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Ice VS Heat – what to use and when

When my clients get injuries or niggles, they often ask what should I do? Should I ice it? Should I heat it? And How long for? Well in this blog I will be answering these questions.

It is important to note that these treatments have mostly been ignored by science: the benefits are far from proven, and obviously it’s not a miracle cure that fixes your injury. However, they have been known to relive symptoms, they are a cheap, drugless way of taking the edge off a variety of common painful problems.

Basics:

Ice is for recent injuries — calming down damaged superficial tissues that are inflamed, red, hot and swollen.
Examples: a freshly pulled muscle, a flare up of Tennis Elbow

Heat is for muscles, chronic pain, and stress — taking the edge off symptoms like muscle aching and stiffness
Examples – Muscular back pain

 

Ice Treatment

Ice is most commonly used when the injury is acute. If the injury has occurred recently (within the last 48 hours) then your main objective is to reduce the swelling, then you need to ice. Ice helps to minimise swelling around the injury, reduce bleeding into the tissues, and can even reduce pain.

Ice can also be used for chronic conditions, such as overuse injuries in athletes e.g. tennis elbow. I recommend that ice be used on the injured area after activity to help control inflammation and reduce the chances of a flare up. DO NOT ice a chronic condition prior to exercise/sport.

My favourite “ice pack” of choice is Frozen peas as it moulds around the injury site. Never place ice directly on the skin – use a damp tea towel and keep the pack moving to avoid ice burns. You should ice for 10-20 minutes.
I have recently read that you shouldn’t use ice packs on your left shoulder if you have a heart condition – so please be careful if this applies to you.

How ice works – the cold causes blood vessels to constrict (get smaller), this can help to minimise the damage and thereby reduce the amount of repair

Heat Treatment

Heat treatments are used for chronic conditions, the heat helps to relax and loosen the tissues and stimulates blood flow to the area. Heat can be used before exercise for over-use injuries.

Heat should not be used straight after activity, and do not use heat after an acute injury (occurred in the last 48hr). Never use heat where there is any swelling, swelling is caused by bleeding in the tissue and heat will draw more blood to the area causing the swelling to get worse.

Heating tissues can be accomplished using heating pads, hot water bottles and wheat bags. When using heat treatments, be very careful to use a moderate heat for a limited time to avoid burns. Never leave heating pads or towels on for extended periods of time or while sleeping.

How heat works – increases blood flow to the area, this provides oxygen and nutrients to aid the healing process and restore movement

When not to use cold or heat treatments:

  • On areas of skin that are in poor condition (e.g. cuts/rash)
  • On areas of skin with poor sensation to heat or cold
  • In the presence of an infection

Muscle tears

If any of you have been following me on Instagram or Facebook you will have seen that I have recently suffered from a tear to my calf. I managed to do a grade 2 tear to my medial gastrocnemius while playing a hockey match!

What causes a tear?

A tear often occurs when you accelerate suddenly or change direction quickly, there are a few who can tear their calf while walking, but this is VERY rare.

What is a grade 2 tear?

There are different grades of muscles tears, grades range from 1 to 3 (1 being minor, 3 being major).

Grade 1:

Grade 1 tears are a result of mild overstretching which can cause some small micro tears in the muscle fibres. Symptoms are normally quite disabling for the first two to three days, e.g. shortened stride length. In most cases, your recovery will take approximately one to two weeks.

Grade 2:

Grade 2 muscle tears result in partial tearing of your muscle fibres. Full recovery normally takes several weeks (4-6 depending on severity). If you return to high load or high-speed sport too soon it can result in unnecessary re-tear, which is reasonably common in moderate calf tears as you often feel ready, but the muscle is still too weak.

Grade 3:

A grade 3 tear is the most severe calf strain, you can completely tear or rupture your muscle fibres. Diagnostic assessment utilising ultrasound or MRI is recommended for this level of tear as surgery mat be required. Full recovery can take several months and may not be 100% in some instances.

Recovery

There are 6 stages to recovery when it comes to any muscle tear. Physiotherapy and Sports Massage are vital during recovery.

