My top 5 tips to reduce stress

1. Make sure you have some personal time

We live in a society where we have many demands placed upon our time: at home it may be sorting out children in the morning or chauffeuring them to and from after school activities, running a home, supporting elderly parents; and at work it may be attending meetings, travelling both here and abroad, or making phone calls at home so as to work with colleagues in other countries. All these factors reduce the time available to fit in an activity that is just for you. So try and schedule some time aside each week to do something you want to do. It might be to go and watch a rugby match with friends; have a long uninterrupted soak in the bath; read a book; or to try a meditation class. Whatever you choose to do that time is precious and to be enjoyed so do not feel that it has to be the first activity to be dropped if you run out of time, your well-being is a priority otherwise you cannot perform your other tasks to the best of your ability. You are important and sometimes you do need to put yourself first.

2. Exercise

Most of the companies that I work in, staff are fortunate to have either an on-site gym or access to a subsidised gym. Use it! If your working day involves spending hours at a desk and then you relax at home by sitting watching TV or gaming for example, then some of your muscles will forget how much they can contract or stretch. Typically hamstrings can become shortened, which in chronic conditions can contribute to low back pain; shoulders can become rounded due to some muscles like the rhomboids being pulled out of position and lengthened.

Regular exercise can break this pattern and help maintain balance in the body. A general gym workout will exercise all the major muscle groups and will invigorate the body. Exercise increases levels of endorphins in the body, which appear to be linked to pleasure centres in the brain and contribute to the feeling known as ‘runner’s high’!

If the gym isn’t for you there are numerous other options: yoga, running, dance classes, pilates, netball or football clubs. Don’t be afraid to try something new!

3. Have a ‘To Do’ list

I love a ‘To Do’ list: sad but true. It can really help to write down all the things you know you need to do, that you are juggling in your head, as the demands these tasks require press upon your time. Even as you write the list remember the SMART mnemonic so that you break down large tasks into smaller components that are easier to achieve. This means that even on a busy day although you may not complete the entire task you will have taken steps towards it. At the end of the day/week, look back at your list and tick off all those you have accomplished. This then allows you to reorganise outstanding tasks and helps prioritise your goals for the next day/week.

4. Take a break away from your desk

It’s so important just to change your position and stretch out. If you own a cat or dog you will see for yourself that after it has been fixed in a position for a while it will turn round and just

If you are unsure what stretches would be best for you then call me on 0759 050 1552 or email susan@powertouchtherapy.co.uk to book an appointment when we can look at your daily activities and devise some simple stretches to meet your needs.

5. Have a massage

Well, obviously I am going to promote massage! But that is because it reduces stress levels. Studies have shown that massage is more effective in altering the body’s biochemistry than just resting or meditating, and has proven effectiveness in reducing anxiety, depression, lowering blood pressure and reducing heart rate. This is achieved by altering the level of pressure applied to each stroke, the fluidity of movement and the techniques used by the therapist.

I know some people feel that if they have a massage they might feel too relaxed to work the rest of the day. Not a problem! I always tell my clients that if ever they have an important meeting or deadline to attend to after a treatment to let me know and I will incorporate some invigorating techniques in the session to leave you relaxed and refreshed. Indeed, a study by Field et al in 1996 showed that as well as reducing cortisol levels (a neurotransmitter that increase with increased stress levels) maths tests were completed faster and more accurately by the massage group than the control group who just sat in a chair.

With all these stress-relieving tips, they need to be incorporated into your daily life to feel the benefit. Spending 30 minutes away from a task may seem like time wasted but is it really if the result is that you come back clear headed, with better focus and clarity to evaluate and complete your task?

If you want to book a massage with me then please call me on 0759 050 1552 and leave a message to let me know your name and contact number or email me: susan@powertouchtherapy.co.uk.

Trigger Points

What are they?

Trigger points are highly irritable bands of muscle that are causing referred pain and irritation to the body. The key to trigger points is that they present with a predictable pain pattern. These can be in the immediate area of the trigger point or it can be referred further afield and some examples are shown in the images below.

Headaches occurring in the red zone can be caused by trigger points in the muscle just below the base of the skull. Typically the muscle can get contracted and tight when a computer screen is not at the right height and the user has to tip their eyes slightly upwards.
Many people will not have
heard of a muscle called infraspinatus but they will have heard of ‘rotator cuff’ with respect to injuries. Infraspinatus is one of the rotator cuff muscles. It is the muscle that covers the shoulder blade (as indicated by the ‘x’ marks on the far left diagram). However, look where this muscle can refer pain and discomfort to!

It is amazing to think that irritation of muscle in the shoulder blade could potentially be causing pain down the arm as far as the hand. Usually the irritation for this muscle is on the upper arm and more to the front than the back but to feel it further along the limb is not a surprise, just less common. Frequently one of the causes of trigger points in the infraspinatus is the position of the arm at night when sleeping.

