Chronic stress can be damaging to our bodies. It can affect respiratory, cardiovascular, digestive and even reproductive systems. But did you know that chronic stress also impacts the musculoskeletal system?
– The mechanism of stress in pain –
When stressful situations arise, the body’s response is to go into a ‘flight, fight response to protect itself against harm or injury. Physically this can be seen through tightening and spasming of muscles. This is an automatic reflex response, where the muscle tension will generally ease once the stressful situation has passed.
Why does the muscle still remain in spasm after the stress has gone?
Sometimes in the case of ongoing chronic stress, the body may have set into a cycle of pain even after the painful stimulus or stress has gone. It protects itself by staying in pain and so when stress arises again the body is already ‘protected’.
This can lead to a range of conditions such as:
Movement dysfunction – Restriction and pain on normal daily activities
Muscular spasm and muscle weakness
Headaches, migraines and Jaw pain
Neck, back and shoulder pain
The pain cycle can lead to further negative patterns
For example, fear avoidance is where a person with chronic stress and pain will start avoiding more and more things to try and stop triggering pain or stress, even though these activities may not be related. This in turn usually decreases physical activity, increases low mood and leads to further patterns around pain. This will continue in a downward spiral until something breaks the cycle.
– How to relieve pain related to stress –
The earlier we assess and treat when the body is stressed both physically and mentally, the less likely the body will get into a pain cycle. Early intervention is key!
Stopping the pain progression
If your pain has lasted more than 6 months, seek the advice of your health care professional. This is to make sure you don’t need a scan, a specialist referral or medication to help break the pain cycle.
During your consultation an assessment will be performed through movement and orthopaedic test. The key is to find out what is going on so we can offer better treatment and management advice. Often during the movement testing we discover something that can help you at home.
If a helpful, pain relieving movement is found, we will explain the what’s going on so you better understand your pain. Its really empowering! If we don’t find a movement that helps we will move on to some treatment.
Treatment can include Massage, Dry Needling, Joint Mobilisation and Cupping to name a few. As Clinical Myotherapists we have a wide range of tools in our tool kit we can draw upon. This step is about assisting the movement therapy further by reducing pain and increasing movement. Oftentimes we can get more out of the movement therapy after treatment intervention.
Lastly a Remedy Routine is given to you which outlines what you will continue doing to get out of pain. It will detail your movement therapy and may include stretches and strengthening but usually that comes a bit later. We will stay in touch via email to closely monitor progression and follow up in about a week initially to stay ahead of your pain cycle and progress your remedy routine.
– Stress reduction –
Stress reduction is an important part of reducing your pain. Things that can help reduce stress include exercise, meditation or mindfulness and talking about your problems with a friend. Sometimes the help of a Counsellor or Psychologist to learn new coping strategies or CBT for example can be very helpful.
Article by Dwan Rosairo & Sarah Hall (BHSc – Clinical Myotherapy) – If you’d like to chat, click here to book a free 15 minute consultation or book a full consult here.
There are several reasons why you might experience pregnancy pains related to muscle, joint and nerve. Depending on where the pain is, the intensity of the pain and the type of pain will determine the best course of action to resolve your pain. If the following exercises don’t help or if your pain is intense, please get a consultation for personalised advice or visit your doctor. Furthermore If you are unsure of why you have pain (i.e. it’s an unfamiliar pain), if this is your first pregnancy or if your pain is severe, sharp, shooting, throbbing or deep you should see your doctor or specialist before all else.
Low Back Pain
This is the most common pregnancy pain we see at the clinic. The pain is usually right on the dimples at the very bottom of the low back. Sometimes there is referral up and down or across the low back as well. From how long women leave it before seeking treatment, I sense that there is a lot of pregnant ladies putting up with low back pain unnecessarily. Although low back pain is a common part of pregnancy and a lot of women experience it, this doesn’t mean you have to put up with it. Here in the clinic we find treating the gluteal and hip flexor trigger points together with some exercises and sometimes ROCK taping very effective. We treat either lying on your back, side lying or face down with a supportive belly pillow depending on how far along with your pregnancy you are, what area we are treating and depending on what you find most comfortable. We won’t keep you in any one position for too long and we will support you with pillows and towels where needed.
