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Myofascial Energetic Length Technique: Why You Should Try It?


Ms. Sue Hitzmann developed a self-treatment system to manipulate and rehydrate the connective tissue. (MELT stands for Myofascial Energetic Length Technique.) Once you learn the method, she said, just 10 minutes three times a week is all you need (Lawlor, 2021 )

“The MELT Method focuses on rehydrating your connective tissue and rebalancing the nervous system to eliminate stuck stress and improve whole body efficiency.”  

Sue Hitzman

MELT Method creator Sue Hitzmann defines it as a hands-off approach to dealing with pain and injury that increases your strength, balance, and flexibility by restoring the stability of your connective tissue.

WATCH: Paula Nutting with Sue Hitzmann, Myofascial Energetic Length Technique

3 Methods of the Myofascial Energetic Length Technique

Rebalance with a Soft Body Roller/Foam Rolling

Nervous System Myofascial Energetic Length Technique

According to Chertoff (2019) Foam rolling is a self-myofascial release (SMR) technique. It can help relieve muscle tightness, soreness, and inflammation, and increase your joint range of motion. Foam rolling can be an effective tool to add to your warm-up or cooldown, before and after exercise. 

Here are some benefits of using foam rolling (Chertoff, 2019);

  • Ease muscle pain
  • Increase range of motion
  • Temporarily reduce appearance of cellulite
  • Relieve back pain

Rehydrate with a Foot Treatment

Foot Myofascial Energetic Length Technique

For this foot treatment, try to keep your head up and not look at your feet.

Instead, use your body sense to feel if you have the ball in the right spot.

You can stand next to a wall or chair to help you balance, if necessary.

Keep the pressure tolerable, and if you feel pain, back off (Miller, 2017)

Rehydrate with a Hand Treatment

Hand Myofascial Energetic Length Technique

Sue recommends doing the self-treatment techniques three times a week — even better, every day — to get immediate relief by rehydrating this tissue and reacquiring space in your joints (YOM Staff, 2020) 

  1. Position-point pressing
  2. Gliding
  3. Shearing
  4. And friction on your hands and arms.

“The MELT hand and foot treatment are designed to rehydrate connective tissue which is a real missing link to pain and learning how to address connective tissue in a very efficient way is what this methodology all about. In rehydrating connective tissue you could actually rebalance your nervous system and get your body’s natural healing mechanisms back on track. . . . . so in just minutes you can self treat your hands and feet and improve whole body communication and balance”

Sue Hitzman

Rebalance with the Neck Release

Neck Foam Roller Myofascial Energetic Length Technique

According to Lindber (2021) The neck release is a gentle way to loosen tension in both your shoulders and neck.

Here’s how to do it for MELT Method;

  • Slowly turn your head from right to left
  • Next, go to a sideway position
  • Use foam roller and place it underneath your head
  • Then, start to create small circles using your head while in sideways position
  • Repeat on the other side.

Here are some possible benefits of Rebalance with the neck release MELT Method:

1. Improved posture and alignment

2. Decreased neck pain

3. Increased range of motion in the neck and shoulders

4. Reduced tension headaches and migraines 

5. Better sleep quality (reduced stress on your muscles)

The idea is that you don’t have to hurt yourself to get rid of the pain. The MELT method is a self-treatment technique that encourages your body’s innate ability to stay healthy by rehydrating the connective tissue system.

Did You Know?

Connective Tissue Fascia

Fascia connects all of our muscles and tendons into one cohesive system and plays a part in everything from our posture to balance to digestion.

When it becomes dehydrated by daily stress, poor diet, and lack of exercise, it works less efficiently, resulting in aches, pains, tension headaches, poor posture, and stiff joints and muscles.

Myofascial Energetic Length Technique is used to reduce inflammation in the fascia system by activating the myofascial meridians. The fascia system is made up of connective tissues throughout your body that help your organs function properly.

When these tissues become inflamed or injured due to repetitive movement patterns or prolonged bouts of stress, they can become painful and restrictive to movement.


Myofascial Energetic Length Technique has been shown to increase circulation and relieve pain in the muscles and joints by increasing the length of their meridians through self-massage therapy using pressure points along their length. This increases blood flow through these pathways which helps improve range of motion and reduces pain because there are fewer restrictions on how far you can move each joint (and therefore how much force it can bear).

The MELT technique can be done anywhere at any time as long as you have access to a chair or wall for support. You'll need some room in front of you so that you have enough space between your hands and feet during each movement.

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Lawlor (2015). Rolling and Flexing to Massage Away Pain and Stress.,Ms.,week%20is%20all%20you%20need

Chaudhry (2017). Effect of MELT method on thoracolumbar connective tissue: The full study.

Ruback (2020). Validation of a Mindful Practice: The MELT Method.

Chertoff (2019). What Are The Benefits Of Foam Rolling?

Miller (2017). Do This Foot Treatment Tonight Before You Go To Sleep.

YOM Staff (2020). Improve Your Hand Strength with MELT.

Mansour (2019).How to use a foam roller to relieve neck, back and knee pain.

Painful wrist remedies and treatment banner

Know How to Treat Painful Wrist: Simple Remedies


If you’re suffering from a painful wrist, don’t worry! It’s completely treatable. Undoubtedly, for those with painful wrist due to some fell down, accidents while doing household chores, or while performing your skateboard stunts.

There are treatments and remedies for that pain, mobility with rotations, medial, and lateral rotation may be just what you need to treat your condition.

Besides, these treatments will help you get back to your daily activities without pain interfering with your quality of life. In fact, our recommended treatment is one of the most effective non-surgical solutions available today.

What is Wrist Pain?

A wrist joint is a joint that connects the hand to the forearm. A wrist fracture takes place when a person broke one of the small (carpal) bones in this joint or commonly, the distal radius, which is twice the size of the two bones that make up the forearm. In addition, this bone often breaks on the lower end part, which is near to where it connects the bones of the hand and thumb.

An image of a hand with fingers over it showing pains on a person's wrist


Sudden impacts. Wrist injuries often occur when you fall forward onto your outstretched hand. This can cause sprains, strains and even fractures. Thus, a scaphoid fracture involves a bone on the thumb side of the wrist, and this type of fracture may not show up on X-rays immediately after the injury.