In this diagram a muscle in the neck causes a much more localised pain pattern, with most of the referred pain occurring in the same position as the muscle, in this case the levator scapulae. This is one of the muscles that people feel tension in when they feel their shoulders have moved upwards and are now are stuck just below their ears. Treating this muscle can sometimes feel quite intense so it is always good to let the therapist know if you feel any discomfort during a treatment so that the techniques can be modified to ensure you are comfortable throughout.

How do you treat trigger points?

Well massage is very effective in treating this type of soft tissue problem. Frequently, clients might be having a massage and say something like ‘I felt that in my arm’ when you are working their shoulder for example. So although the client may not have persistent pain, it is present. If the warning signs are ignored, that pain may become a constant nagging ache as the trigger point progresses to a more chronic state. As the muscle with a trigger point becomes contracted and not functioning as smoothly as it should, neighbouring muscles start to be affected as their movement is inhibited. This then leads to the spread of tension and discomfort in the body.

Massage works to manipulate the soft tissues to find any trigger points and then use techniques such as compression, myofascial release and soft tissue release to relieve them. Ideally, you want to be able to improve the blood flow to the area, find the key trigger points and treat them. As muscles are sticky and are used to being stuck in a particular position it can take a few sessions to ensure you have treated them all successfully. However, the end result is that you no longer have those muscles causing pain and restrictions in your body. Perfect!

If you would like to book in for a massage contact Susan Harrison on 0759 050 1552 or email susan@powertouchtherapy.co.uk

Rumour has it… Movement has it all!

So I have corrupted Adele’s lyrics but I wanted to discuss the benefits of movement as not moving can lead to a host of musculoskeletal problems that could potentially also affect mental well-being.

So many aspects of our lives are sedentary: driving, working at a desk, using a laptop or computer, gaming, eating out with friends or even socialising down the pub! If you think about our body position during these activities, although varied, we have hardly moved our muscles or bones!

I see many clients who have problems with their neck, shoulders, hamstrings, quads, calves or buttocks and usually the reason they have come to see me is because the body is not being moved back to centre (neutral) enough. Look at the images below to see what I mean about the body being stuck in the same position all day.

Head forward, shoulders rounded, back curved, bent legs and inactivity throughout. The lack of movement of the body can lead to a host of musculoskeletal imbalances. Fortunately, massage can take away the discomfort associated with poor posture and even recommend exercises to help you redress some of the imbalances in your body.

At Powertouch Therapy (www.powertouchtherapy.co.uk), we are trained in a variety of different stretching and rehabilitation techniques to help improve your posture. So why not book in for a session. Email susan@powertouchtherapy.co.uk or call her on 0759 050 1552 to discuss your particular needs with her. It may take some time before we get you to work with a spring in your step as shown below but we can certainly help you on your journey!

And if you plan to do this, well I would love to be in on that meeting!

Repetitive Strain Injuries (RSI)

Repetitive strain injuries (RSI)

Frequently in massage practice, we see clients who have repetitive strain injuries caused by overuse. Tennis elbow is a typical one but others include golfer’s elbow, biceps tendonitis, superspinatus tendonitis, Achilles tendinopathy, patellar tendonitis and ITB syndrome. These injuries all involve the tendon, which comprises collagen fibres that effectively anchor the muscle to the bone. Clients with these type of tendonopathies experience a burning sensation, sometimes with even light use of the affected joint, lack of strength and limited range of movement. Although these injuries can respond well to treatment especially if treated during the acute stage, frustratingly it can take many months for it to heal once the condition has become chronic (Rattray and Ludwig, 2000). However, for many clients conservative treatment is effective; very few have to resort to steroid injections or surgery.

But what actually is going on?

There have been many investigations to examine tendons that have overuse injuries. What has been identified is that in the vast majority of cases where people referred to tendonitis (‘-itis’ indicates inflammation), surgery and/or pathology of the affected area has only rarely shown signs of inflammation. Indeed the vast majority of the affected tendons exhibit tendinosis (Bass, 2012).

Studies have shown that the collagen fibres in tendinosis injuries are immature, comprise the wrong collagen mix (there are different types of collagen), with increased vascular networks that are of poor quality and have a dull, greyish surface (Heber, 2012). It is thought that the immaturity of the collagen fibres as the muscle is consistently activated is one reason why tendinosis injuries are chronic conditions.

In tendonitis, the collagen fibre mix is ‘normal’ for a tendon, the fibres are aligned neatly, there is a good vascular network and the surface appears shiny and white but there are inflammatory cells are also present . Tendonitis is more commonly associated with a particular activity that has caused the pain and reaction experienced: excessive strain caused by throwing a ball, running, jumping, etc. It can result in microscopic or partial tears of the muscle and in some cases a complete tear of the muscle that requires surgery.

How to treat tendinitis and tendinosis injuries

Bass (2012) suggests that for tendinosis

Rest
Adjusting ergonomics and biomechanics
Use of appropriate support
Apply ice
Stretch and move area conservatively
Eccentric strengthening
Massage
Nutrition

Are all aspects that should be addressed as part of the rehabilitation of the tendon. In fact for tendinitis many of the factors listed above are also relevant, however, the use of anti-inflammatories, ultrasound, physiotherapy, steroid injections or in severe cases surgery may also be required.

