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
Constant pain
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
Step 1
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.
Step 2
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.
Step 3
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.
Step 4
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.
Step 5
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.
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 women than men”
Is one of the most common symptom experienced by humans. Headaches are usually harmless but can sometimes be a pointer to a more serious illness. That is why, it is always a good idea to see your practitioner or doctor to clear any serious.
“Normally the severity of the headache bears no relation to the gravity of the diagnosis” Dr. Spira.
The assessment involves differentiating between the most common forms of headache and those that may indicate an underlying illness. Here are some categories of the type of headaches:
Normal headaches eg. food reaction, exercise induced, fasting induced
Recurring headaches eg. tension the headaches, migraine, cluster headache
Nerve headaches eg. direct nerve compression – Trigeminal Neuralgia
Muscle contraction headaches
Medication misuse headaches
Head injury headache
Serious cause of headaches eg. Brain tumour
Headache Management
While there is no absolute cure for headaches, they are generally musculoskeletal in nature and therefore there are heaps of treatment options. PLEASE CONSULT YOUR DOCTOR IF TREATMENT OPTIONS AREN’T WORKING.
Medications
Some can be taken to prevent a headache from happening and some when the patient has a headache. CONSULT A DOCTOR FOR ADVISE ON THIS.
Other therapies – Myotherapy
Here are some factors we look at in your Myotherapy session with us –
Where is your pain? (Muscle tension can cause headache type symptoms = this tells us what muscle the headache might be coming from)
Do you grind/clench your teeth? Do you have jaw pain? (Jaw muscle tension can cause neck and head tension)
What activities/movements are you doing when the pain comes on? What repetitive movements do you do in your day?
How is your car, TV and desk set up?
Are there any movement faults in your neck/ upper body/ shoulder that we need to restore? (healthy joint = healthy muscle) Have your ever tried The Mckenzie Method?
Do you have pain at night / in the morning?
What pillow/ mattress do you sleep on? (Duck mattress and Therapeutic Pillows Australia)
What Medications are you on? (e/g/ The pill?)
Water intake? Nutritional reactions? Do you have any food intolerances?
Feel like you qualify in one or more of these dot points? Try spend some time fixing these and see if your headache gets better. We want to decrease the frequency/ intensity before getting rid of the pain all together. Book in a free 15 min chat to see if we can help you!
REFERENCES
Migraine and Other Headaches 2000 Professor James Lance
Headaches 2000 Dr Paul Spira Health Essentials
Understanding Migraine & Other Headaches 2002 Dr Anne MacGregor
Headache 1999 British Brain & Spine Foundation
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).
Cat Stretch
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.
Rib Pain
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
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.
Hip/Groin Pain
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.
The not so latest tech trend in 2021 thanks to COVID -19 is Telehealth or online consultations. Telehealth in the Myotherapy world is a treatment, consultation and exercise session all achieved online, one-to-one. It’s a pain relief option you can access from your home and it’s actually been around for a while. Long enough to have some significant research backing it. The sentiment of the findings has not changed either, with many favourable outcomes supporting Telehealth. In fact, Telehealth rehabilitation outcomes were the same, if not better, than in person care.
See the video below where Clinical Myotherapist Sarah is conducting a Telehealth consultation.
Sarah says: “This video gives you a great idea of what to expect during your own session. We were able to assess and find a relieving exercise for the neck, mid back and low back all in one session! I then sent this customer an email containing her program with the correct technique, reps and sets of each exercise. There was not a laundry list of things to do either, just the things that actually made her feel better as she was already very active and I wanted her to continue on with that as much as possible.”
Evidence Telehealth works.
Have a look for yourself. Head to the leading Online Physiotherapist Karen Finnin’s blog “List of Research Articles About Telehealth In Physiotherapy” to see an updated list of physical therapy and physiotherapy papers supporting Telehealth. There is plenty of research on the validity, safety and effectiveness of Telehealth.
Did you know that Myotherapy uses the same approach as Physiotherapy?
In fact the Clinical Myotherapy is a 4 year Bachelor degree focusing just on the musculoskeletal system. In that time we learn loads of corrective / rehabilitative ways to help customers achieve a pain free state. You could say Clinical Myotherapy is taking one part of Physiotherapy and specialising in just that one area, the musculoskeletal system.
What to expect from a Myotherapy Telehealth Consultation.
Step 1.
We listen to the customers complaint and get subjective information and to gain clarity around what the problem is. This is done through a form that you can fill out in your own time before you e- meet your physical therapist. Problems that need a GP referral and or a scan can also be picked in stage 1 / 2.
Next you will be sent a link before your appointment and join the video call using secure software.
Step 2.
By this stage, we already have some differential diagnosis on what is causing your pain and how to fix it. We now need to assess your movement of the joint involved and surrounding areas to gain objective information to formulate your treatment plan.
Step 3.
We direct you on different treatment techniques to try and alleviate the pain or restriction. This might include movement through The Mckenzie Method, self release techniques and or a muscular activation exercises.
Step 4.