Repetitive stress. Any activity do involves repetitive wrist motion — from hitting a tennis ball or bowing a cello to driving cross-country — these can inflame the tissues around joints or cause stress fractures, especially when you perform the movement for hours on end without a break. De Quervain's disease is a repetitive stress injury that causes pain at the base of the thumb.


It's impossible to prevent the unforeseen events that often cause wrist injuries. Even so, these basic tips may offer some protection:

Build bone strength. Getting adequate amounts of calcium — 1,000 milligrams a day for most adults and at least 1,200 milligrams a day for women over age 50, — can help prevent fractures.

Prevent falls. Falling forward onto an outstretched hand is the main cause of most wrist injuries. To help prevent falls, wear sensible shoes. Remove home hazards. Light up your living space. And install grab bars in your bathroom and handrails on your stairways, if necessary.

Use protective gear for athletic activities. Wear wrist guards for high-risk activities, such as football, snowboarding and rollerblading.

Pay attention to ergonomics. If you spend long periods at a keyboard, take regular breaks. When you type, keep your wrist in a relaxed, neutral position. An ergonomic keyboard and foam or gel wrist support may help.

Steps for Treatment and Remedies:

Sometimes we may encounter events where we do disruption to the joints, which results in fractures. Or could be an interosseous membrane, (a thick dense fibrous sheet of connective tissue that spans the space between two bones forming a type of syndesmosis joint), which is the membrane between the owner and the radius that contracts and be caught in that kind of position.

Addressing mobility with rotations, medial, and lateral rotation

  • Loosen through the interosseous membrane by pouring the right amount of oil on the hands; make them move through the soft tissue well.
A remedial massage therapist gliding down a finger over the wrist of the patient
  • Glide down with your thumb between the radius and the owner.
A remedial massage therapist pressing down a finger on the arm of the patient
  • Roll a thumb over that taut band.
  • Move all the way to the wrist joint.
A remedial massage therapist rolling a thumb on the arm of the patient
  • Next maneuver is to take fingers to the back of the wrist.
A remedial massage therapist maneuvering fingers on the wrist of the patient
  • Gently glide it on a round motion with a thumb
A remedial massage therapist gliding down a thumb on the arm of the patient in a round motion

The gentle rolling motions in this exercise will help loosen the wrist joint. Roll up and down the length of the arm, finishing above and below the wrist joint.

If you have pain in your wrist, this exercise will be good for you. It’s easy to do and can be done anywhere: at the office, while watching TV or eating dinner with friends. You can even do it with your eyes closed if that’s what floats your boat!

Do this a few times each day to ease pain quickly and strengthen your wrist for future strong use.

The exercises that you do for your wrist can be done a few times a day to ease pain quickly. You should do them every day so that they become part of your routine and strengthen your wrist for future strong use. The exercises will help you to feel better, get stronger, and get better!

Lie on your back on a flat padded surface with your arms at your sides, palms facing down.

Lie on your back on a flat padded surface with your arms at your sides, palms facing down.

Place your head on a pillow and relax.

Slowly lift the affected arm straight up over your head until you feel a stretch through the affected side of your body.

  • Slowly lift the affected arm straight up over your head until you feel a stretch through the affected side of your body.
  • Don't force it, and don't hold your breath. Don’t arch your back or bounce when lifting it; just move gently in a natural way.
  • After holding the stretch for several seconds, release and allow the muscle to relax again before repeating this process on the other side (if applicable).

Hold for 10 seconds, then slowly lower arm back to the floor and repeat 10 times.

Hold for 10 seconds, then slowly lower arm back to the floor and repeat 10 times.

You should do this a few times each day. It will relieve pain quickly and strengthen your wrist for future strong use.

Give these exercises a try today to see what you need to do.

  • Use the following exercises to get rid of pain in your wrist:
  • Grab a bottle of water and hold it on your hand with both hands, palms facing up.
  • Then stand up straight, raise one leg so that it is just above hip height and then bend at the waist as far forward as possible until you feel a stretch in your lower back (make sure not to move too far). Hold this position for 30 seconds before switching over to the other side.
  • Sit down on a chair with both feet flat on ground and place hands behind head supporting weight of neck/head through shoulders/chin area; keep chest out lifted up slightly off seat cushion but don't let chest sink too low- make sure not push against table edge!

All content provided on this site is for informational purposes only and should not be used to diagnose or treat a health problem or disease without the advice of a healthcare professional.

Watch this Video

Here's a video brought to you by Paula Nutting, Your Musculoskeletal Specialist, where you can see how to do this treatment and remedies effectively. Watch to go through these steps so you can practice from your clinic and also what homecare you can offer your patients when they are not in your practice. Click here

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Yale Medicine (2022). Wrist Fracture: Causes, Diagnosis & Treatment. Retrieved June 07, 2022, from

Mayo Clinic (2022). Wrist Pain. Retrieved June 06, 2022, from,arthritis%20and%20carpal%20tunnel%20syndrome.

elbow pain tips and hacks for effective treatment

Free from Elbow Pain: Useful Tips & Remedies


If you’re suffering from elbow pain, which is caused by Arthritis. There are treatments and remedies for that, with maneuvers and skin pulling for mobilizing the nerves,  which may be just what you need to treat your condition.

Besides, these Tips and Hacks will help you get back to your daily activities without pain interfering with your quality of life. In fact, our recommended treatment is one of the most effective non-surgical solutions available today.

Elbow Pain Causes

According to Penn Medicine (2022) Elbow arthritis takes place whenever the cartilage in the elbow is embellished , worn or damaged.

Here are some of the most common causes:

  • Overuse due to age
  • Stress and tension
  • Fracture or dislocation.
  • Trauma (such as a fall) or incorrect use of your arm/hand/fingers
  • Degenerative conditions such as osteoarthritis, rheumatoid arthritis or carpal tunnel syndrome

In  addition, Elbow arthritis can be extremely painful and can interfere with daily tasks that involve bending your arm.

