Massage can be very useful in relieving the pain and tenderness associated with iPhone elbow.  Longitudinal release and Cross-fiber friction will help to relax the forearm extensor muscles, and local compression will help to deactivate any trigger points.  Ice massage will greatly reduce inflammation, and client education in conducting self-care for between massage sessions.

The best way to avoid iPhone Elbow is to carry your device in your pocket, purse, or in a belt pouch when you are not actively using it.  Answer your phone, look up information, send a text, and then put it away.  If you must use it for a prolonged time, say in an extended text message conversation, then find a place to sit down and rest it on a tabletop or on your knees.  You’ll spare your hands and elbows pain, and you won’t be one of those distracted iPhone users who bumps into lampposts and other people.

Let your arms hang freely at your sides when you are not using the device, and do some wrist stretches throughout the day.  Here’s a useful stretch for you:

1. Take one hand in the other and gently flex the held hand’s wrist.  That is, bend the wrist in the direction of the palm of the hand.
2. Straighten that same arm’s elbow.
3. Slowly rotate the forearm so the elbow crease is pointing away from your body.
4. Hold for 30 – 60 seconds.

If you are doing this correctly, you should feel a stretch from wrists all the way up to the outside of the elbow – the lateral side of the arm.  Gradually, you will be able to increase the amount of wrist flexion, and even add flexing the fingers at the closest knuckle to the palm.  Do this stretch three or more times a day, and you will notice a big improvement in the reduction of tightness and pain in the elbow.  Self-care is a great way to help relieve your pain.

Stretching will help, but the services of a professional massage therapist can usually completely relieve the pain associated with lateral epicondylitis, usually in one to four one-hour sessions.  This, of course, depends on the severity of the case, but in mild to moderate cases, a single session usually brings tremendous relief.

Book a massage now and be free of your iPhone Elbow!

GGH Route Map on Google

WHEN: 31 January 2010, from 11am to 3pm
WHERE: Kirkham Street and 15th Avenue, at the base of the stairway.

Yes, 2010 is seeing a continuation of our fun and successful Stairway Walk Tours – this time we’ll be going to the neighborhood of Golden Gate Heights, full of curving streets, and interesting vistas of the Pacific Ocean, Golden Gate, and San Francisco itself.  Also, the delightful Grand View Steps, a once-boring set of concrete steps that neighborhood artists and activists transformed with a truly stunning tile mosaic on the risers.  Photographs cannot adequately describe the beauty of the mosaic – you simply must see it yourself!

An event invitation exists over on Facebook, but if you do not have a Facebook account, you can RSVP by commenting to this blog entry.

Link to Google Map

It’s time to leave Old San Francisco and venture west into the neighborhood known as Forest Hill.  Forest Hill contains the largest collection of houses designed by the influential Arts and Crafts architect, Bernard Maybeck, who designed the Palace of Fine Arts, among other famous structures in the Bay Area.  He was a tremendous influes on other architects, including Julia Morgan and others.

This 1.89 mile route takes us through the swooping curves and grand stairways of Forest Hill, including, according the Adah Bakalinsky, the most elegant of all stairways in San Francisco, the grand Pacheco Stairs.

WHAT: Forest Hill Stairway Walk

WHEN: 25 October from 11am to 3pm

WHERE: northeast corner of Pacheco and Merced, facing the Pacheco Triangle (see map)

WHY: to see some incredible homes, vistas, and stairways, and to learn more about the history and neighborhoods of San Francisco.

HOW TO ARRIVE: Muni to Forest Hill Station, or other public transit options are available.

I should note before we start that none of this is intended to be a diagnosis of plantar fascitis, and if you are experiencing heel pain, you should have your physician examine you to determine what’s going on.

What is the Plantar Fascia?

The plantar fascia (also called the plantar aponeurosis) is a thick band of connective tissue on the plantar surface (underside) of the foot.  It originates on the medial tubercle of the calcaneus bone (a particular landmark on the underside of the heel bone), and continues beneath the other bones of the foot out towards base of the toes.  The plantar fascia is made up of collagen fibers that run mostly along the length of the foot, although some move in other directions as well.  The job of the plantar fascia is to support the bones of the arch of the feet by acting as a tie-rod.  From a mechanical perspective, the plantar fascia supports up to 14% of the load the foot has to bear as we move.  So as you can see, it is one of the most important structures in our feet!

What goes wrong?

There are several reasons why plantar fascitis occurs, but a major cause is overpronation of the foot.  The foot pronates, that is, it rolls toward the center line of our body, as a normal function of our stride.  In overpronation, the foot rolls excessively inward.  You can see if you overpronate by looking at your shoes.  If the outer sole of the shoe tends to wear out near the inside of the ball of the foot, you’re probably a pronator.  If the outer edge of the sole of the shoe, you’re likely a supinator.

There is also an indirect relationship between the calcaneal (achilles) tendon and the plantar fascia, especially in adolescents and younger adults.  There are fibers of collagen that connect these two structures together, but as we age, those fibers disappear.  Nevertheless, tight calf muscles and calcaneal tendons can be a contributing factor to plantar fascitis, by providing excessive plantarflexion of the ankle and increasing tension on the plantar fascia.

