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Tendinitis
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An injury that affects sports enthusiasts and office workers
Tendinitis can affect everyone from tennis players and golfers to warehouse and office workers. Known for painful inflammation ("itis" refers to inflammation), scarring of tendons, swelling, and a feeling of weakness, tendinitis inhibits proper muscle function. Muscles form a part of our body's locomotor system. They serve to provide movement and stability of our skeleton and internal organs. The tendon is the tissue at the end of the muscle that connects to the bone.
Common areas of pain
Tendinitis is sometimes confused with or occurs with a condition called "tendonosis," a degenerative condition of the tendon, which also causes pain and dysfunction. The most common sites for both are the shoulder, arms, hip, hamstrings and the Achilles tendon. You may experience pain at the site of the injury or pain can be referred, or radiated, to areas distant from the injury.
The role of repetitive actions
Through repeated micro-trauma, tendons can develop tiny scars. Repetitive strain injuries (RSIs) develop from repeated movements and are characterized by pain, stiffness and tissue scarring. They often involve tendons that cannot adapt to forces placed upon them. Unless you've suddenly whacked your tendon, pain and dysfunction usually occur gradually through repeated trauma to the tendon. A thorough assessment will help determine the cause of your specific problem.
Massage technique for tendinitis
Cross-fiber friction reduces pain and helps heal. Cross-fiber friction massage was developed for treating injuries by Dr. James Cyriax, MD, who is sometimes called the father of orthopedic medicine. In cross-fiber friction, pressure is applied crosswise to the affected tissues for 2-5 minutes. The sensation can be numbing and uncomfortable. However, any pain should subside within minutes, and massage therapists make it a point to work within pain tolerance levels.
The case of tennis elbow
Tennis elbow is a painful condition involving micro-scarring deep within the muscles and tendons of the forearm. These scars consist of fibers which are laid down randomly, limiting movement. To help heal the condition, deep friction is applied across the length of the forearm at the site of the injury. This is similar to rolling the fingers over a pile of toothpicks until they all reorient in the right direction. Realigning the tissues with cross-fiber friction often requires a series of treatments. The goal is to reduce and mobilize areas of scar-like tissue, reduce pain, improve the overall function of the tendon, and restore muscle length and strength.
MASSAGE THERAPY FOR TENDON INJURIES
Specific techniques reduce pain and restore function
Massage is very effective in treating both acute and chronic tendon conditions. Massage therapists draw from an extensive background in clinical anatomy, and hands-on assessment and treatment skills. For tendon injuries, people often find short, regular visits reduce recovery time.
Why massage?
Massage relaxes and lengthens muscle groups in the area of injury and dysfunction. In addition, transverse or cross-fiber friction massage is often used on the area of the specific tendinitis, followed by ice. Massage also helps to ensure that the joint areas above and below the injury site (where applicable) stay relaxed and mobile.
Warm and cold applications
Massage therapists often use hydrotherapy in addition to massage. When inflammation is present, ice may be applied as a natural pain reliever. After the major inflammation winds down, contrast hydrotherapy is often used to improvecirculation to the injury site. This means that warm and cool applications are applied alternately on the area, several times each of warm and cool, ending with cool. Finally, after a few weeks brief heat applications may be used, unless there is a flare-up of symptoms, in which case ice may again be applied. If your tendon is painful after work or exercise, you can use ice at home, following your therapist's guidelines, to reduce the body's inflammation response and relieve pain.
"Strength that has effort in it is not what you need; you need the strength that is the result of ease." --Ida Rolf, PhD, author of Integration of Human Structures: Rolfing
Natural Touch Marketing
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Why Fish Oils Work Swimmingly Against Inflammation and Diabetes
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ScienceDaily (Sep. 4, 2010) -
Researchers at the University of California, San Diego School of Medicine have identified the molecular mechanism that makes omega-3 fatty acids so effective in reducing chronic inflammation and insulin resistance.
The discovery could lead to development of a simple dietary remedy for many of the more than 23 million Americans suffering from diabetes and other conditions.
