Blog - Lucas Massage Therapy

17

Oct

Golfer’s elbow massage Watford

Golfer’s elbow, also known as medical epicondylitis, is a form of tendinitis similar to tennis elbow. Golfing is one of many sources of the affliction, which can result from any activity leading to overuse of the muscles and tendons of the forearm. While the painful sensation at the elbow is similar to tennis elbow, in the case of golfer’s elbow the pain and inflammation occur at the inside (or medial side) of the joint.

The medial epicondyle is a bony prominence on the inside of the elbow. It is the insertion point for muscles used to bend the wrist downward. Forceful, repetitive bending of the fingers and wrist can lead to small ruptures of the muscle and tendon in this area. While the golfing swing produces a tightening in the flexor muscles and tendons they can lead to medial epicondylitis, other activities can produce the same injury.

 

Golfer’s Elbow massage Watford

Sport’s massage therapy has been shown to be effective in the short and long-term management of Golfer’s Elbow. Aims to achieve a:

  • Reduction of elbow pain.

  • Facilitation of tissue repair.

  • Restoration of normal joint range of motion and function.

  • Restoration of normal muscle length, strength and movement patterns.

  • Normalisation of your upper limb neurodynamics.

  • Normalisation of cervical joint function.

Case of injury

Sudden trauma or blow to the elbow. Repetitive stress to the flexor muscles and tendons of the forearm. Repeated stress placed on the arm during the acceleration phase of the throwing motion. Underlying health issues including neck problems, rheumatism, arthritis or gout.

Signs and symptoms

Tenderness and pain at the medial epicondyle, which worsens when the wrist is flexed. Pain resulting from lifting or grasping objects. Difficulty extending the forearm.

Complications if left unattended 

Golfer’s elbow, while generally alleviated by proper rest, can cause increasing pain and unpleasantness if the stressful activity continues. The condition rarely requires surgery and responds well to proper rehabilitation. Should surgery be required, scar tissue is removed from the elbow where the tendons attach.

Immediate treatment

Avoidance of the elbow. RICER regimen for 48-72 hours following the injury. Use of anti-inflammatory drugs and analgesics.

Rehabilitation and prevention

In the case of golfing, the affliction can be reduced in severity or prevented altogether through attention to proper technique and attention to overuse. Golfer’s elbow is more prevalent early in the golf season, when muscles and tendons are not yet sufficiently conditioned. Rehabilitation generally involves avoiding the painful activity for a period. Use of analgesics for pain and anti-inflammatory drugs help reduce symptoms. After healing, resistive exercises may be undertaken to improve strength.

Long-term prognosis

Those suffering from golfer’s elbow generally make a full recovery without surgery or advanced medical care, provided the injured elbow is afforded proper rest from the stressful activity.

25

Sep

Tendinitis of the adductor muscles

Inflammation in the adductor muscle tendons or tendon sheaths due to overuse can cause pain in the groin area. Sprinting, football, hurdling and horse riding can all cause overuse in these muscles. Unresolved injuries such as groin strain can also lead to tendinitis.

The adductor muscles include the pectinous, adductor longs, adductor braves, gracilis and adductor Magnus and the tendons any of these may become inflamed. The pain is similar to a groin strain but onset is gradual and chronic in nature.

Cause of injury

Repetitive stress to the adductor muscles. Previous injury such as groin strain. Tight gluteal muscles.

Signs and symptoms

Pain in the groin area. Pain when bringing the legs together against resistance. Pain when running, especially sprinting.

Complications if left unattended

If left unattended, tendinitis of the adductor muscles can lead to imbalance and injury to the other muscles of the hip joint. It can also result in a tear of one or more of the adductor muscles.

Immediate treatment

Ice and rest from activities that cause pain. Anti-inflammatory medication. Then heat and massage to promote blood flow and healing.

Rehabilitation and prevention

Rehabilitation for tendinitis of the adductors starts with gradual reintroduction into activity with stretching and strengthening exercises for the affected muscles. Use heat packs on the affected area before exercise at first, then continue with good warm-up activities to make sure the muscles are ready for activity. Strengthening the adductors and stretching the opposing abductors will help prevent this injury from recurring. Rehabilitating all groin pulls and other hip injuries completely will also prevent problems with the adductors.

Long-term problems are seldom seen with tendinitis of the adductor muscles after treatment. If pain and limited mobility in the hip persists, additional help may be required from a sports medicine specialist.

 

 

06

Sep

Achilles tendon strain massage Watford

Achilles tendon strains can be very painful and require significant healing time. An injury to this tendon can be debilitating because of its involvement in walking and even balance during weight bearing. Explosive activities that involve pushing against resistance such as rugby and weight training, contribute greatly to this injury.