Try this exercise at home to see if it helps with your low back pain. Its purpose is to gently mobilise the spine allowing all the ligaments, tendons and muscles to get some blood flow and relax. If one way feels better than the other, you could try just doing one part of the cat stretch and finishing back at neutral spine (where the spine is in its natural position with the little dip in the low back).
On hands and knees gently curve your back towards the roof like you are trying to lengthen the back of your shirt. Make sure you softly drop your head as you get to the end of range.
Now do the opposite. Gently dip your stomach and ribs towards the floor this time softly lifting the head as you reach the end of your range.
Repeat 5-10 repetitions. Once you get the pattern working try moving one spinal segment at a time starting at the base of the spine and working your way up to the head. Try adding a breath, breathe out to move and take a breath in to prepare at either end.
Depending on how far into your pregnancy you are, the pregnancy rib pain your experiencing could likely be your baby pressing up against your rib cage, especially in your 3rd trimester if your baby is in the breech position. If this is the case, positional changes, heat and if really bad pain, paracetamol (at the recommendation of your doctor or specialist only) might be of assistance. The most common musculoskeletal cause of rib pain we see in the clinic however is from the change in spinal position. This is from changes to your centre of gravity along with increased levels of the hormone relaxin. This makes the deep supportive spinal muscles (multifidis & rotators) work harder and in a shortened position which activates their Trigger Points which so happen to refer around the ribs. If your pain seems to start at the back or side of the ribs and run around towards the front, this is the most likely cause of your pain. To help alleviate this pain at home, try the following stretch.
Side Lying Rib Rotations
Lie on your side and support yourself with pillows, cushions or towels as needed. One under the head, under the belly and between the knees is often helpful.
Bend your elbow of the arm that’s on top, drawing the elbow to the roof and sliding your hand along the lower arm.
If it feels comfortable open out further by extending the arm behind you until you feel a gentle stretch around the chest area.
Bend the elbow to gently bring the arm back through to the start position.
Repeat 10-15 times each side.
Notes: Shorter limbs make for lighter work, so always start with the elbow bent and lengthen it to increase the exercise. Don’t forget to breathe! Try a breath in for step 2 and a breath out for step 3. Then a breath in to hold and a breath out to come back to the start position.
Sciatica is a very common pregnancy pain. It can come from the lower back or from a deep muscle in your bottom called the piriformis muscle. Sciatica is distinguished by a pain starting around the bottom or hip area and travelling down the leg past the knee, sometimes as far as the ankle or the foot. During pregnancy the hormone relaxin increases making the ligaments soften. This increases the amount of load placed on your muscles, sometimes the muscles can cause the problem, other times you can end up hanging into new postural positions and putting a lot of strain on the joints especially around the lower back and hips which can aggravate the discs or nerve spaces in the lower back. We treat sciatica a lot in the clinic. Try the following exercise for the back and see if it helps.
4 point kneeling – The rock back
On your hands and knees make sure your hands are under your shoulders and your knees are under your hips. Also make sure you are in neutral spine (no dip, no curve).
Gently rock back towards your feet about half way then slowly return to the start position.
Repeat 10 -20 times remembering to maintain neutral spine the entire time.
There are several things that can cause hip and groin pregnancy pain depending on where the pain is therefore it is essential that you get a proper diagnosis before progressing with any exercises or stretches to help. A more serious causes of pain in this area is a DVT or deep vein thrombosis which is a type of blood clot. Some other things that can cause pain in this area are the round ligament, osteitis pubis, pubic symphysis irritation or inflammation and referral from the lower back.