Know more about Elbow Pain

If you have elbow pain, and  maybe one of the various disorders listed below  could be the reason behind that pain. Meanwhile, worn out, sports, or household related injuries cause many elbow conditions. Golfers, baseball pitchers, tennis players, and boxers often have elbow disorders, (Briggs, 2020)

Elbow pain may involve any of the following

  • Arm Muscles
Arm showing musculoskeletal anatomy
  • Elbow Ligaments
image showing elbow ligaments
  • Tendons
image showing a hand with a ben pointing at a model of tendons
  • Bones in the Arms
woman wearing white shirt with elbow pain
  • Bursae

Elbow Pain Treatment

Elbow pain is a common injury that can affect people at any stage of their lives. It's also one of the most painful types of injuries, which means that doctors and physical therapists often recommend treatment options for elbow pain. While there are many ways to treat and prevent elbow pain, some methods work better than others. Elbow pain treatments vary depending on the scale of pain and symptoms you are  experiencing. Nevertheless, most elbow pain requires conservative treatment. Surgery is a last resort if your symptoms don’t improve.

Your treatment options include:


  • Ice the elbow for 15 minutes. A bag of frozen vegetables works well, or you can use a cold compress on your elbow.
  • Rest the elbow in an elevated position for 20 minutes to 30 minutes each day, such as by putting one leg up on a stool and resting the other on the floor below it or even leaning against something (such as a wall). This will help reduce swelling and inflammation around your joint while allowing blood flow through it easier so that it doesn't get clogged up with dead cells and other unwanted material like bone spurs or calcification which can cause further damage over time.


Rest the elbow in an elevated position for 20 minutes to 30 minutes each day, such as by putting one leg up on a stool and resting the other on the floor below it or even leaning against something (such as a wall). This will help reduce swelling and inflammation around your joint while allowing blood flow through it easier so that it doesn't get clogged up with dead cells and other unwanted material like bone spurs or calcification which can cause further damage over time.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

If you’re experiencing elbow pain, there are many different options for treatment. One of the most common methods used in treating elbow problems is medication. Medications can be helpful in reducing pain and inflammation, but they may not help with the underlying cause of your injury. Nonsteroidal inflammatory drugs such as ibuprofen may be prescribed by doctors in severe cases but these medications come with side effects such as nausea, should only be taken if prescribed by medical professionals.

Physical therapy

Physical therapy is another option many people choose when they're experiencing chronic pain due to injuries sustained while playing sports such as basketball or football where there could have been injury sustained during playtime.

Other Ways to Prevent Elbow Pain

Most elbow pain is the result of overuse and injury.

You can prevent them by:

  • correcting improper sport techniques
  • using a proper-sized grip on sports equipment
  • using correct tension on racquets
  • warming up and stretching properly
  • using elbow padding

It’s also important to take breaks from repetitive tasks. Practice exercises that can help strengthen the muscles around your elbow joint.

Exercises for Elbow Pain Relief

  • Stretching
  • Strengthening exercises for the biceps, triceps and forearms:
  • Biceps curls: With a dumbbell in each hand, hold it at shoulder height with palms facing forward. Lower until your arms are at 90 degrees and then raise up again. Repeat 10 times in total before resting for one minute. Then repeat on other arm. Do this two times per day if you have elbow pain in both elbows or just once if it's only one elbow that hurts (or maybe even three times).
  • Tricep kickbacks: Stand on an exercise ball (or similar) with feet hip-width apart so that you are balanced on the balls of your feet; bend knees slightly while keeping hips square; lift hips slightly as if sitting back into a chair (but don't let them go down); slowly lower back down until thighs come off floor; repeat 15 times then rest 30 seconds before repeating again!

Professional Help with Elbow Pain

If you're suffering from elbow pain and can't seem to find a solution, seeing a doctor is the best way to get treatment. The first step is getting an x-ray or CT scan of your elbow. This will help determine what's wrong with your joint and whether there are any other problems involved in its development. You may also need blood tests done as well as an exam by a physical therapist who can evaluate how well your muscles function at rest (which could indicate muscle weakness) or during movement (which could indicate muscle tightness).

When it comes time for diagnosis and treatment, talk with your doctor about the potential causes of elbow problems. Some people might benefit from nonsurgical options like pain relievers such as ibuprofen while others may require surgery if they have advanced arthritis in their joint cartilage—though this decision should be made after careful consideration based on recent findings about how much arthritis affects different parts of our body differently depending on where they sit within them overall structure."

If you have arm pain that persists, see a doctor.

If you have arm pain that persists, see a doctor. If the pain is severe or lasts more than a few days, see your doctor right away.

  • Pain accompanied by swelling: If you feel the pain in only one part of your elbow and it's accompanied by swelling around that area (inflammation), then this could be an indication that there is something wrong with either tendons or ligaments in your arm bones. In this case, it could be helpful to speak with an expert who can help determine whether or not surgery is needed; however, sometimes just rest will do the trick on its own!
  • Pain accompanied by weakness/numbness: Weakness or numbness from arthritis can cause problems throughout the body—especially when combined with fatigue due to poor circulation—so it’s important for anyone experiencing such symptoms not just focus on themselves alone but also seek medical attention right away if possible so they don't wind up doing anything harmful like cutting off circulation even more than normal because we all know how bad having severed limbs would feel!

All content provided on this site is for informational purposes only and should not be used to diagnose or treat a health problem or disease without the advice of a healthcare professional.

Watch this Video

Here's the most effective video where you can see how to do this treatment and remedies effectively. Watch to go through these steps so you can practice from your clinic and also what homecare you can offer your patients when they are not in your practice. Click here

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Penn Medicine (2022). How to Treat Elbow Arthritis. Retrieved June 14, 2022, from,that%20 involve%20 bending%20your%20arm.
Spriggs, B. (2020). Elbow Pain Types of Disorder. Retrieved June 15, 2022, from

Muscle Energy Technique Blog featured photo

Know some Muscle Energy Technique for Anterior and Posterior Ilium

What Is Muscle Energy Technique?

In 1948, Fred Mitchel Sr, D.O. developed a type of osteopathic manipulative medicine (OMM) known as the "Muscle Energy Technique (MET)." MET improves musculoskeletal function by mobilizing joints, stretching tight muscles and fascia, reducing pain, and improving circulation and lymphatic flow (Waxenbaum, 2020). In simple terms, MET is a hands-on approach to treatment that uses the therapist's manual resistance to help the patient move their muscles. Hence, it is believed to work by mobilizing adhesions and restoring normal joint motion. As a result, MET provides pain relief, improves function, and reduces muscle tension. While the exact mechanisms are still being studied, there's plenty of anecdotal evidence to suggest that MET can be an effective treatment for various conditions.