Phase 1 – Early Injury Protection: Pain Reduction & Anti-inflammatory Phase

RICE – Rest, Ice, Compression and Elevation. This is a critical phase and people often say “I don’t have time to ice” – you sit at a desk at work? You can ice it. Watching tv – ICE!

Phase 2 – Regain Full Range of Motion

The torn muscle will successfully repair itself with collagen scar tissue through your body’s natural healing process, this can take up to 6 weeks. During these initial six weeks you must lengthen and massage the area to ensure the tissue isn’t “lumpy” or inflexible. This will prevent re-tearing.

Phase 3 – Restore Concentric Muscle Strength

Your muscle strength and power should be gradually progressed. This involves performing your exercise initially in non-weight bear, before progressing to partial weight bear, full weight bear, and then eventually performing resistance loaded exercises.

Phase 4 – Restore Eccentric Muscle Strength

Using the calf as an example – the muscles work in two directions. They push you up (concentric) and control you down (eccentric). Therefore, VERY controlled Calf raises are ideal recovery at this phase.

Phase 5 – Restore High Speed, Power, Proprioception & Agility

Most tears do occur during high speed movements. Depending on the specific requirements of your sport or lifestyle, your rehab will include exercises and activities that will address your speed, agility and power to reduce your risk of injury reoccurrence (it is also known as Sport-specific training).

Phase 6 – Return to Sport

The perfect outcome will have you performing at full speed, power, agility and function with the added knowledge that a thorough rehabilitation program has minimised your chance of future injury. The key here is to not return too quickly and to have built it up in the gym before returning.

 

I am 4 weeks post tear now and in phase 4 of recovery at the moment, a lot of calf raises are happening, and I will be moving into phase 5 soon! Although it has been highly frustrating it has helped me to realise that I need to look after myself a bit more, get more massages and foam roll my muscles more regularly. PREVENTION is key and Sports Massage is the answer to this. Feel the niggle sort it out – then hopefully you won’t get to the tear phase like me 😦

Tennis Elbow

Tennis elbow or Lateral Epicondylitis as it is clinically known, is a condition that causes pain around the outside of the elbow, it often occurs after strenuous overuse of the muscles and tendons of the forearm. You do not have to play tennis to get this condition! I have seen several cases of Tennis elbow recently so thought I would write a Blog identifying the causes, symptoms and treatments.

Where/when is the pain?

  • On the outside of your upper forearm, just below the bend of your elbow
  • When you lift or bend your arm
  • When gripping small objects or when twisting your forearm e.g. opening a jar

Tennis elbow can last 6 months – 2 years, but it completely depends on the treatment you receive. Tennis elbow is most common in people aged 30-50, although anyone can get tennis elbow if they do repetitive motions.

The cause of tennis elbow

Lateral epicondylitis  (tennis elbow), involves the muscles and tendons of your forearm. Your forearm muscles extend your wrist and fingers. Your forearm tendons (often called extensors) attach the muscles to bone and they attach on to the lateral epicondyle. The tendon usually involved in tennis elbow is called the Extensor Carpi Radialis Brevis (ECRB).
If the muscles and tendons are strained (overused), tiny tears and inflammation can develop near the bony lump (the lateral epicondyle) on the outside of your elbow.

As the name suggests, tennis elbow is sometimes caused by playing tennis. However, it is often caused by other activities that place repeated stress on the elbow joint, such as decorating, playing the violin and repetitive lifting.

Treatment

Approximately 80 – 95% of people suffering with tennis elbow recover fully using treatment. These treatments include:

Rest
The first step is to give your arm proper rest, this involves stopping any sport/repetitive motions or heavy work activities for several weeks.

Ice
10 minutes at a time over the elbow joint, you can also take ibuprofen to reduce any inflammation and reduce the pain you may be experiencing.

Physical therapy
Sports Massage and manipulation into the forearm will help to reduce the tension in the muscles. Specific exercises are recommended to help strengthening the muscles of the forearm. Massage will help to stimulate healing of the micro-tears in the muscles. (exercises are shown on my instagram page @mollysportsmassage)

Equipment check
Check your racquet to make sure it is a ‘proper fit’ for you. Stiffer racquets and looser-strung racquets often can reduce the stress on the forearm. This will take the pressure off the muscles in the forearm and therefore reduce the likelihood of tennis elbow reoccurring.

