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Painful wrist remedies and treatment banner
chapmans reflexes Panful Wrist Wrist pain Wrist remedies
August 4, 2022 Paula Nutting

Know How to Treat Painful Wrist: Simple Remedies

Overview

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

Injuries

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.

Prevention

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

https://youtu.be/7awXHWjYxbY

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References

Yale Medicine (2022). Wrist Fracture: Causes, Diagnosis & Treatment. Retrieved June 07, 2022, from https://www.yalemedicine.org/conditions/wrist-fracture

Mayo Clinic (2022). Wrist Pain. Retrieved June 06, 2022, from https://www.mayoclinic.org/diseases-conditions/wrist-pain/symptoms-causes/syc-20366213#:~:text=Overview,arthritis%20and%20carpal%20tunnel%20syndrome.

elbow pain tips and hacks for effective treatment
Arthritis Pain chapmans reflexes Elbow Pain Painful Elbow
July 21, 2022 Paula Nutting

Free from Elbow Pain: Useful Tips & Remedies

Overview

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

  • 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

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

https://youtu.be/uY5wxoWA6JA

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For More Readable Articles: Click Here

References

Penn Medicine (2022). How to Treat Elbow Arthritis. Retrieved June 14, 2022, from https://www.pennmedicine.org/for-patients-and-visitors/find-a-program-or-service/orthopaedics/elbow-pain/elbow-arthritis#:~:text=Elbow%20arthritis%20occurs%20when%20the,that%20 involve%20 bending%20your%20arm.
Spriggs, B. (2020). Elbow Pain Types of Disorder. Retrieved June 15, 2022, from https://www.healthline.com/health/elbow-pain#types-of-disorders

Muscle Energy Technique Blog featured photo
chapmans reflexes Muscle Energy Technique
July 7, 2022 Paula Nutting

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?

myofascial release

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 using massage instrument

• 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.

neck isometric holds exercise

• 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?

Ilium pain muscle energy technique

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?

stretching

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?

deep breathing

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?

self massage using roller

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

https://www.youtube.com/watch?v=zLQnZ2CqghY

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    References

    Stenersen, B., & Bordoni, B. (2022, January). Osteopathic manipulative treatment: Muscle energy procedure - cervical vertebrae. National Library of Medicine. Retrieved July 7, 2022, from https://www.ncbi.nlm.nih.gov/books/NBK560706/

    Cleveland Clinic. (2022, March 30). Diaphragmatic breathing exercises & benefits. Retrieved July 7, 2022, from https://my.clevelandclinic.org/health/articles/9445-diaphragmatic-breathing

    Physiopedia. (2022, April 13). Muscle energy technique. Retrieved July 7, 2022, from https://www.physio-pedia.com/Muscle_Energy_Technique

    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. https://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/1471-2474-11-32

    Blog Poster and Featured Image 2
    Arthritis carpal tunnel chapmans reflexes chiropractor elbow Elbow Arthritis forearm hand massage myofascial technique myofascial treatment pain physical therapist physical therapy radius remedial massage therapist remedial massage therapists remedial massage therapy rotator cuff self-massage self-stretch self-stretching stretch stretches stretching Tennis Tennis Elbow Pain tightness Tips and Hacks for Elbow Pain Treatment. Your Musculoskeletal Specialist Wrist pain
    June 23, 2022 Paula Nutting

    Fix Wrist & Elbow Pain with This Simple Trick!

    Overview

    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?

    joint pain

    Myotherapy can be used to treat many different conditions, including:

    Elbow Pain
    Wrist Pain
    Neck Pain
    Back Pain/Lower Back Pain
    Shoulder Pain
    Hip Pain
    Knee Pain
    Temporomandibular Joint (TMJ) disorders

    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

    Women smiling and exercising using dumbbells

    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

    Proper posture while working in front of a computer

    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

    sprout

    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

    woman smiling holding a dumbbell to do muscle strengthening exercises

    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

    elderly stretching while sitting

    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

    hand applying cold compress to the elbow

    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

    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

    knuckles pushing man’s shoulder down

    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

    hand 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

    hand with gloves back injection

    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.