Research by Khan (cited in Heber) indicates that for tendinitis injuries when presented at the acute stage recovery time is ‘days to 2 weeks’ yet in the chronic stage is usually ‘4-6 weeks’. Compare this to tendinosis injuries where acute recovery is ‘6-10 weeks’ and for chronic presentation it is 6 to 10 months.

For many tendinopathies, ice and completely resting the affected area for a few days can be the most effective self-care treatment available. Massage, eccentric strengthening of muscles and movement of muscle within pain free range can help with enabling the correct balance and alignment of collagen fibres to develop. Finally, look at the factors that may have contributed to the injury in the first place and see if there are any adjustments (postural, support or techniques) that can be altered to prevent the injury happening again.

References

Bass E. (2012). Tendinopathy: Why the Difference Between Tendinitis and Tendinosis Matters. Int J Ther Massage Bodywork, 5(1): 14–17

Heber M. Tendinosis vs Tendonitis. Web article: www.elitesportstherapy.com/Tendinosis-vs–Tendonitis. Accessed 25^th April 2014.

Rattray F. and Ludwig L. (2000). Clinical Massage Therapy: Understanding and Treating over 70 Conditions. Talus Inc: Ontario, Canada

Tension headaches

“Tense, nervous headaches…”

Well, I am old enough to remember the advert used by a company to promote their tablets for the relief of headache pain. These painkillers are effective and reduce the symptoms but do not get to the root cause of the headache.

Headaches generally fall into two categories:

Primary headaches, which are the most common type and include tension headaches, migraines and cluster headaches.
Secondary headaches, which have an underlying cause such as too much alcohol, concussion, cold/flu, hormonal influences and tempero-mandibular joint pain.

(Source: www.nhs.uk/headaches)

The vast majority of headaches are tension related. A number of studies exist which show that massage is proven to be effective in treating these types of headaches as well as improving sleep quality in people who suffer from them.

I tend to only ever have a headache if I have a bad head cold. For some of my clients it can be very different and I recall one conversation I had with someone who, when I asked how often they had a headache, replied ‘A normal amount,‘ so I asked what a normal amount was and she replied ‘Every day’. That is not normal in my experience! Fortunately after a few treatments her headaches decreased quite markedly, to the point where I would just see her every couple of months for headache maintenance.

So how does massage work?

Treatments for tension headaches will work both front and back of the neck and shoulders to look for knots or adhesions that might be causing the problem. Sometimes when an area is worked the client can feel the headaches developing, this is an indication of trigger point pain. By massaging the muscles, applying heat and stretching, the adhesions can be worked out, muscles re-aligned and headache pain decreases.

Usually a short burst of regular massage therapy is needed to ensure muscles do not return to the knotted position they were in originally when they were causing the headaches. As the knots reduce and the frequency of headaches decrease, appointments can be eked out.

What else might be contributing to my headaches?

From my experience with my clients there are a number of factors that can also cause headaches and if you suffer from them regularly it might be worthwhile checking if any of these factors apply to you.

Are you drinking enough fluid? Frequently clients can resolve their headaches by ensuring they drink 2 litres of fluid a day. Central heating in winter, sweating in summer can affect your own hydration levels so try an extra glass of water if you feel a headache developing and see if that helps.
Working from a laptop that is not correctly positioned for you? Well not only can this cause headaches but it can really affect your posture, and not in a good way! If your head is pointing down at your lap some of the muscles in the front of your neck are working so hard to contract and hold your head in that position while muscles down the back of the neck try to maintain balance that you can develop ‘forward head posture’. Try operating the laptop on a desk with the screen at eye level and use a separate keyboard so shoulders are not hunched up.
Similarly if you hot desk the PC might not be set up for you and the screen height could mean you are tilting your head to see it correctly and overworking some small muscles in the back of your neck causing headaches. Adjust the screen height and see if that reduces tension in the upper part of your neck.
Certain foods may act as triggers for headaches or migraines: coffee, chocolate and cheese are the main culprits but keeping a food diary and seeing if there are any relationships between what you eat and your headaches might be an area you would like to explore.
Grinding your teeth can cause jaw pain and tension that can contribute to headaches. Speak to your dentist but a massage therapist who can work in and around the mouth and neck may help reduce the tension in this area and any resultant headaches.
Tension can build up if there is a lack of physical activity. Try to ensure that you at least take a brisk walk during your lunch hour. See if you can do a regular activity such as football, squash, dancing, yoga or tai chi ‒ anything you think you would enjoy to get you moving!
However if you are always on the go and are exhausted from working hard, looking after family, socialising, etc then you might have a headache because you are overtired so get some rest. You can’t burn the candle at both ends…
Get your eyes checked! Squinting or peering over glasses that have fallen down your nose can again cause your neck muscles to tighten and again lead to headaches. A trip to the opticians will quickly resolve the problem.

Although not exhaustive, I hope this checklist of factors that contribute to causing headaches may prove useful. However, if you have gone through the list and still have a headache that you feel is muscular in its origin then why don’t you book an appointment to visit a massage therapist.

Susan Harrison

Powertouch Therapy