Check the weights you are lifting – reduce the weights and less reps while you are in recovery. All of this will help to speed up recovery.

 

New Year, New Goals?

We all start a New Year with huge plans to be more healthy, try to get down the gym or go for a run more frequently and eat clean but do we ever think about looking after our muscles?

I know I say it every years but why not try and include Massage into your new year resolutions?

1. Get active 

Sports  Massage Therapy has been proven to have major benefits for athletes, including enhancing performance, improving conditioning, speeding up recovery and preventing injuries. If you are going to increase your exercise you need to incorporate massage to prevent any injuries and get the best results for you.

2. Stress Management

I have written a blog about the importance of massage and stress. Studies have shown that getting a massage does infect reduce stress levels and improves mood.  (Please see my other blog for more details)

3. Take control of your pain

We need to take control of how our body is feeling and listening to it more. I see so many people who say ‘I thought it would go away and now its worse‘. If you get a massage as soon as you feel the niggle the likelihood of it turning into an injury is significantly reduced. It will also decrease the recovery time, if you allow a niggle to get worse you will need more treatment to correct the issue. You may also need to stop training which would really affect your fitness goals!

Its simple, include Sports Massage in your Healthy New Year Goals and this will keep you on track and tackle any nasty niggles!

For the month of January I am offering a beer a friend deal. Your friend gets 20% off their first 1hour and you get 10% off your next treatment!

T&C apply, please message me for more details and I cannot wait to see you all in 2019!

Stress and Massage

So, it is mental health awareness week in the US this week – yes, I may be jumping on their event a little bit BUT in light of recent events in the media etc. I really felt like writing this blog about stress and the benefits of massage.

Mental health isn’t something that people want to talk about, yet we are always happy to use the word STRESS. If you feel yourself constantly saying ‘I’m so stressed’ you need to think about the WHY. From a sports massage point of view, I see many clients that come in and say ‘I carry all my stress in my shoulders’ or ‘when I’m stressed I get tension headaches’ – why is it that the more stressed we are the tighter the muscles become?

The ‘science’

The activation of the stress response causes muscles throughout the body to tense up. When the stressful situation ends, the muscles will relax. However, if the stressor (e.g. work, family etc.)  is constant, the muscles may remain in a tensed state which may lead to joint aches and pains, tension headaches, back and neck pain.

How can massage help relieve stress?

During a massage there is an increase in the release of dopamine and serotonin and a reduction in cortisol levels, these chemicals are all directly linked to stress.According to the National Institutes of Health, massage therapy may (definitely will) help relieve your muscle tension. As a massage therapist I would use various techniques to manipulate the muscles to help them return to a relaxed state. This will therefore help to reduce tension, reduce pain and in turn reduce stress.

Furthermore, stress can also be linked to high blood pressure and heart condition, some research has shown that regularmassage therapy will help to lower blood pressure and heart rate, which will reduce the strain on your heart and help you maintain a healthier circulatory system.

Finally, massage is really about doing something for yourself, taking that time out of your busy life to have someone else look after you, decrease your pain, talk about things other than your stressors!

1 Year Anniversary of Locker 27

So over the weekend I celebrated 1 year at Locker 27! I cannot believe how quickly the time has gone, I do feel like I have been there forever (in a good way).

I recently did and interview talking about how I got into doing sports massage and all the challenges that I have faced along the way. Therefore, this blog will be my story to getting my amazing room at Locker 27.

When I was at University I wasn’t sure what I wanted to do when I finished my Sports Science Degree, I knew I enjoyed the anatomy and physiology modules of my course but had no idea what to do as a full time job. I decided to do a Sports Massage Diploma as a CV booster as I was thinking about doing a Physio masters and this would help me get onto a course. The company I selected ended up asking me to set up the Sports Massage course at my University and I was in charge of getting students enrolled on the course.

