, I think you save yourself shoulder strain AND you can get a better stretch by using a towel, belt, or scarf.

- Holding your towel in your right hand, raise your right arm straight up.

- Bend the arm at the elbow, resting your hand in between your scapulas.

- Reach behind your back with your left arm until you have hold of your towel.

- Gently pull down with your left arm until you feel a stretch through your tricep/outside of your shoulder area.

- Hold for 20 seconds, working up to five deep breaths.

- Switch sides. Repeat.

And there are also these!

Happy Stretching!

Fascia & Myofascial Release

     Fascia is a network of connective tissue linking everything that exists between head and toe.  It surrounds muscle fibers, muscle groups, blood vessels, nerves, organs, and bones.  When unrestricted, it resembles a web, allowing full range of motion, blood flow, and nerve function.  When the fibers become condensed - almost fused together, there can be a slew of ailments: aches/pains, limited mobility, and decreased circulation and sensation.  For more information, here's a great link - Fascia: Indepth

Ever ruined a sweater from pulling one little thread?  That domino effect is similar to what happens when your connective tissue becomes restricted in one or more areas.

Welcome to your Fascial System.

See how the pull starts near the left hip, and seems to pull the right shoulder down along with it?  The fascia in your hips does more than that when it gets dehydrated, injured, or held too long is any position (i.e. sitting at a desk).  It can start pulling on your low back and your legs.  I can't tell you how many times clients have come to me with low back pain, and left with easier movement and less pain after I've massaged their hips, glutes, and legs.  Here are some myofascial meridians to give you an idea of what I'm talking about.

                      

                          The Spiral Line                     The Functional Lines       

So what can you do about that tight connective tissue?

Myofascial release separates fascial restrictions using a gentle pressure with little or no lotion/oil.  It frees the muscles, nerves, blood vessels, etc. that have been 'glued down' by the fascia; reducing pain and increasing mobility and circulation. 

Do you suffer from low back pain?

Here are some stretches to keep you happy, healthy, and active!

Lunge psoas stretch:

-Place left knee on padded surface with left foot extended (carpet, folded towel, blanket, pillow, etc.)

-Place right leg forward to form a right angle

-Place hands on right knee OR slowly straighten arms over your head

-Lean forward to increase stretch

Advanced psoas/hip flexor stretch:

- Place right knee on a padded surface (carpet, folded towel/blanket, pillow, etc.)

- Step left foot out to form a right angle with left knee

- Place left hand on left knee for balance (you can also have a chair next to you for more stability)

- Grab right foot with right hand behind back

(If you can't reach yet, you can use a belt, yoga tie, resistance band - anything to be able to pull your right foot up to eventually meet your right hand.)