    Conclusion

    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

    https://www.youtube.com/watch?v=3urx1FCw39E

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      References

      Australian Physiotherapy Association. (2020, October 1). Value of physiotherapy in australia. https://australian.physio/sites/default/files/Report_FA_WEB.pdf

      Bernstein, S. (2021, July 31). What’s physical therapy? How to feel and function better. WebMD. https://www.webmd.com/pain-management/what-is-physical-therapy

      Myotherapy - better health channel. (n.d.). Better Health Channel Australia. https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/myotherapy

      What is myotherapy? (n.d.). Myotherapy Association Australia. https://www.myotherapy.org.au/About/Myotherapy

      both hands massaging man's neck
      benefits of stretching in our body chapmans reflexes chiropractor neck pains
      June 18, 2021 Paula Nutting

      Target Platysma or Neck Pain Easily using this Method!

      This is one of my 3 favourite muscle names in the body – it’s in your neck and it’s called the platysma!First of all, what is the platysma? It is a muscle that begins at the jawline, right at the mandible, and runs down in a fan shape to the superior portion of the clavicle. It is responsible for helping the mouth and lips to move. Specifically, it is the muscle that we use when we react with fear or fright – when our mouth is drawn down or to the side.

      Image from Wikipedia

      Many therapists miss out on getting the best outcomes because they overlook this little muscle. In fact, did you know that a lot of neck-related pain can be traced to the platysma? As therapists, 75% of people entering our clinic complain of either neck or lower back pain! If you are focusing your techniques at the back, which is quite often joint-related or soft tissue around the traps, splenius, etc, then can I ask you to try this simple technique on your next neck pain client?

      I could go as far as to say unless we address the tightness in the platysma. We won't get full neck movement.

      Your First Moves

      First, you must assess your client’s neck range. From a relaxed, sitting position, have your client lookup or go into full neck extension. Watch and be vigilant on the lift to note any tightness of the anterior neck esp the flat band of the platysma. Have your clients return to neutral or as neutral as they can. This video will show you step by step how I teach the muscle and surrounding soft tissue via way of an active glide. This way both of you are working together. Plus, they are increasing their afferent and efferent nervous system. They will also increase their agonists and antagonists, and myofascial trains.

      Active Glide

      For therapists out there, when we do active movements, it means that both you and your client or patients are actually actively involved in the process.

      1. Stand on the treating side, in this case, stand on the right and have the client turn their head to the right, as far as they can go comfortably. 2. Place two fingers or knuckles. If you have OA issues just above their right clavicle at the midline closest to the supraclavicular notch and sink into the tissues. The fingers will be facing out towards the AC joint on the superior line of the clavicle so that you can take up the tissue along with its attachments. 3. Have your client slowly rotate their head back towards the left as far as they can go comfortably. 4. As they move their head allow your fingers to glide along with their muscle. Work with a pace that mimics the speed of the rotation and at the tension of the hypertonic muscle/fascia. 5. I always apply any technique three times before I re-assess. NB* make sure you DO re-assess! 6. Repeat the same process on the other side.

      The Results

      As you’re doing this, it should feel “tight” and “stretchy” or “burny” to your clients – all signs of fascia, muscle, and/or tendon. Have your clients test their range again, by moving their heads up, down, and side to side. The results can be astronomical in pain management, posture, and range. You should be able to see the tissues are not as taut as this time around.

      The beauty of this work is that you can offer it to clients as homecare.  This is an attempt to release any ongoing restrictions felt in the neck. This is another cool technique that adds value along with the other ways to assist in neck pain that we've discussed in earlier videos.

      Have fun and hope this helps you and your clients in the future! 
      Breathing breathing techniques chapmans reflexes proper breathing stress stress management
      May 27, 2021 Paula Nutting

      Can’t Breathe Properly? Fix It In Just 120 Seconds!