What Are Some Common Active Technique Treatments Aside from Muscle Energy Technique?

There are many different types of Active Technique treatments, but some of the most common include:

Myofascial release: This involves applying gentle pressure to the fascia (the connective tissue surrounding muscles) to release tension and improve blood flow. There has been some debate about myofascial release, with some questioning its efficacy. However, a growing body of research suggests that myofascial release therapy can benefit many conditions.

• Muscle stripping: This technique uses manual resistance to "strip" or lengthens muscles. So, what is muscle stripping? Muscle stripping is a technique that uses manual pressure and movement to separate and stretch the muscle fibers. This is said to help improve blood circulation and promote the healing of injured muscles.

It's used to treat a variety of issues, such as Tendonitis, Muscle pain, Scar tissue, Stress, Fractures, Muscle Knots

Furthermore, muscle stripping is a massage used to treat muscle pain and tension. It is believed to work by breaking up knots and adhesions in the muscles, which can relieve pain and improve flexibility. This procedure is generally performed on the abdomen, hips, and thighs. To perform muscle stripping, the therapist will first apply a layer of oil to the area that needs treatment. They will then use their fingers or a tool to massage and stretch the muscles, which helps break down any knots or tension. This process is repeated until the therapist is satisfied with the results.

Moreover, the side effects of muscle stripping can vary depending on the individual but may include swelling, bruising, pain, and numbness. In some cases, patients may experience temporary difficulty walking or standing.

Nevertheless, muscle stripping is often used to treat chronic pain, tension headaches, and carpal tunnel syndrome. It can also be helpful for athletes who are looking to improve their performance and reduce the risk of injury.

• Isometric holds: In this treatment, the therapist will ask the patient to contract their muscles against resistance for a certain period. This treatment is thought to help relieve muscle tension because it causes the muscle fibers to stretch and recoil. This helps break down the knots or adhesions that can form in the muscle tissue, leading to pain and tension.

You'll need to find a sturdy surface like a table or countertop to do an isometric hold. Place your hand on the surface and squeeze your hand and forearm muscles as hard as you can for 10 seconds. Release and rest for 10 seconds, then repeat the hold for another 10 seconds. Do this for a total of three rounds.

So, what are the risks of isometric holds? Well, like any type of exercise, there is always a risk of injury. If you're not careful, you could end up straining or even tearing your muscles. That's why it's important to start slowly and gradually build up the intensity of your holds.

Another thing to watch out for is cramping. If you hold your muscles in a static position for too long, you might start to experience cramps. This is usually nothing to worry about, but you should speak to your therapist if the cramps are severe or persistent.

There are a few occasions when you should avoid doing isometric holds. If you're pregnant, have high blood pressure, or are recovering from surgery, it's best to speak to your musculoskeletal specialist before starting this treatment. Additionally, it's important to stop and consult your musculoskeletal specialist as soon as possible if you experience any pain or discomfort during an isometric hold.

How Can Muscle Energy Technique Help With Anterior and Posterior Ilium Pain?

Here are some ways on how Muscle Energy Technique (MET) can help with anterior and posterior ilium pain:

Stretching the muscle helps to lengthen it and improve flexibility. When the muscle is flexible, it can work more efficiently and with less tension. This can help to reduce pain and discomfort.

Breathing helps to control muscle tension and relaxation. It also helps improve blood circulation, providing more oxygen and nutrients to the muscle. This can further reduce pain and discomfort, as well as improve healing.

To maximize the effects of MET, you can also do follow-up self-massage at home. Self-massage helps break up scar tissue and adhesions, which can cause pain and restrict movement. It also helps to increase blood circulation and improve healing.

Does Muscle Energy Technique Have Any Side Effects?

There are some risks associated with using Muscle Energy Technique. As with any physical therapy, there is always a chance of injury. You could pull a muscle or even damage your joint if you're not careful.

Another thing to be aware of is that MET can be pretty intense. Some people find it uncomfortable, and it can take a while to get used to the sensation. It's important to start slowly and build up your tolerance gradually.

As with any musculoskeletal treatment, always consult a musculoskeletal specialist like Paula Nutting before starting MET. They can advise you on whether it's the right choice and help you avoid any possible side effects.

How to Address Anterior and Posterior Ilium Pain?

Anterior and Posterior Ilium Pain can be addressed through stretching, breathing, and self-massage. Stretching is key to releasing tension in the muscle and preparing it for movement. A good stretch technique is important to elongate the muscle without causing pain or discomfort.

Breathing is also essential for effective MET. You need to ensure you're breathing deeply and rhythmically to get the most out of the stretch.

Finally, self-massage is a great way to release any tension that has built up in the muscle. A good massage technique will help increase blood flow and reduce inflammation.

How Can I Stretch Effectively?

There are a few things to keep in mind when stretching effectively.

First, always warm up your muscles before stretching. This can be done by taking a light jog, jumping jacks, or simply marching in place.

Second, be sure to hold each stretch for at least 20 seconds. This will allow the muscle to relax and lengthen.

Third, don't bounce as you stretch. This can cause the muscle to tear and may lead to injury.

How Can I Stretch Effectively?

When using Muscle Energy Techniques, breathing deeply and rhythmically is important to achieve the best results.

Not only does this help to relax the body and clear the mind, but it also helps move the energy around the body correctly.

Deep diaphragmatic breathing is done by contracting the stomach muscles to push the air out of the lungs. It allows you to use 100% of your lung capacity and increases your lung efficiency.

How Can I Self-Massage Effectively?

There are a few ways to self-massage effectively. One is to use a massage ball or foam roller to target specific muscles. Another is to use your hands to massage the affected area. And finally, you can use a technique called compression massage, which involves pressing down on the muscle with your fingers or thumbs. 

Watch This Video and Subscribe to Learn More!