In the clinic we mostly see people with pain relating to an imbalance of muscles around the pelvis and low back. Due to being right or left dominant in stance and exercises we tend to be a bit stronger on one side. As the relaxin hormone kicks in these muscles have to support your pregnant body more and more. If some muscles are stronger than others they start to play a game of tug of war which can cause pain in many different areas. We get people in who have already been diagnosed with things such as symphysis pubis, osteitis pubis, lower back disc irritation and round ligament pain just to name a few. Most people we see have more general aches and pains through the glutes, hips and groin and have not yet had a musculoskeletal diagnosis. We find either way, it comes back to this imbalance of muscles so our assessment, treatment and prescribed exercises will revolve around loosening off the tight muscles and strengthening the weak muscles. If there is inflammation we might use taping to help support to give the area a chance to heal. Taping is very safe during pregnancy unlike many anti-inflammatory medications.
One of the most common exercises I give to pregnant women is to strengthen their glutes and hamstrings. If you are still comfortable lying on your back try the first exercise, otherwise try the side lying exercise.
Pelvic Curl with Thera-band
Tie the band firmly around your thighs and lie on your back.
Place your knees and feet approximately hip width apart. Make sure your knee heights are the same before continuing, we want everything in alignment.
Next imagine dots on your shirt and pants where your spinal segments are. What colour are your dots?!
Press with 50% effort out into the band and peel one dot at a time away from the floor starting at the bottom and working you way up to your shoulders. This should take about a 5 seconds and is nice to do on a breath out.
Take a breath in at the top to prepare.
Breathe out to slowly return the dots back down to the mat, this time starting at your shoulders and working down towards your bottom, try not to skip the lower back and maintain the pressure out into the band if you can.
Repeat 5 repetitions the first time you do it and see how you feel the following day. Slowly add an extra repetition each day until you are doing 20 a day.
Sidelying leg kick with Thera-band
Tie the band around your thighs just above your knee and lie on your side supporting yourself with pillows particularly for the head and your belly.
Lift your leg to hip height then keeping your body steady, squeeze your glute muscles to take the leg behind you about 5-10 cms depending on your flexibility.
Slowly return it back to the start position and repeat 5 times each side. If you feel good the next day you can add 1 repetition each day until you are doing 20 each side.
I hope you’ve gotten something out of todays article on pregnancy pain. Please remember that these are not tailored exercises for you specifically so if your pain persists or gets worse please come in and see us or if serious problems with your doctor or specialist. Here at Waverley Myotherapy Clinic we use a pregnancy pillow so you may be able to lie face down, a real treat during pregnancy! Once you are too big for the pregnancy pillow we will support you with pillows in the sidelying position. If you have any questions please contact us.
Pectoralis minor (the deeper smaller chest muscle) can cause pain in the front of the shoulder and down the arm when the Myofascial Trigger Points are activated. When tight this muscle can also compromise the bundle of nerves that run down the arm and tip the shoulder blade forward giving you a rounded shoulders look and winging the lower tip of the shoulder blade off the rib cage. As Myotherapists we see a lot of tight pec minors, in fact just about everyone that comes into the clinic has tight pec minor muscles!
So with that in mind here are a few good stretches to try. If yours is really tight you may get referral down your arm when doing the stretch or you may feel like it doesn’t ease off. If this happens to you, you will need to do some self myofascial release with a spikey ball before you stretch it.
Simply find the sore point, put the ball on it and put yourself and the ball against a wall or the floor depending on how much pressure you desire. Roll it around or let it sink in for about 60 seconds on the sore spot and your done! If you still have pain during the stretch after that you might be doing it incorrectly or you might need a different stretch so best to contact your musculoskeletal specialist in that case.
Step 1. Put your hands on the door frames above head height with your elbows bent.
Step 2. Lunge through the door until you feel a stretch then slide the hands further up or down until you feel a deeper stretch.
Step 3. Hold for 60 seconds or try a contract relax version. This can also be done one side at a time in the doorway for a stronger stretch.
Foam Roller Arm Circles: my personal favourite!
Step 1. Lie on a full foam roller with it length ways along your spine including supporting your head.
Step 2. Take both arm straight towards the wall behind you so that they come close to your ears.
Step 3. Start to bend the elbows as your slide your arms down by your sides trying to let your arms relax towards the floor as you do so.