      Are you in a constant state of stress? With everything that has been happening in the world right now, I cannot blame you. Several things can trigger stress, such as sudden changes in your environment, feeling pressure, and anxiety. There is such a thing as ‘good’ stress, which can help us when trying to meet deadlines, or when our body acts on instinct when we are in danger. However, too much stress can be quite draining emotionally and physically. One physical aspect it triggers significantly is our breathing.

      Breathing is usually an involuntary act, which means that your body does it even without conscious effort. This is important because our entire body needs oxygen to function properly. Proper breathing has multiple benefits such as mental clarity, better cognition, improved posture, helps the quality of our sleep and even aid in proper digestion.

      8 Ways to Increase Lung Capacity For Running

      by Runner's Blueprint

      But when our body is experiencing stress, it hinders our effective breathing. Everyone experiences stress occasionally, so when that happens, we will need to work on our conscious breathing. This requires the use of the cortex of the brain. Stimulating the motor cortex helps the brain stem to work with up and down regulators to improve things such as posture, pain regulation and overall oxygen efficiency.

      Two Breathing Techniques

      To help with that, I recommend using your diaphragm when breathing. This is also called belly breathing. I have two techniques for you to practice being able to get a feel for diaphragmatic breathing.

      1. Lie face up, with your knees bent and your feet flat on the ground.
      2. Place a book of your choice on your belly.
      3. Breathe in deeply and visualize the muscles of your lower regions of your thorax activating whilst taking the air in through the nose.
      4. Exhale through the mouth. Repeat this process at least ten times.

      You should be able to see the book on your belly rise and down as you use your diaphragm to breathe.  However, if you are still having trouble, I will share with you another technique which involves locking down your upper ribcage. Doing so will restrict the top end of the breathing cycle and will consequently work the lower end of the breathing cycle. To do this technique, you will begin as you did the with the first exercise, lying face up with the knees bent and feet flat on the ground.

      1. From this position, take one hand and place it underneath your buttocks.
      2. Then, take the opposite hand, reach across your chest and wrap it halfway down your upper arm.
      3. Again mindfully taking each breathe in through your nose.
      4. Exhale through the mouth. Repeat this exercise ten times.

      Both techniques are truly helpful to stimulate oxygen throughout the body. I ask my patients to do this each morning when they wake up or whenever they are feeling stressed and have a place they can stop for 2 minutes. Firstly I make sure they have stimulated their neuro lymphatic points aka Chapmans Reflexes, you can literally do this anywhere at all.

      For a better view of this exercise, have a look at this Youtube video.

      both hands massaging man's shoulders
      chapmans reflexes shoulder pain
      January 19, 2021 Paula Nutting

      Best Pain-Free Myotherapy for Sore Shoulders

      How can you shoulder a burden if the burden is your shoulder?

      Admit it, your shoulders were designed to make every action possible, they adduct, abduct, flex, extend both vertically and horizontally and circumduct which means they can perform tasks as simple as lifting a pen through to carrying loads that can be as much as your weight or even greater. However, despite their versatility, shoulders are not well designed and are prone to injuries when overworked. And that explains the hassle of being unproductive when experiencing mild to intolerable shoulder pain. In today's article, we are to learn the Best Pain-Free Subscapularis Massage for Shoulder Pain.Whatever kind of pain it is, many therapists elect to focus on massaging the region of the complaint without looking further into the mechanisms of the shoulder. Massaging the local region is an effective solution if we are working towards increasing our mild inflammatory response when we work on the tissues, the general increase of fresh blood to your muscle and oxygen-rich nutrients purportedly assisting in tissue health BUT, a deep tissue massage could worsen the situation. The American Massage Therapy Association defines the shoulder as the interlocking of bones, cartilage, tendons, and fluid.  It comprises muscles including the upper trapezius and levator scapula above, the rhomboids and lower trapezius medially, and the latissimus dorsi posterior and laterally. It also contains the rotator cuff which includes supra and infraspinatus, teres major and minor, and the subscapularis which is the largest and strongest muscle of the four rotator cuff muscles. A tricky muscle to access but necessary if you want good outcomes.Despite that, not a lot of people do work on the subscapularis when treating shoulder pain and when they do, it is painful and uncomfortable. In this article let me unravel a way for you to treat the pain without pain.