Searching for effective techniques to resolve your patient's hip pain? Paula Nutting, Your Musculoskeletal Specialist, discusses Anterior and Posterior Ilium pain relief using Muscle Energy Technique (MET). Try it now! click here

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Stenersen, B., & Bordoni, B. (2022, January). Osteopathic manipulative treatment: Muscle energy procedure - cervical vertebrae. National Library of Medicine. Retrieved July 7, 2022, from

Cleveland Clinic. (2022, March 30). Diaphragmatic breathing exercises & benefits. Retrieved July 7, 2022, from

Physiopedia. (2022, April 13). Muscle energy technique. Retrieved July 7, 2022, from

Fleckenstein, J. (2010, February 11). Discrepancy between prevalence and perceived effectiveness of treatment methods in myofascial pain syndrome: Results of a cross-sectional, nationwide survey - BMC musculoskeletal disorders. BioMed Central.

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Fix Wrist & Elbow Pain with This Simple Trick!


Elbow and wrist pain are common problems caused by various factors such as overuse, injury, or arthritis. The simplest way to address elbow and wrist pain is to stretch the muscles in the arm and hand through range. Stretching will help reduce muscle tension, which will help with much of the pain you may be experiencing at any of these joints. Manual therapy is another option for people with chronic elbow or wrist pain.

Hence, a certified Musculoskeletal Therapist like Paula Nutting, Your Musculoskeletal Specialist, can teach you numerous exercises that will lengthen and strengthen the muscles around that are problematic in your body. This will usually help alleviate pain in the area.

Myotherapy is another treatment option for people with chronic elbow or wrist pain. Myotherapy is a form of physical therapy that focuses on the muscles and soft tissues of the body (Healthline, 2016). It is a hands-on treatment that uses massage, stretching, and joint mobilisation techniques to relieve pain and improve mobility.

According to the Myotherapy Association of Australia, Myotherapy is a trusted medical specialty that uses evidence-informed assessment, treatment, and rehabilitation for musculoskeletal pain, dysfunction, and injuries. In simple terms, “It helps people in pain to move better and lead their best lives.”

What can Myotherapy treat?

Physical Therapy Vs. Myotherapy

You may have seen physiotherapy and Myotherapy mentioned online or on TV, but what do these treatments entail? Are they the same thing? Do they offer the same benefits?

In this post, we'll explore the differences between physiotherapy and Myotherapy. We'll outline what each treatment involves, its benefits, and who they're typically recommended for.

Physiotherapy uses physical interventions and education to promote, maintain and restore physical function and health. Physiotherapists work with people of all ages who have a range of health conditions, including musculoskeletal conditions (like arthritis, back pain, carpal tunnel syndrome, or sports injuries), neurological conditions (like stroke, Parkinson's disease, or cerebral palsy), respiratory conditions (like asthma, chronic obstructive pulmonary disease or cystic fibrosis), cardiovascular conditions (like coronary artery disease, heart failure or hypertension), metabolic conditions (like diabetes or obesity), and cancer.

A study concluded that physiotherapy provides substantial benefits to Australians at all stages of life and in response to many different life events. Benefits include better quality of life such as reduced pain, increased mobility, reduced burden of disease and longer life expectancy, and  avoided costs of healthcare (Australian Physiotherapy Association, 2020).

Physiotherapy is a great option for anyone suffering from injury or illness who wants to regain mobility and quality of life. It can help people of all ages and abilities, from newborns with birth injuries to athletes who have suffered a sports injury to the elderly who are struggling with arthritis.

If you're looking for treatment for a specific condition or want to improve your overall health and wellbeing, physiotherapy could be the right choice for you.

On the other hand, Myotherapy is a type of massage that uses targeted pressure and stretches to release muscle tension. It can treat various issues, including muscle pain, tension headaches, neck pain, and jaw pain. Therefore, Physiotherapy is a holistic treatment that uses various exercises, remedial massage, and body manipulation to help patients recover from injury or illness, while Myotherapy is a more specific approach as it focuses on determining the underlying causes of muscular pain and dysfunction and rehabilitating musculoskeletal injuries.

Both physiotherapy and Myotherapy offer a range of benefits that can help improve your quality of life. If you're experiencing pain or discomfort, either of these treatments is worth considering.

Simple Lifestyle Changes to Prevent Elbow and Wrist Pain

If you're experiencing pain in your elbows or wrists, you're not alone. In fact, it's one of the most common musculoskeletal complaints.

There are a number of things you can do to help reduce or prevent elbow and wrist pain. In this blog, we'll share some tips that have been proven effective.

Use Proper Form When Exercising

One of the most common causes of elbow and wrist pain is using the improper form when exercising. Think about the last time you did bicep curls at the gym. If you didn't use proper form, you might have experienced pain in your elbows and wrists. This is because when you curl your arms, you're putting a lot of stress on these joints.

To avoid this pain, make sure to use proper form when exercising. This includes using the correct weight, keeping your back straight, and not locking your elbows.

Take Regular Breaks

When you're stuck in the same position for hours on end, your muscles can start to ache. Not only that, but if you don't take regular breaks, you risk developing musculoskeletal problems like carpal tunnel syndrome and cubital tunnel syndrome.

These problems are caused by compression of the nerves and blood vessels in your elbow and wrist. The symptoms can range from mild discomfort to pain and tingling sensations and, in some cases, can lead to permanent nerve damage.

To avoid these problems, take regular breaks from your workstation. Get up, walk around for a few minutes, or do some stretches. If you can, try to vary your tasks throughout the day so that you're not doing the same thing for hours on end.

Use the Right Equipment

One of the best ways to prevent elbow and wrist pain is to use the right equipment. This includes choosing the right keyboard and mouse and adjusting the height of your chair and computer screen.

When it comes to keyboards, it's important to find one that's comfortable for your hands. The keys should be easy to reach, and the keyboard should be positioned so that your wrists are in a neutral position. You may also want to consider a keyboard with a split design, which can help reduce tension in your wrists. The mouse is also important, as it can strain your wrists if it isn't comfortable to use. Try to find a mouse that fits comfortably in your hand and has buttons that are easy to reach. You may also want to consider a mouse with a scroll wheel, as this can help to reduce movement.

If you're having trouble finding the right equipment or are unsure how to adjust your current setup, talk to a Remedial Massage Therapist for help. They can recommend products and advise on making your workstation more ergonomic.

