Tag Archives: pain

Piriformis as an internal rotator?

I’d like to hear from you.  What’s your take on this?

Why is it that we can stretch piriformis by externally rotating the leg as we bring the knee toward the opposite shoulder?  Or in yoga pigeon pose?

Piriformis. The piriformis muscle is a deep muscle located beneath the gluteal (butt) muscles. The piriformis muscle laterally rotates and stabilizes the hip. This muscle is important for athletes who participate in running sports that require sudden changes of direction. The piriformis works along with other hip rotators to turn the hips and upper leg outward (external rotation of the hip). Strong and flexible hip rotators keep hip and knee joints properly aligned during activity and help prevent sudden twisting of the knee during quick side-to-side movements, quick turns, lunges or squats.

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Filed under body mechanics, Flagstaff pain relief, hip pain

Anterior Hip Capsule Release

Free the Hips (fig. 1)

Prolonged sitting, hip flexor tightness, overuse and misuse can all cause hip problems.  Often when the “soft tissue” i.e., muscle, becomes tight the deeper layers of the connective tissue surrounding a joint will become short, stuck and glued down.  The hip capsule is unique in that it has a sort of rotatory arrangement of its fibers.

One commonly seen pathology, is the head of the femur (ball) becoming fixated into the posterior portion of the acetabulum (socket).  A pain generator to be sure, as the bone grinds on the inside of the joint space.    This may occur as a result of a dropped arch, internally rotated leg, and rotation of the femur.

One way to address the issue at the hip, is to position yourself or client/patient as shown in (fig.1).  This external rotation of the femur causes the head of the femur to migrate into external rotation, stretching the iliofemoral lig., which attaches the hip to the thigh and visa versa.    (The one that gets all glued up during bouts of great hip flexion and approximation of muscular origin-insertion.)  If you are a therapist using this technique position hands just inferior to greater trochanter.  Gravity will help those who help themselves.  To add an enhancer to this position, you may try pelvic tilts…tuck the tail bone under and back out.  Some people may feel a bit strange about this enhancer so I recommend pushing the knee into the floor for a count of 6-8 seconds, release and repeat 3-5 times.   You may also feel a bit of increase in ROM in adductors, sometimes that feels great.  DO NOT use this technique if you have to great a range of motion already.  In my opinion loose joints are more dangerous than tight joints.  Enjoy!

For more info or to book a session with Geoffrey Bishop, LMT in Flagstaff, AZ…call 928-699-1999.  e mail at staytunedaz@gmail.com

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Filed under Arizona Massage CEU, Flagstaff pain relief, High Altitude massage, Myoskeletal Alignment, pain management, Sport massage, Uncategorized

Winter Aches and Pains, Pt.1

Winter is upon us.  With the changing of the seasons there come change in the body.  A variety of muscles, that may have been in some state of hibernation, are called upon to get us through the new conditions, when the air gets cold, the snow falls and the stressors of the holidays build.  Without proper preparation and awareness, it may be easy to become fatigued and possibly injured.  Let’s discuss a few of the common concerns we see at Stay Tuned Therapeutics.

Leg, Groin and Pubic Bone pain.

Weakness or tightness in the adductor muscle group of the thigh may play a major role in the development of groin “pulls”, SI joint dysfunction, pubic bone pain, medial knee pain, etc.  Stabilizing the legs under our body in the slick conditions after a new snow fall is one of the responsibilities of the adductors.

The attachments (origin) coming from the periosteum of the pubic and ischium bones of the pelvis are common locations of strain.  Commonly noted in athletics where there is a forceful abduction during an internal rotation and adduction movement, such as soccer, we can imagine the reverse to be true as well when slipping on unstable surface such as ice. Hip adductor injuries occur most commonly when there is a forced push-off (side-to-side motion). High forces occur in the adductor tendons when the athlete must shift direction suddenly in the opposite direction. As a result, the adductor muscles contract to generate opposing forces.  We have all taken a bit of a slip, during running, walking to the car, lift line etc., leg shoots out, and we suddenly contract our adductors forcefully to bring the leg back under us.  This opposing action is a major cause for injury.

In the next entry we will look at, strength, flexibility and balance, in an attempt to prevent hip/groin injury in the winter season.  Also, we will also look at other common injuries and stressors as the holidays grow near.  Stay Tuned.

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Maintenance Techniques for twitter-finger.

Having been a massage therapist for 13 years now I have never had an injury to my arms, wrists or hands.  You can use these simple exercises to ensure a long life in whatever job you have that requires extensive use of the hands and forearms.