Another factor in the severity of plantar fascitis is obesity.  The heavier we are, the more weight the feet have to bear, and this can cause considerably more strain on the foot and fascia than our bodies can handle.

A final factor is in wearing shoes too long after they have worn out.  Shoes that are ill-fitting or old and no longer providing the proper support for your stride type (pronator/supinator) can contribute to the symptoms of plantar fascitis.

Where does it hurt?

The classic symptom of plantar fascitis is significant heel pain upon first rising from bed – those first few steps to the bathroom in the morning.  Typically the pain decreases as the foot warms up from walking around, but often there is a low-level of pain throughout the day.  The pain tends to be most severe right at the heel bone where the fascia attaches to it, and then radiates toward the toes.

Plantar fascitis is self-limiting, meaning that it will generally go away on its own, usually in six to 18 months.

What treatment options are availble?

Physicians will generally prescribe NSAIDS (aspirin, acetomenophen, ibuprofen, etc) to alleviate the inflammation and decrease pain.  As well, they will direct the patient to stretch the calves, possibly do ice massage, and shoe inserts are sometimes also indicated.  All of these things are very useful in reducing the symptoms.

In more severe cases, night splints, casts, or even surgery are options for treatment.

However, I have found that self-care and detailed, thorough bodywork can do wonders in treating plantar fascitis.

Stretching

Two stretches are very important in reducing the pain of plantar fascitis.   The first is one you should do when you first wake up in the morning, and that is dorsiflex your ankles.  Dorsiflexion is the action performed by your shin muscles (tibialis anterior) – bring the dorsal (top) surface of your foot toward your knee.  This will stretch the achilles tendon and calf muscles (soleus and gastrocnemius muscles) and take some tension off of the plantar fascia, and it will help mitigate the pain of the first morning steps.  To do this stretch:

1. Inhale.
2. As you slowly exhale, dorsiflex your ankle by contracting the tibialis anterior.
3. Repeat several times, until you feel the calf muscles relaxing and stretching.

The other strech is another calf stretch, but this one done from a standing position:

1. Face a wall and place one foot approximately 6-8 inches from the wall, toes pointing toward the wall.
2. Place the other foot approximate two-three feet from the wall, toes pointing toward the wall.
3. Inhale.
4. As you slowly exhale, shift your weight from the back leg to the front leg.  Keep your heels planted on the ground.
5. Breathe normally, and hold this stretch for two to three minutes.  You will feel the calf muscles open up, and the tension on the calcaneal tendon relax.
6. Switch feet and repeat steps 1 – 5.
7. Repeat this stretch with the back knee bent for one round, and straightened for another round.  That way, you will target both the gastrocnemius (knee straightened) and the soleus (knee bent), and more thoroughly stretch the calves.

Ice Massage

Fill several 3 or 5 ounce paper cups with water and freeze them.  When frozen, remove a cup from the freezer and peel back an inch or so of the cup, exposing the ice.  Using the remaining cup as a handle, massage the heel and underside of the foot with the ice, in circular motions and with medium pressure, for 10 to 15 minutes.  You will have to continue to peel the paper cup back from the ice as it melts, and you’ll want a hand towel to blot the water as it melts, but this is a highly effective treatment for plantar fascitis.

You can combine ice massage and the second stretch I mentioned above:

1. Ice massage the plantar surface of the foot as directed.
2. Perform the second stretch listed above.
3. Repeat with other foot.

Another way of using ice is to soak the feet in a basin of water and ice cubes in the evening when you get home from work.  Soak the feet for 10 to 15 minutes in this icy bath and after ward, dry them off and do that stretch.

How can massage therapy help?

Highly targeted, therapeutic massage can help by relaxing and lengthening the muscles of the calves, the calcaneal tendon, as well as directly working on the plantar fascia and muscles of the underside of the foot.  This work can be very deep, but highly beneficial because through it, we can help to re-educate your legs and feet to retain their relaxed states.  Many clients see dramatic improvement in three to four weekly one-hour sessions, as the feet and legs receive detailed attention.  Pain can be reduced and eliminated with a combination of self-care and massage.

If you are experiencing the pain of plantar fascitis, massage and self-care can be a huge help!  Why not book a session with me today and get the ball rolling to a pain-free stride?

References:

1. Plantar Fascitis and Other Causes of Heel Pain: 1999 Barrett, O’Malley
2. Plantar Fascitis: Office Management: 2007 Patel, Holman
3. Treatment of Plantar Fascitis:  2001 Young, Rutherford, Niedfeldt

With that in mind, here are five stretches that you can do in just a few minutes a day to decrease the tension that you hold in your shoulders.

First, take the arm across the chest and with the free arm, grab the upper arm or shoulder.  Inhale, and as your exhale, pull the arm across the chest, which stretches the shoulder, especially the rhomboids, between the shoulder blades.  Repeat this movement: inhaling and exhaling and pulling three to five times on each side several times a day, and you’ll notice that your shoulders feel more open and flexible.