Don't Overdo It

We get it. You're eager to make a change and start feeling better. But sometimes, less is more. Don't overdo it in the beginning and risk aggravating your injury. Start small and work your way up.

If you're unsure what's causing your pain, consult a therapist or doctor who can help you diagnose the issue. They may prescribe a few simple exercises to help stretch and strengthen the muscles around your elbow and wrist.

Stay patient and be mindful of how your body is feeling. You'll start to see progress if you're consistent with your treatment plan.

Strengthen Your Muscles

Strengthening your muscles is a great way to help prevent elbow and wrist pain. This can be done in several ways, including through exercise, massage, and a brace or splint.

One of the best exercises to help prevent pain is the wrist curl. To do this, you'll need a weight (or canister of water), which you'll hold in your hand with your palm facing down. Next, slowly curl your hand towards your body, keeping your elbow stationary. Hold for a second before lowering the weight back to the starting position. Be sure to repeat on the opposite arm.

If you're looking for a more targeted exercise, try the plank. This exercise works your entire core, as well as your forearm muscles. Start in a push-up position, with your forearms resting on the ground. Hold for 30-60 seconds before repeating.

Stretch Your Muscles

One way to help reduce pain is to stretch your muscles. This can be done before and after you do any activity that might cause pain.

Before you start any activity, stretch the muscles in your arms and hands for a few minutes. You can do this by sitting or standing and reaching your arms as high as possible above your head. You can also clasp your hands behind your back and stretch your shoulders.

After you've finished any activity, take a few minutes to stretch the muscles in your arms and hands again. This time, focus on the muscles in your elbows and wrists. You can do this by gently rotating your wrists in both directions, bending and straightening your fingers, and gently pulling on each finger.

Use Heat or Cold Therapy

You can use heat or cold therapy to help reduce elbow and wrist pain.

Heat therapy can help to increase blood flow and reduce inflammation. You can use a heating pad, hot water bottle, or heating gel pack.

Cold therapy can help to reduce swelling and pain. You can use a cold pack, ice pack, or even a bag of frozen vegetables.

Take Over-the-Counter Pain Relievers

If the pain is manageable, you can try over-the-counter pain relievers to help reduce inflammation and discomfort. Ibuprofen and aspirin are two of the most common types of pain relievers, and they can be purchased at any local pharmacy.

However, it's important to consult your doctor before taking any medication, as they may not be suitable for everyone. If you're pregnant or have a pre-existing medical condition, you should speak to a health professional before taking any medication.

Get a Massage

Massage is a great way to help relieve muscle tension and stress, which can often lead to pain. If you're experiencing elbow or wrist pain, booking a massage with a remedial massage therapist is a good idea.

Not only will they be able to help relieve the pain, but they can also give you some tips on how to prevent it from happening again.

Try Acupuncture

Acupuncture is a traditional Chinese medicine practice that involves inserting thin needles into specific points on the body. Acupuncture is an effective treatment for reducing pain and inflammation and has been used for centuries to treat all sorts of conditions.

If you're experiencing elbow or wrist pain, you may consider trying acupuncture. Acupuncture is a relatively safe treatment and can be done in a therapist's office, so it's a great option if you're not comfortable with needles.

Use Trigger Point Injections

One of the most common musculoskeletal pain treatments is trigger point injections. This is a treatment where a small amount of local anaesthetic is injected into the taut muscle fibres causing pain.

The anaesthetic will help release the muscle's tension and stop it from sending pain signals to the brain. This treatment often stops pain straight away and can prevent the need for more invasive treatments further down the track.


Pain in the elbow and wrist can significantly reduce your quality of life. Luckily, there are many things you can do to reduce and prevent this pain. From making small lifestyle changes to seeing a therapist, these tips will help you get on the path to relief. Want to know an easy stretching and massage technique for elbow and wrist pain in just 1 minute?

Watch This Video and Subscribe to Learn More!

Here's a video by Paula Nutting, Your Musculoskeletal Specialist, teaching you how to fix elbow and wrist pain in just 1 minute! Click here

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Australian Physiotherapy Association. (2020, October 1). Value of physiotherapy in australia.

Bernstein, S. (2021, July 31). What’s physical therapy? How to feel and function better. WebMD.

Myotherapy - better health channel. (n.d.). Better Health Channel Australia.

What is myotherapy? (n.d.). Myotherapy Association Australia.


Myotherapy: Glenohumeral Joint Pain Treatment

Patients can come in with pain and stiffness from the neck that can refer to and causes elbow wrist and shoulder pain- acromioclavicular (AC) joint and the glenohumeral (GH) joint. Typically, it impedes movements such as lifting of the arms, brushing the teeth, or holding a golf club. It may be described as a moderate pain or a chronic pain that could affect sleep especially if it’s the shoulder you sleep on.

Shoulder Anatomy

You can help them by applying a variety of techniques to relieve uncomfortable pain or sensations in and around that area. But first, let's understand the shoulder anatomy. Since it is one of the most unstable joints in the body with the most movement, it can be complex to understand its structure and functionality.

Shoulder Structure and the three kind of bones, glenohumeral joint- Chapmans Reflexes Blog Image

The two shoulder joints that are prone to injury are the acromioclavicular (AC) joint and the glenohumeral (GH) joint. 

  • The acromioclavicular joint is situated where the clavicle is in contact with the acromion and the scapula. 
  • The glenohumeral joint is where the socket of the scapula connects with the rounded head of the humerus. It is responsible for the wide range of motion of the shoulder including flexion, extension, internal and external rotation, adduction and abduction and circumduction. 

There are  eight muscles attached to the bones of the shoulder. They are responsible for the form we see of the shoulder and underarm, they aid in its range of movement, and help protect the GH joint which is the main primary joint involved in function.

The deltoid muscle, which you may also know as the deltoideus muscle, is the shoulder muscle considered to be the largest and responsible for stabilization of the shoulder joint for the prevention of dislocations. 