Next we retest the original assessed areas to see if we have improvement in pain and or movement.
Step 5.
Then we discuss what we have done, why it has helped and make sure you understand how you felt better. We finalise a specialised management plan using what we have identified to have helped in the session, so you can continue to improve without us. This will include what lifestyle factors are inhibiting your recovery, your goals and the plan moving into the next session. “Our aim isto teach you how to govern your own treatment plan and have control of your own body.”
Aftercare
Booking a follow up session allows us to keep progressing your treatment to make sure what we are doing is going to help for the longer term. We are likely to change or add to your program overtime so you continue to make progress. How follow ups progress will depend on lifestyle factors and other underlying factors. For example if the pain has been there for years already there might be a few layers to peel back compared to a newer pain complaint.
Check ins. We keep in close contact via email, text or phone call to ensure your program is on track to achieving your pain and movement goals.
Referral if needed. If for some reason we are not progressing, rest assured we will get you to the right health professional to assist you further. This might be to a GP so you can continue your management plan or it might be a scan to better understand what is going on.
Take home exercise program / review exercise program
Ergonomic set up of desk / car or other activities you do each day
Running biomechanics check or biomechanics checks of common exercises that might be being done wrong to your body. e.g. deadlifts, kettle bell swings, push ups and pilates/ gym style exercises.
Myotherapist Sarah’s experience with using Telehealth to help friends and family back home.
“I’ve been using the idea of online consultations for some time now. I used to have time to travel home to country Victoria and help friends and family. After a few years, due to time constraints, I could only get back for special occasions. The usual story!
I still wanted to help people so I started asking if we could chat via phone or video to see if I could help them. The results we got were amazing. Research has caught up to my experience and shows that indeed staying “hands off” can be beneficial for recovery from pain and injury. This is because I’m teaching tools to help the customer get themselves out of pain.
I encourage anyone experiencing pain or restriction that can’t get to the clinic to give this a go. Whether you live interstate, are feeling unwell or on holidays. This can absolutely help you, the research supports it!”
How to make a start.
If you’d like to try an online consultation with us, simply head to our booking page here and give it a try. We have morning, afternoon, evening and weekend availability. We are currently offering a free 15 minute assessment with a fully qualified Clinical Myotherapist. If you’d like to take advantage of this no obligation offer please fill out the form below.
Testimonial from happy Telehealth Customer
“Dwan was able to assess my pain, provide a solution and look at the faults in my movement that caused the problem in the first place. Oh by the way, this was all done over a video call! Would highly recommend her to anyone.” John 20/03/2020.
When you have poor posture during your workout, it can lead to neck, shoulder and back complaints. Watch Sarah explain the biomechanics of what might be happening during your workout.
To assess if this is a problem you might need to address, get someone to take a photo of you from the side on profile, just as Sarah stands side on in the video. If you’re at the gym you can get a bit of an idea standing side on in a mirror but you won’t be able to see your neck posture properly and it’s not a good idea to be checking your posture throughout a movement such as a deadlift or squat so def set up a camera or get someone to film you for movement based posture self analysis.
Common posture seen during workout
Ear is forward of your shoulder
Shoulders and ears are forward of the centre of your hips
Whole body is tilted forward
Whole body is tilted back
Sway back (bottom tucked with rounded shoulders)
Kyphotic / Lordotic back (exaggerated curve both in the upper and lower backs with forward tilt of hips)
Straight back (reduced curve in the upper and lower back)
Causes
It’s one thing to treat and manage poor posture but it’s good to know what things might be causing it so you can start to make some positive lifestyle changes too. The most common causes of poor posture we see in the clinic are:
Sitting at a desk for work without regular breaks
Studying at a desk without regular breaks
Imbalanced upper body or core exercise programs
Side sleeping without adequate support
Couch potato syndrome
Gaming without adequate support
Overuse of iphone/ipad
Lack of awareness of posture
Poor biomechanics during sport such as tennis or golf
At Myothrive we like to address the underlying cause of your posture problem by doing a thorough assessment to see what’s strong, weak, long and short. From this we can help workout what pre workout routine will help you get in better alignment beforehand and watch stretches or release work might be helpful for after your workout.
If you think your posture could be improved, reach out and we can have chat, simply fill in the form below or ask our bot to contact us for you. We find the sooner you address postural concerns the less likely you are to end up with pain or injury. This goes for sport as well. Adding load by repetition in a game of soccer or netball can be just as bad as lifting a heavy weight when it comes to poor posture. If you know you need our help, you can click here to find a time that suits you best.
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, […]
Have you ever experienced low back pain that is also a pain in your Bottom? When LBP strikes it is hard to know what to do or how to become pain free again. Clinical Myotherapist Dwan Rosairo explains Lower back and leg referral pain to you! What and why? LBP at any stage of life […]
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.
TOS is related to the nerves that come from your neck down into your arm
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 […]
our shoulders and your knees are under your hips. Also make sure you are in neutral spine (no dip, no curve).
and lie on your side supporting yourself with pillows particularly for the head and your belly.