The strain can be graded on scale from 1 to 3:

Grade 1 strain: Stretching or minor tear of less than 25% of tendon.

Grade 2 strain: 25-75% tearing of the tendon fibres.

Grade 3 strain 75-100% rupture of the tendon fibres.

Cause of injury

Abrupt, forceful contraction of the calf muscles, especially when the muscle and tendon are either cold or inflexible. Excessive force applied to the foot forcing the ankle upward into dorsiflexion.

Signs and symptoms

Pain in the Achilles tendon, from mild discomfort in grade 1 strains to severe, debilitating pain in grade 3 strains. Swelling and tenderness. Pain when rising on the toes. Inability to bend the ankle. Stiffness in the calf and heel area after resting.

Complications if left unattended

A minor tear may become a complete rupture if left unattended. Bursitis and tendinitis may develop from the inflamed tendon rubbing over the heel.

Immediate treatment

RICER. Anti-inflamatory medication. Then heat and massage to promote blood flow and healing. Immobilization and medical help for grade 3 strains.

Rehabilitation and prevention

Rest is important and a gradual return to activity must be undertaken. Stretching and strengthening the calf muscles is important to rehabilitation and to prevent recurrence. Warming-up the calf muscles properly before all activities, especially those involving forceful contractions such as sprinting, is essential to prevent strains.

Long-term prognosis

Due to the lower blood supply in tendons, they take longer to heal than the muscle, but with rest and rehabilitation the Achilles tendon can return to normal function. Severe ruptures usually require surgical repair.

 

 

 

 

 

22

Aug

Patellar dislocation

A subluxation or dislocation of the patella (kneecap) commonly occurs during deceleration, for example when slowing from a run to a walk. The patella slides partially out of the groove between the femoral condyles but does not limit mobility. Pain and swelling may accompany this condition. Athletes who have a muscle imbalance or a structural deformity, such as a high patella, have a higher chance of subluxation.

If the outer muscle of the quadriceps, vastus lateralis, is stronger than the inner muscle, vastus medialis, the imlbalance may cause an uneven tension on the patella, pulling it out of alignment. In addition, the lateral femoral condyle and patella may be bruised. This happens with forceful contractions such as planting, changing direction or landing from a jump.

Cause of injury

Strength imbalance between the outer and inner quadriceps. Impact to the side of the patella. Twisting of the knee.

Signs and symptoms

Feeling of pressure under the patella. Pain and swelling behind the patella. Pain when bending or straightening the knee.

Complications if left unattended

Continued subluxations can cause small fractures in the patella, cartilage tears and put stress on the tendons. Failure to treat a subluxation could lead to chronic subluxations.

Immediate treatment

RICER. Anti-inflammatory medication.

Rehabilitation and prevention

During rehabilitation activities that do not aggravate the injury should be sought, such as swimming or biking instead of running. Strengthening of vastus medialis and stretching vastus lateralis will help correct the muscle imbalance that may cause this condition. A brace to hold the patella in p;ace may be needed when initially returning to activity. To prevent subluxations it is important to keep the muscles surrounding the knee strong and flexible and avoid direct impact to the patella.

Long-term prognosis

Subluxations respond well to rest, rehabilitation and anti-inflammatory measures. Rarely surgery may be required to prevent recurring subluxations due to misalignment or instability.

25

Jul

Knee ligament sprain

Medial collateral ligament sprains are usually caused by force applied to the outside of the knee joint as in a tackle in football. Force applied to the outside of the knee causes the inside of the knee to open, stretching the medial collateral ligament. The extent of the stretch determines whether the ligament simply stretches, tears partially or completely tears.

Cause of injury

Force applied to the outside of the knee joint.

Signs and symptoms

Pain over the medial portion of the knee. Swelling and tenderness. Instability in the knee and pain on weightbearing.

Complications if left unattended

The ligament, in rare cases, may repair itself but if left unattended could lead to a more severe sprain. The pain and instability in the knee may not resolve. Continued activity on the injured knee could lead to injuries in the other ligaments due to the instability.

Immediate treatment

RICER. Immobilization. Anti-inflammatory medication.

Rehabilitation and prevention

Depending on the severity of the sprain, simple rest and gradual introduction back into activity may be enough. For more severe sprains, braces may be needed during the strengthening phase of rehabilitation and the early portion of the return to activity. The most severe sprains may require extended immobilization and rest from the activity. As range of motion and strength begin to return, stationary bikes and other equipment may be used. Ensuring adequate strength in the thigh muscles and conditioning before starting any activity that is susceptible to trauma to the knee will help prevent these types of injuries.