      Here is how to apply the Best Pain-Free Subscapularis Massage for Shoulder Pain:

      1. Standing - Check the range of internal rotation (medial rotation).

      We should always get a benchmark of ROM when treating. It is for the patient as well as us to understand the before and after of treatment.FABRE for internal and external mobility is a great way to start. By this I mean to have them bend their elbow at a 90-degree angle, swing it inward reaching behind the back, and touch the inferior aspect of the opposite scapula. By doing this, you and your client can get an understanding of the quality and amount of mobility through the range, how stiff the shoulder is, where they feel the pain and or restrictions, and post-treatment, you can get a comparison and more ideas on what extra work needs doing or what exercise prescription is required.

      1. Supine - Lay down on a table.

      A massage table is perfect but NOT completely necessary. If you don’t have one you can look for a flat surface that is comfortable i.e., the carpeted floor or a mat, or even a very firm mattress. They need to be able to relax their shoulders. Laying down will also make it easier for you to locate the muscles to work on.

      1. Exercise/treatment - Do low-load muscle activations.

      What is low load muscle activation???If I ask you to perform a task such as raise your arm, you will recruit many muscles to perform that action. If I ONLY want ONE muscle to work then I need to get you to perform the EXACT movement that this muscle is required to do BEFORE the synergists turn on to assist in the action.So a low load action is one that is very small and very gentle. It required the therapist to know what the action of the muscle is and to have the client in the exact position for that muscle to fire first.https://www.yourmusculoskeletalspecialist.com/chapmans-reflexes-virtual-workshopsOur subscapularis performs two movement patterns for long and short-range so we need to improve the firing sequence of the muscle at these two ranges for effective treatment gains. When the action or strength of contraction of the muscle returns, so too does the resting length improve. This means the stronger the muscle the longer it sits at rest. When it is at a better resting length there is far less compression into the joint capsule and therefore less work for the other muscles working in the rotator cuff.Before we start this best pain-free Subscapularis Massage for shoulder pain, let’s consider draping and privacy issues. Both males and females should have appropriate covers for the breast tissue (wear appropriate crop tops) before you do the low-load muscle activation. If your client has lower back pain, put a pillow or bolster under the knees to keep the back flat.

      Start in short-range as it’s easier for the shoulder if there are signs of impingement through end range.

      As the therapist slide your fingers along the rib line and drop in behind the anterior part of the scapula and until you can palpate the muscles of subscapularis.Pop your fingers down to that area and link in so that you can feel the movement when the patient is doing a contraction.For Short Range
      • The subscapularis is going to adduct the arm, so the elbow comes in towards the body at the same time as the forearm medially rotates. This is a very gentle contraction for a few seconds only and then FULLY relax and repeat for approximately 20 repetitions. You will start to feel your palpating fingers sliding and gliding down between the spaces of the ribs and under the scapula as the muscle starts to soften and lengthen.
      For Long-Range
      • Do an isometric contraction. Take your client's arm into their overhead end range and hold it there, have them perform the similar to “spiking” a volleyball. That is returning the straight arm down to their side by using the armpit muscles to perform the action. The subscapularis is now drawing the arm forward and down. Repeat the “up, down, relax” contraction until you see that the arm is starting to go further into extension without impingement.

      1. Stand and repeat to see the results.

      Do the FABRE or Apley’s scratch position again to measure your range of internal rotation once done and compare it with the previous one.As you can see, treating shoulder pain doesn’t need to be as painful as you believed. This is really one of the simplest ways to apply a treatment for improving a weakened or damaged muscle for the client and removes the pain and fear response attached to the treatment.