Once I started the course it became obvious that I really loved it and started to think about making it my career. I didn’t know anything about setting up a business, but I knew that is what I would have to do if I wanted to make it a full time job! So, at the age of 21 I was a business owner and completely 100% self employed and very scared. The first year was tough, but I decided to work under the umbrella of other companies to gain experience and do some private work on the side. I cannot thank these companies enough for that year of experience – it massively helped me to gain confidence and enhance my skills as a therapist.

In September 2017 I started at Locker 27 – I knew it would take a while to build up a client base large enough to be there full time so for a while I had a couple of locations on the go. This was SO tough on my body, I was driving from one location, eating lunch in the car and then starting all over again at the next. Some days I was working 12 hour days – but it was definitely worth it!

I have now been full time at Locker 27 since May and it has been amazing – I have a lot more time to myself to grow my business, work on my social media presence and grow my knowledge. My clients are lovely, friendly and I love making a difference to their lives. This difference could simply be ‘I got a PB in my latest completion’ or could be as big as ‘I am no longer in pain’.  The staff at Locker have been so welcoming and I definitely feel part of the locker family!

Challenges/difficulties:

  1. Location – finding the right place for me took a while, I worked at 3/4 different locations before finding Locker 27 but each location taught me different things not just about massage but also about how to (or not to) run a business.
  2. Age – I am young, some locations didn’t want to give me a job because I was so young and they didn’t think I had enough experience. This was tough to overcome because I can’t change my ages – however I felt my youth was a bonus! I was fresh out of studying with a vast knowledge base of the latest scientific studies and with the most up to date training.
  3. Tax – I did not have a clue how to do a tax return, they don’t teach you this in maths at school, I was so lucky as a family friend offered to help me and I couldn’t have done it without him. The most important thing is to stay on top of it, record everything as you go along and don’t get behind!

 

Thank you to everyone for supporting me over the last 2 years – here is to many more!

Is your Desk Job causing your hip pain?

I had a client recently say that their hips were hurting and felt tight, they told me that they had been sitting at their desk for a long period of time and doing a lot more driving. I explained that sitting for a long period of time is 1 of the most common causes of hip pain.

Sitting for a long period of time causes the glutes to be inactive and cause the quads and hip flexors to become tight. There is no scientific evidence of this, but it has been argued that sitting for long periods at a time physically shortens the hip flexors.

Therefore, it is so important to make sure that you take regular breaks from sitting and do some simple stretches that will prevent tight hips and prevent long term damage. Tight hips will have a knock-on effect on the lower back and glutes. So, if you have pain here you may also have tight hips, so these stretches are aimed at you too!

There are a few things you can do that will help you to reduce the tightness in the hips. One is to try and stand more during the working day, if there are standing desks in your office then try and use them for a couple of hours a day. It is a great way to break up the sitting pattern. If you do not have a standing desk area, then at least try and stand up throughout the day. For every 60minutes of work try and stand for 10.

The most effective is to do regular hip stretches, if you can do them during your breaks then that is perfect, if not then at least get them in before or after work.

  • Kneeling hip flexor stretch

Kneel on one leg, the other in front of you make sure you knee is at 90 degrees to your foot. Drive your hip forward and your knee into the ground. Your iliopsoas muscle (one of the hip flexors) requires isometric activation to stretch it.

  • Runners lunge stretch

If you cannot kneel then an adapted stretch is to position yourself as if you are about to start you race, lift the back knee off the floor. It is like a lunge but with a straight back leg (picture of how to do this stretch or see the image at the top of the blog)

  • Modified Camel Hip Stretch

Put both hands on your lower back and lean back, push your hips forward and look up to the sky.

  • Standing Quad Stretch

If you cannot balance very well then use a wall or chair for support. Lift your heel up towards your glutes (bottom) and hold the foot in your hand. To increase the stretch, push your hip forward.

Foam rolling your quads, ITB and TFL is another brilliant way to help with releasing the hips. Monthly massage is another brilliant way to help prevent tension, massage focusing on the hip flexors, quads, ITB and glutes will help to improve flexibility and reduce tightness in the hips.

 

All of these stretches will be featured on my instagram @mollysportsmassage over the next few days