Long-term prognosis

The ligament will usually heal with no limitations, although in some cases there is residual looseness in the medial part of the knee. Very rarely, surgery is required to repair the ligaments. Meniscal tearing may also result in a severe sprain that may require surgical repair.

 

15

Jul

Piriformis syndrome

Piriformis syndrome is a result of impingement of the sciatic nerve by the piriformis muscle. Incorrect form or improper gait often leads to tightness and inflexibility in piriformis. The condition occurs more frequently in women than men (6:1). When piriformis becomes tight it puts pressure on the underlying nerve, causing pain similar to sciatica. The pain usually starts in the mid-gluteal region and radiates down the back of the thigh.

Cause of injury

Incorrect form or gait while walking or jogging. Weak gluteal muscles and/or tight adductor muscles.

Signs and symptoms

Pain along the sciatic nerve. Pain when climbing stairs or walking up an incline. Increased pain after prolonged sitting.

Complications if left unattended

Chronic pain will result if left untreated. The tight muscles could also become irritated causing stress on the tendons and points of attachment.

Immediate treatment

RICER. Anti-inflammatory medication. Then heat and massage to promote blood flow and healing.

Rehabilitation and prevention

During rehabilitation a gradual return to activity and continued stretching of the hip muscles is essential. Start with lower exercise intensity or duration. Identifying the factors that caused the problem is also importatnt. Strengthening the gluteal muscles and increasing the flexibility of the adductors will help to alleviate some of the stress and prevent the piriformis from becoming tight. Maintaining  a good stretching regimen to keep the piriformis muscle flexible will help, while dealing with the other issues.

Long-term prognosis

Piriformis syndrome seldom results in long-term problems when treated properly. Rarely, a corticosteroid injection or other invasive method may be required to alleviate symptoms.

10

Jul

Hip flexor strain massage Watford

Hip flexors are located on the front of the hip and lift the thigh up or bend the waist forward or down when the limbs are fixed. These muscles are used a lot in cycling, running, kicking and jumping activities. When a new load is placed on the muscle or repetitive stresses are encountered without rest, the muscle may stretch or tear.

Cause of injury

Repetitive stress on the hip flexor muscles without adequate time for recovery. Excessive stress placed on the muscles without appropriate strengthening and warm-up. Improper form when running, cycling or other activities. Forceful hyperextension of the leg at the hip.

Signs and symptoms

Pain in the upper groin area over the anterior portion of the hip. Inflammation and tenderness over the hip flexor.

Complications if left unattended

Hip flexor strains left untreated can become chronic and lead to inflexible muscles that could lead to other injuries. The muscle could also continue to tear, eventually leading to a complete rupture from the attachment.

Immediate treatment

Cessation of the activity. Ice the area immediately. X-ray for possible fracture or bone chips.

Rehabilitation and prevention

Use of proper protective equipment during activities and strengthening the supporting muscles around the hip for added padding and protection. Unfortunately there is not a lot that can be done to prevent falling or contact with the hip area.

Rehabilitation includes rest until the pain subsides, then gradual reintroduction on the activity. Any activities causing pain should be discontinued until the area is pain free.

Long-term prognosis

Hip pointers seldom cause long-term disability and most athletes can return to full function after treatment and a rehabilitation period. Surgery is seldom required except in severe fracture cases.

 

 

25

Jun

Slipped disc

Discs are segments of connective tissue that separate the vertebrae of the spine, providing absorption from shock and allowing for the smooth flexing of the neck and back without the vertebral bones rubbing against each other.

A slipped disc (also known as a herniated, ruptured or prolapsed disc) results when the shock-absorbing pads or intervertebral discs split or rupture. The discs contain a jelly-like substance which seeps out into the surrounding tissue, causing local inflammation and pressure on the spinal nerves (and occasionally the spinal cord) where they exit the spinal canal. Slipped discs most frequently occur in the lower back although any disc of the spine is vulnerable to rupture.

Cause of injury

Improper weightlifting technique. Excessive strain. Forceful trauma to the vertebral disc.

Signs and symptoms

Pain in the back or neck. Numbness, tingling or pain in the buttocks, back, upper or lower limb. Changes in bowel or bladder function (this is rare but should be treated as a medical emergency).

Complications if left unattended

Slipped or herniated discs require medical attention and evaluation. Symptoms of slipped disc may indicate other underlying ailments including fracture, tumours, infection or nerve damage, with serious – in certain cases, life-threatening – implications.