      Don't forget to watch this Best Pain-Free Subscapularis Massage for Shoulder Pain video

      CLICK ON THE VIDEO (Best Pain-Free Subscapularis Massage for Shoulder Pain) for the best way to see them in action and remember what I’ve taught you, take note of these processes so that you’ll never worry about painfully treating the shoulder. If you want to know more, visit my YouTube channel where I teach you how to do treat related concerns.
      woman holding her left shoulder pain
      chapmans reflexes chiropractor lower back pain shoulder injury
      December 24, 2020 Paula Nutting

      Shoulder Injury, Neurolymphatic Point Stimulation Case Study

      Clinical features

      This is a shoulder injury and neurolymphatic point stimulation case study.  A 44-year-old healthy female came to me presenting a 5 ½ months-post fall that caused a fracture to her greater tubercle and dislocated the humerus posteriorly.

      Intervention and Outcomes Before using Chapmans Reflexes

      A variety of interventions were performed by her physiotherapist before commencing treatment with me and the application of Chapmans reflexes.Non-surgical relocation of the humerus was performed by her surgeon followed up with weekly rehabilitation therapy with physiotherapy using closed chain small exercises. To date, she has a humeral elevation close to 80 degrees. She was also seeing her regular chiropractor, Dr. Sandy [10 years +]. She has included acupuncture to try for more movement in the shoulder complex. Dr. Sandy referred her to me to address the still limited range of motion.

      Interventions using Chapmans Reflexes and Various NMT

      For the interventions using Chapmans reflexes, one treatment was applied per week for three weeks. Then one more 14 days later with follow-up in so that she could return to full ROM and strength. This also enables her to perform push-ups from a toe stance. The pain was significantly reduced to VAS less than 1/10. I also addressed her underlying chronic lower back pain complaint.

      METHODS

      INITIAL PRESENTATION

      Mrs. W showed:
      1. tension/hypertonicity
      2. tight left lateral neck and shoulder
      3. some altered sensation
      4. numbness over the region of the lateral humerus. Her description of the region included "feels like a block" and
      5. "has a heaviness when trying to reach overhead".
      Over the last 10 weeks, she stated that the medial and anterior deltoid muscle "now finally getting the tone and feels like it is activating". She had actively been doing her home care as instructed by the physiotherapist assigned to her. The home care included the use of heat packs to alleviate the tight and tense soft tissue.

      Assessment

      Her levels of stress were reported were extremely high. She stated that she felt like she was holding everything internally. She was unable to take full diaphragmatic breaths and her thoracic range of movement was limited in all ranges.Strength testing was performed and showed moderate weakness on the diaphragm-supraspinatus isometric test. There is also a moderate weakness to the latissimus dorsi, the thoracic extensors, posterior deltoid/shoulder complex, and the external humeral rotators.

      Treatments

      Treatments for Mrs. W included the following:
      1. Chapmans Reflexes – Commenced by stimulation of the neurolymphatic points feeding the diaphragm and then teaching her diaphragmatic breathing to elicit the “relaxation response” and trigger the parasympathetic nervous system. Chapmans Reflexes were applied to the neurolymphatic points for the latissimus dorsi anterior and posterior points and the Tx and shoulder extensors, where I followed the protocol of vigorous but not deep rubbing for 30 seconds in each region. Once these areas were stimulated her strength had improved to very strong isometric holds of the shoulder muscles and increased ROM of humeral extension and internal adduction.
      2. Muscle Energy Technique - Following the neurolymphatic stimulation, I added a muscle energy technique to the humeral internal rotators. This will allow greater resting length in these muscles and increase mobility and ROM of humeral external rotation. During the post isometric relaxation phase, the resting length of the muscle will be greater. This technique has been found to effectively reduce capsular restrictions noted at the glenohumeral joint through ROM.
      3. Low load muscle activation - She then performed a low load muscle activation of the subscapularis in its closed position. The action of the subscapularis is internal humeral rotation as well as adduction of the humerus. This allows the target muscle to contract independently from the other muscles used in the action of the primary muscle.
      4. Neuromuscular techniques - Various neuromuscular techniques including glides and gentle cross fiber movements to the biceps, pec minor, posterior deltoid, and the fascial line between the triceps in supine were applied. Seated active movements of the head and neck in rotation to the left upper and mid trapezius and thoracic erector spinae, prone to the left latissimus dorsi, around the scapula, rotator cuff, and levator scapula were also applied. Mobilization of the bilateral Cx joints to address the left-sided stiffness. Both sides were painful but became less painful after 3 applications on each side.
      5. Homecare - This included activating the neurolymphatic points of the diaphragm, 10 diaphragmatic breathing, and breathing full breaths often through the day.
      Mrs. W had plenty of resentment issues over the fall and the lack of support with those around her during the incident. So, we also discussed ways for her to do self-anger management and let anger become less of an impediment to her treatment progress.