Take computing for instance, there is no other way you found this information, how many hours a day do you spend on the keyboard, the mouse, or just hunched over in that nice chair?  Now, how many minutes a day do you spend providing regeneration to the injured/over used tissue.  Now, what is your plan for pain free longevity in this position you so love?

You may be the type of person who just prefers having a massage to treat aches and pains, great, I’ll take your money.  However, do you realize that hard earned money you invest in therapy will go so much further if you take some responsibility?

Take 5 minutes and follow me through on these exercises, if you need a band contact me and you can stop by, or I will ship one.

Stay Tuned…

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Filed under Flagstaff deep tissue massage, Flagstaff pain relief, Flagstaff therapeutic massage, Myoskeletal Alignment, pain management

Women Need Expanded Musculoskeletal Care During Pregnancy

Stay Tuned Therapeutics offers musculoskeletal work for pregnancy in Flagstaff, Arizona.  Here’s why…

ScienceDaily (Mar. 12, 2007) — Despite the high prevalence of musculoskeletal pain during pregnancy, few women in under-served populations receive treatment for their low back pain, according to a February 2007 study in the Journal of Manipulative and Physiological Therapeutics (JMPT).  Moreover, researchers found that pain in a previous pregnancy may predict a high risk for musculoskeletal complaints in future pregnancies.


According to Clayton Skaggs, DC, the study’s chief author, 85 percent of women surveyed reported that they had not received treatment for their musculoskeletal pain, and of the small percentage who perceived that their back complaints were addressed, less than 10 percent were satisfied with the symptom relief they obtained.

“Based on the findings of this study, doctors of chiropractic and other health care professionals need to expand the musculoskeletal care available during pregnancy, especially in underserved populations,” Dr. Skaggs said.  “As a proactive step, health professionals should consider including back pain screening as part of early obstetrical care to help identify musculoskeletal risk factors and allow for early education and/or treatment.”

Researchers surveyed more than 600 women at a clinic that serves predominantly an uninsured, underinsured or Medicaid-insured population.  Surveys were offered to all obstetrical patients and were designed to collect information about pregnancy-related pain and quality of life issues.  Of those women who responded to the survey, two-thirds reported back pain and nearly half of all women reported pain at two or more locations, including pelvic pain and mid-back pain.

The study findings suggest that pregnant women with back pain are predisposed to sleep disturbances.  In the survey, close to 80 percent of women reporting sleep disturbances had back pain, whereas only 8 percent of women without pain reported problems sleeping.  More alarming was the significant relationship between reports of musculoskeletal pain and the use of pain medication.  Three-fourths of the women who reported pain also described use of pain medication.

“We saw a direct association between sleep deficiency and back pain,” the authors said.  “These results raise the question of whether or not the high incidence of pain medication use reflects a lack of education about potential risks of medications or more an inability for the pregnant women to cope with the pain.”

The study’s authors also found a relationship between pain in a previous pregnancy and pain in the current pregnancy.  Similar to the results of other studies, researchers found that 85 percent of women who experienced pain in a previous pregnancy reported pain during their current pregnancy.

The study was the result of on-going collaboration between Logan College of Chiropractic and the Department of Obstetrics at Washington University School of Medicine.


Adapted from materials provided by American Chiropractic Association.
American Chiropractic Association (2007, March 12). Women Need Expanded Musculoskeletal Care During Pregnancy. ScienceDaily. Retrieved September 29, 2009, from http://www.sciencedaily.com­ /releases/2007/03/070307075536.htm

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Filed under Flagstaff deep tissue massage, Flagstaff pain relief, Myoskeletal Alignment, pain management, Pregnancy Pain

7th Interdisciplinary World Congress on Low Back & Pelvic Pain

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I will be going to the 7th Interdisciplinary World Congress on Low Back & Pelvic Pain.

We would like to invite you to join us for the 7th Interdisciplinary World Congress on Low Back & Pelvic Pain, to be held in November 2010 in Los Angeles, U.S.A. This program is held every three years. All the disciplines involved in the treatment and research of musculoskeletal disorders around the globe come together in a stimulating meeting related to musculoskeletal disorders. Those of you who attended the last meeting in Barcelona will need no further encouragement to attend what promises to be another great congress. This is a great opportunity to meet and talk with members of diverse disciplines from all around the world.

Scientific sessions are already being planned and the quality of the speakers will be excellent. In addition we will offer you a relaxed atmosphere to meet, chat and have fun.

We hope you will all be able to join us.