Step 4. Repeat for 10-20 reps or until you feel they have relaxed off. You may also add a small 0.5 – 1 kg weight to help the stretch.
Floor Roll Away Stretch
Step 1. Lie on your back with one arm out at a 45 degree angle above you head with the elbow bent.
Step 2. Anchor your arm with some leg weights or a heavy pillow.
Step 3. Roll your body gently away from the side being stretched until you feel the stretch coming into the deep pec area.
I hope you have fun giving these stretches a go. If you have consistently tight pec minors it is worth chatting with your practitioner about testing the strength of your lower trap muscles. These muscles do the opposite action and are commonly weak in conjunction with a tight pec minor. Click here to check out some tips on how to test and strengthen your lower trap.
What is TOS and how do us myo’s treat it? That’s what today’s blog is all about! If you have any hand or arm symptoms such as pain, numbness or tingling even if it only occurs at night it would be worthwhile having a read.
What is TOS?
Thoracic outlet syndrome is where the blood vessels and/or nerves become squashed between the first rib and the clavicle. This can result in numbness, tingling or pain in the neck, shoulder, arm or hand or a combination of symptoms in a combination of areas on down the same arm. If you’re experiencing any of these symptoms it can be diagnosed and treated. It usually takes a month or two to resolve. If your symptoms are severe we suggest going straight to a medical practitioner for scans and specialist opinion however if your symptoms are moderate or mild Myotherapy may be a quicker and cheaper alternative to alleviating your pain.
How does Myotherapy treat TOS?
We will first do some clinical assessment including a neural assessment to check what is causing your symptoms. Sometimes even though you have the symptoms of thoracic outlet syndrome, your pain and symptoms can be coming from elsewhere such as carpal tunnel, from the neck of referred pain and tingling from trigger points around the shoulder, neck, arm or forearm. Once we determine the true cause for your symptoms we can usually do some treatment straight away.
The treatment for TOS specifically involves treating the muscles and mobilising the joints involved in drawing the first rib and the clavicle closer together. These might include the scalenes or the pectoralis minor for example. Next we will work with you to develop a plan so it doesn’t become a recurring theme. This may involve simply identifying the cause and changing some habits however it may also include some home based exercises, self treatment with a self release tool or some specific exercises you will need to do under supervision. We take into account your busy lifestyle so don’t worry that you’re going to go home with a long list of exercises.
What is the best home treatment for TOS?
Want to try something at home to help? Find us on instagram or facebook @myothrive for tips such as spiky ball release for the pectoralis minor muscle. Because the pec minor attaches from the coracoid process which sits just under the collar bone, and then down onto the first couple of ribs, when it gets tight and short, it can lift the rib cage up causing a narrow space for the nerve, artery and vein to pass through. By gently releasing the muscle we can allow the rib cage to drop back to it’s usual resting place and give more space to the blood vessels and nerves. Overdoing this one will leave you feeling bruised so take it slow for best results.
If you want to organise a chat with one of the Myotherapists here at Myothrive, simply email us at [email protected] and we can organise a time. Want to book now? Here’s the link!
Headache Assessment Headache relief comes from a thorough assessment. We can tell in the clinic if your pain is musculoskeletal by taking a history of your headaches and assessing your joints, muscles and nerves. If we see anything of concern, we will refer you to your doctor with a letter of findings. “more common in […]
There are several reasons why you might experience pregnancy pains related to muscle, joint and nerve. Depending on where the pain is, the intensity of the pain and the type of pain will determine the best course of action to resolve your pain. If the following exercises don’t help or if your pain is intense, […]
Do you ever experience groin or hip pain during or after running, deadlifts or squats? Do you feel like you never get a good hip flexor stretch even though to you they feel tight? It might be a hip alignment issue. A hip alignment issue can lead to Femoral Acetabular Impingement (FAI) which means an impingement of the hip.
FAI can become a problem for active and sedentary people alike. It may be aggravated by activity, sitting for long periods of time, operating the pedals in a car and crossing your legs.