Often, one side or the other is easier to get the hands together than the other.  This is perfectly normal, and just means that you need to work the less flexible side more often, but it is possible to achieve increased flexibility and range of motion.

A third stretch of the shoulders involves bringing both arms behind the back and clasping hands, as if one were handcuffed, shown in the next photo.  Inhale, and as you exhale, lift the arms toward the sky.  This stretches the subscapularis and the pectoralis minor in your upper chest.  And additional benefit is if you slowly roll your self forward while you do this to make your hands point to the sky, you can deepen and intensify the stretch.  Sometimes when you do this, you will feel a “pop” in your upper back/lower neck.  This is your cervical/thoracic junction (the vertebra that make up the last neck and first chest vertebra), re-aligning themselves.

Stretch number four is similar to the second stretch, except use your free arm to grab your elbow and inhale.  As you exhale, pull with your free arm, gently stretching the arm behind your head.  This stretches the teres minor, tricep brachii, and latissimus dorsi muscles.

And finally, stretch number five, inhale, and as you exhale, bring your shoulder up to your ears. Then the reverse, inhale, and as you exhale, push your shoulders down and try to grab the floor.

These stretches will help increase your shoulder flexibility and sense of relaxation.  Do them two or three times a day, and after a few days to a week, you’ll really notice the difference in the comfort of your shoulders.

Every household should budget massage therapy into their financial plan.  If you think you can’t afford massage therapy right now, consider this information from massagetherapy.com:

Massage is a vital part of self-care that has a positive ripple effect on us as we work, play, and care for others.  Massage can boost immunity, helping fend off illness–meaning fewer medical bills and days off work. Better sleep, reduced anxiety, and a sense of emotional balance are just a few additional benefits of bodywork during tough times.

If you think about it, massage is an excellent value. The price of massage has remained stable in recent years, as the cost of movies, meals out, and sports events has risen. Which of these has the power to improve your health and your outlook on life?

Following are health reasons all American adults should be including massage in their family budgets and schedules.  Massage:

• Reduces anxiety
• Reduces the flow of stress hormones
• Improves sleep
• Boosts the immune system
• Improves energy levels and reduces fatigue
• Improves concentration
• Increases circulation
• Improves self-esteem
• Reduces frequency of headaches
• Releases endorphins

The positive effects of regular massage can have benefits in many areas of your life.

Home

Massage therapy will also help families under stress create healthier households with clear-thinking and more relaxed moms and dads.  Children are very sensitive and often pick up on tension in a household, parents who are taking care of themselves are more likely to be better caregivers and provide a sense of security to their kids.  This goes for caregivers of aging parents and other family members.

Work

The health benefits of massage can help forestall illnesses and lost work time, especially when you may be asked to produce more with fewer resources.  Decision-making skills will be better and your performance is likely to be improved with a clear focus and more energy.  A hint for the boss:  Research shows employees exhibit less stress and improved performance when given twice-weekly, 15-minute massages in the office!

Health Conditions

Those with already existing health conditions can continue to reap benefits in the following ways.  And proactively caring for health through massage may help reduce costly doctor visits and use of prescription and over-the-counter medications.

So the real question isn’t can you afford a to get a massage, but rather can you afford not to?  Book a massage today!

1. Stretch. If you are getting massage for pain and discomfort, stretching is essential for you. Frequency is more important than length of a stretching session.
   • Try setting up a reminder sound like a chime on your computer to remind you to stretch for 2 minutes every hour, or 5 minutes every two hours.
   • Follow this simple routine. Exhale as you stretch whatever feels tight or uncomfortable to a feel-good position, and inhale as you return to a starting position. Ask your massage therapist for specific areas.
2. Exercise regularly. Even very moderate exercise can help relieve pent-up muscle tension and improve your circulation, two benefits you may have also notices after massage. Walking, gardening, golfing and tai chi are all ways to get your heart pumping and your muscles moving, and can also help shift your attention from your worries to relaxation and the enjoyment of life.
3. Take time to relax. Change your schedule to include more down time, even if it’s only 15 minutes for deep breathing or a walk after work or at lunch. Get away from chores on the weekend for a morning or afternoon to enjoy some time in nature or a pot of tea with friends.

Take action – book a massage today – set a goal for yourself to receive regular bodywork; you’ll do yourself a world of good!

1. Support your forearms when you can, but do not rest them or your wrists on anything while typing.
2. Don’t pound on the keys; use a light touch.
3. Hold the mouse lightly as if you were cradling a small bird; don’t grip it hard.
4. When typing,  keep all your fingers and your thumb softly curved.  If you tend to keep your pinkie finger raised or stiff, begin trying to relax it to avoid injury.
5. Take mini-breaks every few minutes.  Stop, let your arms hang to your side, shake them out, and take several full breaths.
6. Stretch frequently. Hold your arms out in front of you, and bend your wrists one way and then another.  Ask your massage therapist for specific stretches and self-massage techniques for the forearms and wrists.

Massage Therapy is a wonderful way to help keep the forearms relaxed, and to help prevent injury, as well as reduce pain.

Book a Massage with me today!