Writing in the advance online edition of the September 3 issue of the journal Cell, Jerrold Olefsky, MD, and colleagues identified a key receptor on macrophages abundantly found in obese body fat. Obesity and diabetes are closely correlated. The scientists say omega-3 fatty acids activate this macrophage receptor, resulting in broad anti-inflammatory effects and improved systemic insulin sensitivity.
Macrophages are specialized white blood cells that engulf and digest cellular debris and pathogens. Part of this immune system response involves the macrophages secreting cytokines and other proteins that cause inflammation, a method for destroying cells and objects perceived to be harmful. Obese fat tissue contains lots of these macrophages producing lots of cytokines. The result can be chronic inflammation and rising insulin resistance in neighboring cells over-exposed to cytokines. Insulin resistance is the physical condition in which the natural hormone insulin becomes less effective at regulating blood sugar levels in the body, leading to myriad and often severe health problems, most notably type 2 diabetes mellitus.
Olefsky and colleagues looked at cellular receptors known to respond to fatty acids. They eventually narrowed their focus to a G-protein receptor called GPR120, one of a family of signaling molecules involved in numerous cellular functions. The GPR120 receptor is found only on pro-inflammatory macrophages in mature fat cells. When the receptor is turned off, the macrophage produces inflammatory effects. But exposed to omega-3 fatty acids, specifically docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), the GPR120 receptor is activated and generates a strong anti-inflammatory effect.
"It's just an incredibly potent effect," said Olefsky, a professor of medicine and associate dean of scientific affairs for the UC San Diego School of Medicine. "The omega-3 fatty acids switch on the receptor, killing the inflammatory response."
The scientists conducted their research using cell cultures and mice, some of the latter genetically modified to lack the GPR120 receptor. All of the mice were fed a high-fat diet with or without omega-3 fatty acid supplementation. The supplementation treatment inhibited inflammation and enhanced insulin sensitivity in ordinary obese mice, but had no effect in GPR120 knockout mice. A chemical agonist of omega-3 fatty acids produced similar results.
"This is nature at work," said Olefsky. "The receptor evolved to respond to a natural product -- omega-3 fatty acids -- so that the inflammatory process can be controlled. Our work shows how fish oils safely do this, and suggests a possible way to treating the serious problems of inflammation in obesity and in conditions like diabetes, cancer and cardiovascular disease through simple dietary supplementation."
However, Olefsky said more research is required. For example, it remains unclear how much fish oil constitutes a safe, effective dose. High consumption of fish oil has been linked to increased risk of bleeding and stroke in some people.
Should fish oils prove impractical as a therapeutic agent, Olefsky said the identification of the GPR120 receptor means researchers can work toward developing an alternative drug that mimics the actions of DHA and EPA and provides the same anti-inflammatory effects.
Co-authors of the paper are Da Young Oh, Saswata Talukdar, Eun Ju Bae, Hidetaka Morinaga, WuQuiang Fan, Pingping Li and Wendell J. Lu, all in the Department of Medicine, Division of Endocrinology and Metabolism at the University of California, San Diego; Takeshi Imamura, Division of Pharmacology, Shiga University of Medical Science; and Steven M. Watkins, Lipomics Technologies, Inc.
Funding for this research came, in part, from a National Institutes of Health grant and the Eunice Kennedy Shriver NICHD/NIH.
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Editor's Note: This article is not intended to provide medical advice, diagnosis or treatment.
Journal Reference:
1. Da Young Oh, Saswata Talukdar, Eun Ju Bae, Takeshi Imamura, Hidetaka Morinaga, WuQiang Fan, Pingping Li, Wendell J. Lu, Steven M. Watkins, Jerrold M. Olefsky. GPR120 Is an Omega-3 Fatty Acid Receptor Mediating Potent Anti-inflammatory and Insulin-Sensitizing Effects. Cell, 2010; 142 (5): 687-698 DOI: 10.1016/j.cell.2010.07.041
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 A Healing Touch Massage
A Healing Touch Massage
More than just a name... it's a promise!