On the other hand, even if you don’t have any symptoms these exercises may improve the quality of your chosen exercise. Check out the video below where I demonstrate 3 simple exercises that are quick and easy to help get your hip alignment improving. Let us know your favourite by leaving a comment!
Think you might have FAI?
There are 3 main types of FAI but often aligning the joint can make a huge difference to pain and function. Often people we treat in the clinic avoid surgery and cortisone injections all together.
Cam – This type of FAI occurs from a bit of extra bone on the head of the femur which then jams on the hip socket (acetabulum) during activity. This type typically occurs in young athletic men.
Pincer – This occurs more often in middle aged women and is the least common type of the 3. This type is caused by extra bone around the lip of the hip socket at the front then as the femoral head rotates it catches or jams against the extra bone.
Mixed – This is a combination of the two previous types; cam and pincer. As described above it causes a catching or jamming in the front of the joint capsule.
These 3 types all describe bone issues however often the pain is from other tissues around the area including ligament, tendon and muscle. Better hip alignment helps reduce the bodies protective mechanism. If movement begins to feel easier and pain begins to reduce, we know we are on the right track!
If these exercises didn’t help your hip alignment or hip and groin pain we have a lot more tricks in our Myotherapy bag. Reach out and we can have a conversation or click here to book. We offer both online and face-to-face consultations.
What to learn more? Check out this other articles.
Femoroacetabular Impingement (FAI) also known as hip impingement is a problem among active and sedentary people alike. Symptoms may include pain in the groin or hip area and restricted hip range of motion (ROM). It may be aggravated by activity (both intense and endurance types), sitting for long periods of time, operating the pedals in […]
Shoulder posture is often overlooked until pain hits. We use our shoulders so much without realising. Every time we are at the computer mousing or typing away, every time we reach for our cup of coffee, every time we pick up the kids, the washing, the toys lying around and if you’ve made some time for yourself, every time you do your HIIT workout or yoga routine. We all know by now to relax the shoulders down away from the ears (hopefully without pinning them!) so I’ve focused this blog on a few different tips. Hope you get benefit and please if you have any questions, email me, I love questions!
Tip 1. Fix shoulder blade alignment
Did you know that your shoulder blades are not fixed to your rib cage? This is key, because it means it’s all up to the muscles to hold them in place so if you’re not aware of their positioning, they could be doing all sorts of things! Winging (the inner border of the shoulder blade lifts off the rib cage) is one of the most common postural concern of the shoulder blade.
Correct Winging with this routine…
To fix winging of the shoulder blades you first need to find awareness of them. To do this try these cues:
Widen your upper back by thinking of stretching your shirt sideways
Imagine you’re trying to blow up balloons that exist under your arm pits without using your chest muscles (this is hard but good!)
Before you start this next one, sit up tall and bring your ribs back over your hips (i.e. no flaring ribs). Next, hold onto the front edge of your seat, gently pull towards yourself and imagine the shoulder blades gluing firmly onto the ribcage.
No you know what you’re feeling for you can try incorporating your new skill into your workout routine. Try using a band to activate the muscles before you start your workout. Simply use the cues above for 1-3 set of 10 light pulls and 10 light pushes with a band (start with yellow, the lightest band and work your way up as you improve. Bands available at Myothrive). Then keep the cues in mind as you perform your workout. If you lose your awareness you can come back to the basics until you feel it again. Over time your shoulder blade posture will get better and better!
Tip 2. Fix Rounded Shoulders
Rounded shoulders can happen in two ways. It can come from the shoulder blades when weak lower trapezius muscles are combined with tight pectoralis minor muscles. We are going to focus on this problem today as the second problem takes a bit more assessment and specific exercises.
The other way you can get rounded shoulders is from the shoulder joint itself which is a ball and socket joint. The shoulder is the most moveable joint in the body in terms of its available range of motion. It doesn’t have much ligament support and is really reliant on the muscles and tendons to hold everything in position. This means if one of the muscles gets tight, or if ones gets weak then the shoulder can become slightly out of position. The most common movement we see is when the head of the arm (the ball) moves forward in the joint (the socket). This can lead to impingement, bursitis and tendinopathy or in short, pain and inflammation! As I mentioned, this second way of shoulder joint movement takes a little more assessment and personalised exercise prescription, so if you think this might be you, it might be worth booking in an Online Consultation with one of our musculoskeletal professionals here at Myothrive.