The other muscles which work with the deltoid for shoulder movement and its functions include:

  • Infraspinatus - for arm raise and lowering
  • Triceps brachii - arm straightening
  • Pectoralis major - connects to the sternum
  • Pectoralis minor - stabilizes the scapula
  • Teres major - arm rotation 
  • Biceps brachii - rotates the forearm; flexes the elbow
  • Latissimus dorsi - helps with arm rotation and movement away from and close to the body
  • Subscapularis - aids to rotate the humerus 
  • Supraspinatus - help to raise arm away from the body

Shoulder Pains and Problems

Muscle Energy Technique

When any of the aforementioned muscles become dysfunctional, inhibited and reduced in their passive resting length, they tend to pull the humerus forward. According to OrthoInfo, shoulder problems that patients can experience fall into these categories:

  • Tendon inflammation - can be bursitis or tendinitis
  • Shoulder Instability - stretched lining of the shoulder joint, labrum, or ligaments 
  • Arthritis - joint tenderness and swelling
  • Fracture - can be caused by trauma or injury from a fall, sports activities, vehicular accident, or a direct hit to the shoulder

Other causes for shoulder pain that are less common include infections, tumors, and nerve related problems.

See Related Video: Shoulder Pathologies: Different Causes and Cool Tubing Treatments

In this article, we are going to focus on glenohumeral joint pain and an amazing muscle energy technique that could improve the humerus’s resting position. This will improve the quality and range of motion and reduce the notable pain felt by your patient. 

Almost any joint in the body can be safely treated with these techniques. Many sportsmen utilize them to avoid future muscle and joint injuries. It's primarily used by people who have restricted range of motion in their neck and back due to facet joint dysfunction found in the neck and back, for those who have broader issues like shoulder pain, sciatica, scoliosis, unsymmetrical legs, hips, or arms, and to treat chronic muscle pain, stiffness, or injury.

See Related Video: BEST exercises for the majority of shoulder problems using the water

Conducting the Assessment

You can clearly see how  far forward the humerus of the patient is. To conduct the test, ask them to be seated comfortably. Stand behind the patient and place your hand over their shoulder. Press your thumb into the tissue, as is in the picture below, until you can palpate the humerus. Note how far forward the humerus is, you can apply a second finger along with your thumb for a more clearer view.

Conducting the assessment for shoulder pain, glenohumeral joint and problems-Chapmans Reflexes Blog Image

Upon confirming that the humerus is anteriorized and checking if any symptoms of pain locally, and/or radiating up in the neck down to the elbow and wrists are present, you can go ahead with this simple muscle energy technique that will improve length of restricted tissue and bring the humerus back into the glenohumeral joint.

Related article: Shoulder Pathologies: Different Causes and Cool Tubing Treatments


Let’s begin with the treatment steps. Here’s what you can do:

  1. Have your patient lie on their back (supine).
  2. Put your four fingers behind the humerus while your thumb and wrist sits on top of the humerus.
  3. Slide your thumb down until you get into a firm position.
  4. Push the top end of the humerus down, letting it press onto the table. At the same time, let your other hand elevate the elbow. Continue to do this seesaw-like motion that gently moves the humerus in the capsule a couple of times. Since it can be quite tender, remember not to apply too much force. 
  5. Apply gentle pressure until you can feel the bony end range and ask the patient to push their elbow to the floor and hold it for about 10 seconds. 
  6. Let the patient take a deep breath and when they release their breath you reduce the pressure applied to the limb whilst ensuring that the joint remains in an isometric position. 
  7. Repeat steps four to seven: You apply a rhythmic rocking back and forth motion of the humerus within the joint space for approximately 30 - 45 seconds or until it has a softer feel on the movement, it will start to have a smoother end feel. Continue with the gentle push while the patient takes a deep breath. When they breathe out, stop applying pressure as a counterforce on their humerus. When you apply the muscle energy technique, here are several tips to remember. When pushing down gently, hold it for about 10 seconds and ask the patient to exert 30% to 40% of their effort. Let them take a deep cleansing breath in and when they breathe out, that's when they stop contracting. You can do this three times before reassessing the joint position again. This should make headway into better movement patterns and reduced myofascial pain of the shoulder and surrounding compromised structures.

Watch This Video

Here's a short video where you can see how the steps are carried out. Watch to learn more how to follow through with the muscle energy technique. Try it from your clinic and you will see positive changes in your patients pain and function.

hand over painful neck

Stiff Neck Causes and Remedial Self-Massage for Relief

The pain a stiff neck brings about can be very bothersome and serve as a hindrance when it comes to carrying out the tasks that we need to do everyday. But what exactly causes this tightness in our necks? I was thinking about just general ways that I can give you a little bit of help with some aches and pains. As you know, I've tried to specialize in musculoskeletal, hence the name. We also look at what's going on with the connective tissue as well. Things about joints, the fascia, the nervous system and ways to actually make you feel like you are feeling stable. Today, I'm going to focus on the neck and give you some tips on how you can relieve a ropy and bandy scalene if you’re on your own or cannot come into the clinic to see someone like me.

Causes of Stiff Neck:

  • Looking down for a long period while reading, writing, or using your phone;
  • Excessive or vigorous movement of the neck;
  • Sleeping in the wrong position, which exerts too much pressure on the neck
  • Clenching the jaw;
  • High stress levels;
  • Medical conditions such as osteoarthritis and spinal disorders
  • Trauma to the neck or back due to injuries, a hunched posture, or picking heavy weights; and
  • Sudden movement of the head due to whiplash, which can pull your neck muscles and also can give rise to other serious symptoms.
Source: Vaughan, J. (2021)