Dan O'Clair & Roxie Reimer
480-215-9471 or 602-568-1531
PO Box 3070
Apache Junction, AZ 85119
Providing in-home therapeutic massage to the metropolitan Phoenix area since 2003.
Call for your appointment today!
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You didn't miss the September newsletter, I did. Somehow September came and went before I was even aware of it!
Now Fall is in the air. We've had "unseasonably warm" weather, but "they" kept telling us it will cool off soon! Finally it has. Only it really cooled off! Not to worry, well be back in the 80s in just a few days. Friends in many parts of the country would be grateful for just a little of our heat to extend their gardening or their enjoyment of the season before really cold weather sets in. In Traditional Chinese Medicine we are on that cusp between Summer and Autumn known as "Indian Summer." It is a time of transition; and you may find yourself in transition at this time as well.
Certainly as our Arizona weather starts to change many more of us venture out to finish outdoor projects that didn't get completed before the heat came or to enjoy a hike or bicycling. Some of you are runners and you can now run at more reasonable hours than in the heat of summer.
You may be facing other transitions as well. Some of you are transitioning from your primary residences to your winter homes. Others have moved from long time residences into places closer to family or with more amenities. Wherever you find yourself, right now would be a good time to receive some bodywork.
This weekend Roxie and I will be attending a three day Myoskeletal Alignment workshop in Tucson lead by Erik Dalton. I've followed his work through his newsletter and facebook the past year and incorporated some of his techniques. Now I've decided it's time to take a course with him. I'm as excited as a six-year old in a candy shop with a whole dollar to spend!
I hope you enjoy this issue, I've tried to bring you some great content that you'll find helpful.
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So You Need to See the Dentist?
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Recently I've had a couple of clients who have been getting dental work done; the kind that has you sitting in the dental chair with your mouth wide open for over an hour. If it's been awhile since you've had to hold your mouth open wide for any length of time, and you've forgotten how difficult it is I challenge you to set your kitchen timer for 5 minutes and stretch that jaw open... oh yeah, now you remember.
Anatomy
The mandible, or lower jaw, is connected to the temporal bone of the skull via the temporomandibular (TM) joint, an extremely complex joint which permits movement in all planes. (We'll save Temporomandibular Joint Dysfunction, TMD or TMJD for another time.)
The muscles of mastication (chewing) originate on the skull and insert into the mandible. There are four primary muscles that move the jaw; the masseter, the temporalis, the medial pterygoid and the lateral pterygoid. The first three are all jaw closers, the lateral pterygoid is the only one that opens the jaw, or depresses the mandible. And remember, you have two of each of these muscles a set on the right and a set on the left. So while you are sitting with your mouth stretched open wide, six muscles want to close and two are desperately trying to keep the jaw open.
Dental Work and Massage
"What does this have to do with massage?" you ask. Six muscles being stretched and two muscles resisting that stretch for an hour or so, tells me your jaw is going to be sore (even before you add in the injections and dental procedure). And sitting in that chair (no matter how comfortable they've gotten) trying to be perfectly still, inevitably has you tensing muscles in your neck. In addition, if you're a chicken like me, the stress and anxiety of the whole experience has you feeling like you've been to the gym for a much needed workout or like you've gone a few rounds with Rocky in the ring.
But can massage really do anything to help? I'll let my client Meg share her experience with you.
"I recently found it necessary to have a root canal on a back tooth. Besides the obvious stress from the situation, I endured several hours in the dentist's chair with my head slightly turned to one side and my jaw forced open all the way. Although the root canal was completed, I was left with a severe headache. By the next morning my head, my neck and both upper and lower jaw bones were aching. The tooth needed to be ground down a bit more so my bite was correct, but the headaches continued. I finally called Dan and as soon as he was done with the massage session, I felt relief. I then needed to go back to be fitted for a crown so made an appointment with Dan for the next day. I highly recommend seeing Dan [or Roxie] after any dentist visit. The whole situation is a stressful one and I have found massage to be the best way to feel better fast."