Try this routine…
To fix rounded shoulders we want to take a 2 pronged approach. One, we want to release the tight muscle at the front (pectoralis minor) and second, we want to strengthen the weak muscle at the back (lower trapezius).
Release pectoralis minor with a spiky ball, lacrosse ball or tennis ball either on the floor or against the wall. Below is a picture of the trigger points you are trying to find. Place the spiky ball against the trigger point then come to the wall or floor to add pressure. Next, move your arm up and down the wall to assist releasing the trigger point. You can simply hold the trigger point if you prefer. 60 seconds is plenty and a max of 3 spots. Pro tip: use a yoga block or book to add distance between yourself and the wall or floor.
2. Stretch pectoralis minor – see this post for three ways to stretch pectoralis minor.
3. Strengthen lower trapezius – see this post for ways to strengthen lower trapezius or find us on instagram or facebook for videos and pics (@myothrive)
Try these cues for during your workout to help shoulder posture:
Think of keeping your collar bones smiling 🙂
Keep the front of your shirt wrinkle free
Wear a tight shirt, if you feel your shirt starting to stretch around the shoulder or shoulder blade adjust until corrected.
Pro tip: Make sure not to over correct or pull your shoulders back unnaturally, this will work against your efforts. Just let it all happen naturally with time, with these tips you will get there!
Tip 3. Fix Head Forward Posture
If you have head forward posture it can place extra stress on the muscles around the shoulders which can lead to poor shoulder posture. This can happen in two ways. Firstly, it can cause the muscles that attach from the neck to the shoulders to work under stretch or work in positions that make their job more difficult. This in turn can create pain and trigger point activity in those muscles but like a cascade effect can also create tension and compensation in other muscles around the shoulders and shoulder blades.
Secondly, the nerves that come out from the neck down into your shoulders, upper back and arms can be put under stress. When these nerves get stressed they send signals that tell the muscles they are in control of to tighten. This is a protective mechanism because all the nerves feel is danger, they don’t necessarily know what is wrong or where. This over reaction can create a lot more pain than you bargained for.
Try this exercise…
This is one of my favourite exercises to help head forward alignment and thus, shoulder posture! Sit or stand in front of a mirror, imagine your chin is sitting on a shelf. Gently slide your chin back off the shelf until you feel the first point of resistance. Do 5-10 repetitions. I like to do this throughout my day by incorporating it with going to the bathroom. Doing small amounts more often will have a quicker effect.
Once you’ve been doing this for about a week or 2, you can try adding some over pressure to push slightly beyond that first point of resistance. If you have neck pain or suffer from headaches, just stick to the basic or come get some personalised advice from us by booking a Online Consultation. Here’s some more tips to help correct a head forward posture.
A few more tips…
Seeing is believing! Set up your video camera and watch yourself at your desk, watching TV, on your phone or doing a workout. Sometimes simply seeing what you’re doing incorrect can help you to adjust. Record yourself again doing it correctly so you can associate the new feeling with the correct head posture.
Lift your gaze. Get your screen higher whether it’s your desktop, laptop or iphone, try using books or pillows to prop up the screen to a better height. Same when you are working out, lift your gaze slightly until you feel your head is alignment with your spine. This one tip can help your shoulder posture a lot!
Strenghten your neck muscles. People have generally become a bit scared of working out the neck muscles in fear that it will create neck pain. It’s quite the opposite, weakness is associated with far more pain than strength! A great neck workout is to lie face down and perform your head retractions explained above. Just imagine sliding your chin off the shelf. Start with 1 set of 5 and work your way up to 3 sets of 10 over time. This can be done on hands and knees rather than on your belly if you prefer just try to resist dropping your head to far forward on the relax phase though!