Immediate treatment

Bed rest, application of alternating ice and heat. Use of anti-inflammatory and analgesic medication.

Rehabilitation and prevention

Rest and limited activity for several days is usually indicated, though normal, non-athletic daily activity should be resumed soon thereafter to prevent atrophy and restore mobility in the spine. Physical therapy may be combined with massage and gradually increasing exercise of the back after the pain has subsided. Strengthening and flexibility exercises, proper warm-up, avoidance of excessive or sudden weight lifting and attention to good sports technique may help avoid the injury.

Long-term prognosis

Most disc injuries are resolved without surgery, given proper recovery time. Though full restoration of strength and mobility may generally be expected, discs are vulnerable to re-injury, particularly for weightlifters and athletes placing significant demands on the back muscles, tendons and ligaments and on the spine itself.

17

Jun

Dislocation of the shoulder

Dislocation of the shoulder at the GH joint may occur when an athlete falls on an outstretched hand or during abduction and external rotation of the shoulder. Significant force is required to dislocate a shoulder unless the athlete is experiencing re-injury. A shoulder dislocation occurs when the head of the humerus pulls free of the glenoid fossa of the scapula.

While several types of shoulder dislocation exist, the most common is anterior dislocation which represents 95% of all cases. In this dislocation injury, the structures responsible for stabilizing the anterior shoulder, including the capsule and the inferior glenohumeral ligament, are torn free from the bone. Compression fractures of the posteromedial humeral head known as Hill-Sachs lesions are associated with anterior dislocations. More commonly, avulsion of the anterior glenoid labrum can occur, which is known as a Bankart lesion.

Cause of injury

Violent contact with another athlete or solid object. A fall onto an outstretched hand. Sudden, violent torsion of the shoulder.

Signs and symptoms

Severe pain in the shoulder. Arm held away from the body at the side, with the forearm turned outward. Irregular contour of the deltoid muscles.

Complications if left unattended

Dislocation of the GH joint causes damage to the joint ligaments, resulting in the joint becoming less stable and considerably more prone to successive dislocations during athletics. Immobilization of the shoulder during the healing phase does not fully prevent such re-injury, which may require surgical intervention, since the immobilized ligaments often fail to heal in the proper position. Damage to the axillary artery and nerve can also occur, causing weakness tn the deltoid muscle.

Immediate treatment

Realignment or reduction of the dislocated joint. Immobilization and analgesics for pain.

Rehabilitation and prevention

Most initial shoulder dislocations are treated without resort to surgery, although subsequent dislocations may require surgical care. Many athletes suffer a range of disabilities following dislocation. An alternative to surgical treatment – prolotherapy – involves injections directed at the middle and inferior glenohumeral ligaments. This may offer better relief from pain, restoration of mobility and a speedier return to athletic activity. Further, the technique avoids the formation of scar tissue common after surgery.

Long-term prognosis

A large percentage of athletes may be unable to continue sports following a shoulder dislocation without subsequent injuries or the need for surgical treatment. Furthermore, athletes who undergo surgery following shoulder dislocation are often unable to perform at their former level. The alternative method of prolotherapy may offer relief and more effective healing.

10

Jun

Quadriceps tendinitis

Inflammation of the quadriceps tendon can be a result of repetitive stress to the quadriceps or excessive stress before the muscle is conditioned. Minor tears may occur in the tendon when it is stretched while subjected to loading. Pain just above the patella (kneecap), especially when extending (straightening) the knee, usually accompanies this injury.

Cause of injury

Repetitive stress to the tendon, e.g. running or jumping. Repetitive acceleration and deceleration, e.g. hurdling or football. Untreated injury to the quadriceps.

Signs and symptoms

Pain just above the patella. Jumping, running, kneeling or walking down stairs may aggravate the pain.

Complications if left unattended

The quadriceps muscles may become stiff and shortened and the tendon will become weak if left untreated. This could lead to a rupture of the tendon. A change in gait or landing form in the case of hurdlers can lead to other injuries as well.

Immediate treatment

Rest and ice. Anti-inflammatory medication. Training modification.

Rehabilitation and prevention

Rehabilitation should include stretching and strengthening exercises for the quadriceps. Activities such as swimming can be helpful to reduce the stress on the tendon during rehabilitation. Return to a normal activity schedule should be delayed until pain subsides completely and strength is restored. Keeping the quadriceps flexible and strong will help prevent this condition.

Long-term prognosis

A full recovery with no long-term disability or lingering effects can be expected in most cases of tendinitis, and surgery is only necessary in extremely rare cases.