What made this massage work so well for Meg (and many others) was time spent working muscles of the face, those six jaw muscles and muscles of the neck that were impacted by the time spent mouth wide open in an unnatural position.
So you need to see the Dentist? Call and schedule a massage for later that day or the following day to see how much better you can feel!
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HIgh Heels Reshape Leg Muscles and
Create Pain When Not Worn
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By Rachael Rettner, LiveScience Staff Writer
Women who wear high heels daily might be signing up for more than a little foot pain. Habitual high-heel wearing can lead to changes in the calf muscle and tendons, according to a new study.
So much so that these women actually experience discomfort when they walk around sans stilettos.
The high-heel habit can cause fibers in the calf muscle to shorten, and the Achilles tendon, which connects the calf muscle to the bone, to stiffen and become thicker. While this set-up doesn't pose problems when the heel is propped up, it can lead to discomfort when standing or walking around flat-footed because the muscle and tendon are stretched beyond their normal range of movement.
"In a way, the system has adapted to this new position," said study researcher Marco Narici of Manchester Metropolitan University in the United Kingdom. "When they wear high heels the muscles feel more comfortable."
The results were published July 16 in the Journal of Experimental Biology.
Measuring muscles
When people put on high heels, their ankles are raised and their calf muscles are held in a shortened (contracted) position. Scientists know that when people place their muscles in a shortened position for a long period of time-such as in a plastic cast-the muscle literally becomes shorter, Narici said.
Narici wondered if constantly wearing high heels could also cause muscle shortening.
"I thought that: women wearing high heels were doing an experiment for us without knowing it, so all we had to do was recruit them and test them," he told LiveScience.
In addition, there is anecdotal evidence from the 1950s that secretaries experienced discomfort when they took off their high heels and walked barefoot, Narici said, which also suggested perpetually wearing high heels causes changes.
The study participants included 11 women (average age 43) who had worn stiletto high heels (at least 2 inches, or 5 centimeters high) for five days a week for two years or more. Most of the subjects said they felt discomfort when they were standing barefoot. A control group of nine women who did not regularly wear high heels was also included.
Narici and his colleagues first measured the size of the women's calf muscles using magnetic resonance imaging (MRI). However, they didn't find any differences in muscle volume between the two groups.
Next, they used ultrasound to measure the length of the calf muscle fibers, finding they were 13-percent shorter in high-heel wearers compared with the control group.
Having shorter fibers should affect how the muscle contracts-shorter fibers should generate less force and make walking less efficient in these women. But the researchers couldn't find any differences between the two groups in terms of how the calf muscle contracts.
An examination of the Achilles tendon showed the tendons of high-heel wearers were thicker, and thus stiffer, than those of non-high heel wearers.
The thicker tendons counterbalance the shorter muscle fibers and allow the muscle to behave normally, Narici said. But the combined effect of the thicker tendon and the shorter fibers is the likely reason behind the soreness felt when high-heel wearers ditch their stilettos.
High heels aren't the only footwear risk. A separate study in 2008 found that constantly wearing flip-flops alters how you walk, changing the gait in subtle ways that can lead to problems and pain in the sole, heel and ankle.
Ditch the heels?
Narici doesn't think the results mean women should give up wearing high heels. But he recommends stretching exercises after a day of wearing high heels to prevent the muscle fibers from shortening.
Currently, Narici and his colleagues are investigating whether thicker Achilles tendons make running less efficient.
Narici conducted his work with Robert Csapo of the University of Vienna, Austria, and Olivier Seynnes and Costis Maganaris of Manchester Metropolitan University.
The study was funded by Manchester Metropolitan University and the University of Vienna.
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12 Tips for Getting Regular Exercise
-- and the Benefits for Happiness
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by Gretchen Rubin
Exercise is a KEY to happiness. Research shows that people who exercise are healthier, more energetic, think more clearly, sleep better, and have delayed onset of dementia. They get relief from anxiety and mild depression. They perform better at work.