Yours sincerely,

Dr. Andry Vleeming

Dr Vert Moony

Dr Colleen Fitzgerald

Scientific Committee
Andry Vleeming, Vert Mooney, Colleen Fitzgerald, Jaap van Dieen, Maurits van Tulder, Robert Schleip, Leon Chaitow, Mel Cusi, Paul Chek, Diane Lee, Paul Hodges, Peter O’Sullivan, Paul Watson.

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What is Myoskeletal Alignment Techniques?

From Erik Dalton, PhD, founder of Freedom From Pain Institute, creator of Myoskeletal Alignment Techniques.

What makes MAT Special?

Well-documented theories explain how joints become fixated from myofascial stressors; yet relatively unknown in the massage therapy community is how joint dysfunction creates protective muscle spasm and dysfunctional strain patterns, such as forward head postures, slumped shoulders and scoliosis. This reflexogenic relationship between muscles and joints is the foundation of the Myoskeletal Alignment Technique and is considered not only uniquely different from traditional thinking, but possibly an important next step in addressing abnormal strain patterns caused by muscle/joint imbalances.

Massage therapists can now safely address all soft tissues, including ligaments, nerve dura, fasciae, discs and joint capsules, responsible for much of the pain previously blamed on muscles alone. Osteopathic methods, such as muscle energy, strain-counter strain and mechanical link, are also designed to relieve muscle/joint dysfunctions, but the MAT method complements today’s bodywork practices as it was specifically designed to fit a massage-therapy format.

One distinguishing goal that establishes the MAT method apart from other techniques is its dependence on identification and correction of joint fixations. This is accomplished by systematically releasing deep spinal muscles, ligaments and fibrotic joint capsules that torsion and compress spinal joints. In some cases, a bodyworker may apply direct pressure to bones to release fibrotic muscles that create joint blockages, but the intent is always soft-tissue work.

Posture’s Roll

Most manual therapists today agree that no therapeutic approach to neck/back pain is complete unless body posture is generally improved. Whatever the root of the client’s condition, special attention must be dedicated to posture-especially the correct positioning of the pelvis. Many therapists complain that postural assessments are often too complex, too time-consuming, too clumsy-in a typical massage setting with the client draped.

The MAT method lessens assessment anxiety with an efficient five-minute hands-on evaluation that quickly identifies gross body asymmetries, such as pelvic tilts, short legs, sacroiliac dysfunctions, scoliosis, facet restrictions and hip-capsule adhesions. MAT also incorporates Vladimir Janda, M.D.’s upper-and-lower crossed visual assessment method for easy recognition of muscle-imbalance patterns that cause neck and low-back pain. Combining these hands-on and visual assessment techniques allows the therapist to immediately tell which muscles are tight and pulling unevenly on the body’s bony framework, and which weak muscles are permitting the asymmetry. Janda’s muscle-imbalance research has gifted bodywork practitioners with a remarkably useful model for explaining how predictable muscle imbalances cause predictable faulty postural patterns, such as slumped shoulders, forward heads, swaybacks and dowager’s hump. (Hands on procedures using Janda’s formula are detailed in Part II of this series.)

Ultimately, for long-lasting relief of chronic neck/back pain, the MAT system works to achieve these goals:

balancing the head on the neck

balancing the neck on the shoulders

balancing the shoulder girdle on the rib cage

balancing the pelvis on the femurs

restoring pain-free movement

Recent studies have confirmed a noticeable reduction in noxious neural input entering the spinal cord and brain when the postural goals listed above are met. In 1979, biomechanical researcher J. Gordon Zink, D.O., coined the term “common compensatory patterns” to describe routinely found postural patterns in the neuromyofascial-skeletal system. His studies were the first to validate how structure and function play a dual role in posturally initiated pain syndromes. Eventually, he concluded that postural muscle stress leads to chronic, recurrent central nervous system irritation initiated by sensory receptors, such as mechanoreceptors, nociceptors and chemoreceptors.

Postural muscles are structurally designed to resist fatigue and function in the presence of prolonged gravitational exposure. If their capacity to resist stress is lost, the postural muscles become irritable, tight and shortened. Fortunately, as balance and function are re-established in distorted myofascial structures, hyperactivity in agitated joint and muscle receptors rapidly dissipates. Zink’s conclusion leads to the underpinnings of the client’s outcome: less sympathetic muscle spasm, less limbic system activation, less stress-and less pain.

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Filed under Arizona Massage CEU, Flagstaff Arizona massage, Flagstaff deep tissue massage, Flagstaff pain relief, flagstaff sports massage, Flagstaff therapeutic massage, High Altitude massage, Massage CEU Arizona, massage education, Myoskeletal Alignment, Myoskeletal Alignment CEU, pain management