  • Feel along the suboccipital ridge all the way along, both sides, to see if they feel even.
  • The area that feels painful, is not the area of complaint.
  • Gently tuck your chin down and feel around the back of the lower part of your skull (the top 3 survival muscles) and feel around the lateral joints.
  • Feel with two fingers and do some cross-fiber work .
  • Keep your shoulders down so you do not activate the trapezius muscles.
  • Once you find the tight ridge, palpate and see if you can feel into the area where the ribs are.
  • Feel for the upper trapezius and duck anteriorly to it, then press your fingers down into that tight space.
  • Palpate around the other side to see if it’s the same or different.
  • Drop your ear down to give a little bit of softness to the tissue of the lateral neck which will allow you to really sink deeper into the muscle.
  • Press and depress onto that region of the lower neck, it is the area that feels like it would be accessing your first rib, by doing this movement we are also making small changes to the restrictions or tightness over the second rib.
  • Laterally flex away from the area and give yourself a little active stretch while sinking down a little deeper.
  • As you work along your neck, press towards it and then gently glide away.
  • Repeat the process one more time this time moving a little more medially. Come closer to the neck dropping down and in.
  • Start to pull away and take the chin away, then try to access those fibers for posterior scalene, dropping down and back then coming along and forward.
  • Palpate and see if that made a difference. The scalene should be feeling less taught and bandy, and you should feel better through the range.
I want you to think about the things that make a difference to the neck. Sometimes we have to look at other distal attachments. We can apply joint play on our first and second ribs if they are stiff, palpate along the clavicle where the subclavius is and work on those fibres. Focusing also on the pectoralis major and minor to improve functional movement of the clavicle and shoulder joints. Assess one side versus the other to see if the problems felt in the neck can be compared to and aligned with the tightness felt in the chest tissues. Watching the video attached to this blog will assist you greatly in some self-treatment options whenever you feel restricted in the neck. References: Source: Vaughan, J. (2021) How to Get Rid of a Stiff Neck. eMediHealth. Retrieved from
stretching both hands at the back of an old client

Self-Shiatsu for Physical and Mental Healing

  These days, self-care is as important as total healthcare [1] for a person to be able to survive this pandemic, physically and mentally. Self-care is basically taking care of oneself for the purpose of achieving physical, mental, spiritual, and financial well-being. One important aspect of self-care is the physical care which eventually covers the other aspects of self-care.  Musculoskeletal specialist Paula Nutting interviewed her guest,  Leisa Belmore, a shiatsu specialist from Toronto, Canada. She has been a shiatsu specialist for twenty years already. Her approach is more western than its origin in the east. She is working in an integrative clinic in a hospital with other biomedical and complementary practitioners. The clinic especially focuses on creative artists who suffer physical injuries, chronic conditions, and mental issues. Shiatsu points on specific body issues for physiological reactions. She also has written and collaborated on research papers with medical practitioners, including a behavioral therapist, nurse practitioner, physiotherapist, chiropractor, registered dietician, massage therapist, social worker, psychiatrist, and soon, a language pathologist. According to Belmore, not taking care of oneself is detrimental to the career of an artist. While in lockdown, she opted to run her workshops virtually, teaching self-shiatsu as well. She addresses the neck and shoulders as well as the hands and arms. According to her, the most prone to injury is the hands, not just for the shiatsu therapist but also for chiropractors, other manual therapists, massage therapists, and physical therapists. As for the shiatsu therapists, their thumbs are usually the most commonly injured joint due to the treatment style of the Shiatsu, thumbs are the tool to compress on the relevant chi points of the body.    Leisa gave some tips on Self-Shiatsu:  
  1. Finger-to-wrist stretching, rotation of the hand, joint and finger rotation
  1. When doing shiatsu, use the pad of the thumb of the finger, not the tip.
  1. Extend the thumb when using it; don't flex it.
  1. Apply gradual pressure to the area between the thumb and the point of the finger.
  1. There are three pressure points that must be applied to each in between the fingers of the hand.
  1. After applying pressure on the points in between the fingers, the phalanges are addressed next. Every joint of the fingers has points that need to be pressured on by pressing them from front to back and on the sides too.
  These tips can help a person calm down. She has her website where there are several videos they can watch to learn how to do self-shiatsu to assist with anxiety and sleep disturbances [2] as well as the app for shiatsu, too. These videos and apps were able to help with sleeping patterns for some patients as well as concentration problems. Leisa demonstrated how to do it gently for the flexibility of the muscles and the nervous system. She specified that the neck and shoulder muscle areas are good places to work on. She demonstrated how to do the sub occipital area of the neck by putting both hands just above the occipital area and holding the area longer. If it feels tight or tender, then move to the right side, the next point, and do the same, then on both sides of the spineous processes. Repetition is good to achieve better results.  Posture has been adversely affected because of the increased usage on the computer while working at home and being busier than working on site. To improve postural positions we can address various points in the sternum and the chest area remembering that stretching is also very important to include in self care.  The incidence of anxiety has increased since COVID and we need to be mindful that some treatment may not be applicable to people with specific medical conditions or who are reticent about it. It is better to start small with little things to do and if they are doing anything positive, encourage that. Some have self-esteem issues. Since spending time in solitude can be boring, she suggested trying small goals such as meditating for ten minutes twice a week. She also added self-care tips for everyone, such as stress management to help sleep. Have a little time for ourselves to do something that we enjoy, such as walking, reading a book, or simply hanging out with friends. She also created a variety of PDF's for some specific health conditions. Leisa created them so that they are easy to understand and do not contain medical terms for easier understanding. Self-care sessions such as self-shiatsu, stretching points, are self-care for specific needs. She shows them how it is done, talks to them, and lets them demonstrate it to her. When asked about lower back pain, Leisa started in the lumbar region, pressing on the erector spinae along the lateral edges of the lumbar vertebra; this is good for sciatic pain she said. Then next is the part of the pelvis near the spine, which is good for people who stand or sit for prolonged periods of time. It is comfortable to apply Shiatsu on the massage table, but keep it at a low height for best biomechanics i.e. using your body weight for pressure. For the hands, there are several stretches made to remove tightness in the soft tissue. For the face, the pad of the point finger is used to press on the points below the eyes and the brow bone above the eye area. If the patients’ learn Shiatsu, they will have more control over their conditions, especially in areas concerning their mental health. Leisa’s latest study was on care-partners with patients with dementia and shiatsu therapy. She had first hand experience being able to work with her father, who had dementia, and realized that they could have interaction without the need for words. Further study needs to go towards the mental wellness of both carer and the patient using this style of therapy. This simply shows that Shiatsu is not just for physical relaxation but also for the appeasement of the troubled mind. Together with other medical and complementary practitioners, it can support the goal of well-being for everybody.  

View the entire Ask-Me-Anything event with Leisa below:

    1 - Self-care | Public Health | Royal College of Nursing (  2 - Effectiveness of Hand Self-Shiatsu to Promote Sleep in Young People with Chronic Pain: a Case Series Design (
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