Also, although it's tempting to flop down on the couch when you're feeling exhausted, exercise is actually a great way to boost energy levels. Feeling tired is a reason to exercise, not a reason to skip exercise.
But even when you admit that you'd feel better if you exercised, it can be very hard to adopt the habit. My idea of fun has always been to lie in bed, reading, preferably while also eating a snack - but I've managed to keep myself exercising over the years by using all these tricks on myself:
1. Always exercise on Monday. This sets the psychological pattern for the week. Along the same lines...
2. If at all possible, exercise first thing in the morning. As the day wears on, you'll find more excuses to skip exercising. Get it checked off your list, first thing. It's also a very nice way to start the day; even if nothing else goes right, you've accomplished that.
3. Never skip exercising for two days in a row. You can skip a day, but the next day, you must exercise, no matter how inconvenient. (Lately, I haven't been following this rule, and it has really affected my routine for the worse. I'm going to re-double my commitment to it.)
4. Give yourself credit for the smallest effort. My father always said that all he had to do was put on his running shoes and close the door behind him. Many times, by promising myself I could quit ten minutes after I'd started, I got myself to start - and then found that I didn't want to quit, after all.
5. Think about context. I thought I disliked weight-training, but in fact, I disliked the guys who hung out in the weight-training area. Are you distressed about the grubby showers in your gym? Do you try to run in the mornings, but recoil from going out in the cold? Examine the factors that might be discouraging you from exercising.
6. Exercise several times a week. If your idea of exercise is to join games of pick-up basketball, you should be playing practically every day. Twice a month isn't enough.
7. No time to exercise and take a shower? Find a way to exercise that doesn't require you to shower afterward. Each week, I have a very challenging weight-training session, but the format I follow doesn't make me sweat. (Some of you are saying, "It can't be challenging if you don't sweat!" Oh yes, believe me, it is.)
8. Look for affordable ways to make exercising more pleasant or satisfying. Could you upgrade to a nicer or more convenient gym? Buy yourself a new iPod? Work with a trainer? Get a pedometer to keep track of your walking distances? Exercise is a high life priority, so this a worthwhile place to spend some money if that helps.
9. Think of exercise as part of your essential preparation. For times you want to be in especially fine form, whether in performance (to be sharp for an important presentation) or appearance (to look good for a wedding) or mood (to deal with a stressful situation), excercise is the answer. In college, my roommates and I always made sure to exercise the day of a big party. Studies show that exercise does help.
10. Remember one of my favorite Secrets of Adulthood (courtesy of Voltaire): Don't let the perfect be the enemy of the good. Don't decide it's only worth exercising if you can run five miles or if you can bike for an hour. I have a friend who scorns exercise unless she's training for a marathon -- so she never exercises. Even going for a ten-minute walk is worthwhile. Do what you can.
11. Suit up. Even if you're not sure you're going to exercise, go ahead and put on your exercise clothes. Pack your bag. Put the dog's leash by the door. Get prepared. If you're ready to go, you might find it easier just to go ahead and exercise. Sometimes, a very trivial thing -- like not knowing where your shoes are -- gets in the way.
12. Don't kid yourself. Paying for a gym membership doesn't mean you go to the gym. Having been in shape in high school or college doesn't mean you're in shape now. Saying that you don't have time to exercise doesn't make it true.
People often ask me, "So if I want to be happier, what should I be doing?" and I always say, "The first thing to do is to make sure you're getting plenty of sleep and some exercise."
I know, that answer doesn't sound properly transcendent and high-minded on the subject of happiness, but research shows that you'd be wise to start there. And I've found that if I'm feeling energetic and well-rested, I find it much easier to follow all my other happiness-inducing resolutions.
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Gretchen Rubin is the author of the #1 New York Times bestseller, The Happiness Project - an account of the year she spent test-driving the wisdom of the ages, the current scientific studies, and the lessons from popular culture about how to be happier. On her popular blog, The Happiness Project, she reports on her daily adventures in the pursuit of happiness.
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Next month I'll share some of the exciting things we learn in Tucson.
Until then... yours for better health,
A Healing Touch Massage
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