      2ND TREATMENT

      Mrs. W did her homework using the breathing exercises to manage her stress and chest restrictions. She also wrote her resentment issues down on butcher paper and stated that she was “feeling like moving forward a bit more”. Her shoulder’s range had improved but still with pain and some mild swelling for a few days post-treatment. She attempted to do toe push-ups (did 3 this morning) which she had been unable to do.

      Assessment

      There were still some weaknesses with thoracic and humeral extensors and latissimus dorsi. Also, there was still weakness in recruiting the neck muscles to assist in the strength testing with a note to actively retracting the jaw in every movement. Strength testing also included weakness in neck flexion so the neurolymphatic point for the region was included. Assessment of supine rotations of the lower limbs to assess the balance of the soft tissues of the trunk lateral flexors, obliques, and deep lumbar rotatores, multifidi, and intertraversii muscles were done. Looking at the Anatomy trains and links to the functional backline, lateral line and spiral line with the connections from the shoulder and pelvis have led me to include lumbar muscle energy techniques to address rotations or torsions of the sacrum and/or ilia.

      Treatments

      1. Chapmans Reflexes - These were applied to the left latissimus dorsi, thoracic flexors/humeral extensors, and sternocleidomastoid/deep neck flexors. Re-assessment of strength was markedly improved with almost complete full range of shoulder abduction.
       
      1. Local cross-fiber friction and neuromuscular techniques - These were applied to the upper anterior humerus/anterior deltoid tendon, subclavius, 2nd/3rd ribs at the sternalis region - using forced inspiration and expiration; myofascial ringing of my hands across the lateral humerus/ interosseous membrane just inferior to the deltoids with active humeral rotation, compression/stripping into the thenar muscle. These techniques were chosen to include the fascial arm lines of the Anatomy Trains. Studies show that restrictions along these superficial and/or deep arm lines will alter the biomechanical efficiency of the shoulder complex and cervical ROM. Lumbar muscle energy technique and gluteal stretches were included in this treatment. [Shoulder Injury & Neurolymphatic Point Stimulation - A Case Study]
       
      1. Homecare – A 30-second stimulation of the neurolymphatic points of the latissimus dorsi, thoracic flexors/humeral extensors, deep neck flexors/SCM, and diaphragm were prescribed including 2 minutes of diaphragmatic breathing. I started Mrs. W on the functional stabilizing activity of wall springing push-ups x 20 daily. This reduces the load of the shoulder complex and still offers eccentric and concentric contractions to any of the muscles with attachments to the scapula, humerus, or ribs.
       

      3RD TREATMENT

      Mrs. W had been doing the Chapmans activations each day. She has full pain free range of the humerus in all ranges, has been doing wall springing push-ups and today performed 15 toes push-ups for her physician. He has commented that her post-non-surgical relocation recovery has accelerated far greater than usual progressions. He is very happy with her outcomes.

      Assessment

      The latissimus attachment pain is finally settled and latissimus strength is 100%. Shoulder ROM was considered to be full range in all planes, though a painful taut band was noted on the left teres major. We are now focusing on an ongoing episodic complaint of lower back pain which is 6-7/10 on the VAS scale and can flare up with long hours standing at work. Strength testing showed the weakness of the left lateral sling including lateral trunk flexors, gluteus medius/minimus; weak right gluteus maximus, right hip flexor iliopsoas, right superficial front and back fascial lines with weakness in strength testing of the quadriceps, gastrocnemius, and tibialis anterior.

      Treatments

      1. Neurolymphatic points stimulation  - This was applied to the weakened muscles tested listed above. Neurolymphatic points relevant to musculoskeletal dysfunction are found primarily on the anterior of the body, when there is chronic weakness/stress we also need to treat the associated posterior Chapmans Reflex points housed near the erector spinae of the relevant spinal nerves.
      2. Low load activation - I added low load muscle activation to the left rhomboid to increase the stability of the left rotator cuff of the scapula which affects the spiral line of the anatomy trains.
      3. Prone various neuromuscular techniques - These techniques were applied to the gluteus maximus, minimus, and medius, adding compressive mobilizing techniques to the sacral ILA, sacrotuberous and iliolumbar ligaments, complimenting with myofascial release/passive internal rotations of the deep hip rotators, also applied XFF to the tendon of the right quadriceps in supine with Mrs. W adding active femoral rotations.
      4. Homecare – Mrs. W continued to apply her 30 seconds of vigorous but not hard rubbing to the neurolymphatic points associated with the latissimus dorsi, thoracic flexors/humeral extensors, deep neck flexors/SCM, diaphragm and continue her diaphragmatic breathing each morning and if she felt she was going into a stress state. She will also include the low load muscle activation of the rhomboid muscle to address any dysfunction of the spiral line of the anatomy train.
       

      4TH TREATMENT

      Mrs. W booked in 2 weeks later – she had increased her University assignment load and she works full time as a registered nurse which added more stress to the shoulder and back. One episode of neuralgia from the right side of the neck resulted in a silent migraine occurred with excessive hours in front of the computer. Her shoulders were still maintaining full range of motion but last week, a feeling like a band or pressure developed across the posterior deltoid and over the shoulder which is still present today. No complaints of lower back pain since the last treatment.

      Assessment

      Full strength when testing the shoulder muscles which was encouraging. There was also a full range of movement though a feeling of the band over the deltoid still present. The taut band and pain commonly referred to as a "Trigger Point" was no longer present on palpation of the teres major. Lumbar rotations in supine were equal and full range. Sacral hypertonicity and painful areas were no longer a concern.

      Treatments

      1. Local neuromuscular treatment - This was applied to the left shoulder commencing with positional release techniques to the external rotators of the humerus, glides to the pectoralis minor and major.
      2. Prone neuromuscular techniques - These techniques were also applied to the full-back, latissimus dorsi, lumbosacral and thoracolumbar fascia, shoulder rotator cuff, upper trapezius, and levator scapulae.
      3. Homecare - Activation of the Chapmans Reflexes three times a week and increase to daily if the range reduced in any of the humeral movements were advised. She would continue with the low load muscle activation of the rhomboid before stronger shoulder exercises. She would have to find strategies to add small breaks into the assignment writing tasks so that long hours working at the computer are broken up.

      LAST TREATMENT

      Two weeks further to follow up and all ranges are full, pain-free, and feel easy throughout the entire range. I added a bike exercise to help with stress management. She would continue with the low load muscle activation and Chapmans Reflexes point stimulation.

      Treatments

      1. Therapeutic management - She asked to have a more relaxed treatment so I removed any neurolymphatic point stimulation or exercises to the treatment protocol and gave a general treatment including glides, effleurage, petrissage, myofascial release techniques, positional release techniques, some active and passive stretches.
      2. Homecare - She would continue with the physiotherapist's exercise routine adding the low load and neurolymphatic point stimulation before these rehabilitation activities.
      I followed up 6 and 12 months later and Mrs. W had no further need to intervene on her shoulder.  
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