Archive for September, 2008

Repetitive Stress Injuries and Massage

Repetitive motion of the hands, arms, and shoulders can lead over time to numbness, tingling, pain, and weakness in the arms and hands. These injuries are known by a collection of terms: Repetitive Stress Injury (RSI), Collective Trauma Syndromes, and by the most common term: Carpal Tunnel Syndrome.

While Carpal Tunnel Syndrome is a specific diagnosis, the term is sometimes inaccurately used to describe any RSI that affects the hands.

What is Carpal Tunnel Syndrome?

CTS is a condition where the median nerve is compressed in the wrist at the carpal tunnel. The Carpal Tunnel is the space between the flexor retinaculum, a halter of connective tissues that protects and stabilizes the tendons of the forearms flexors and blood vessels and nerves, and the small bones of the wrist, which are collectively called the carpal (scaphoid, lunate, triquetral, pisiform, trapesium, trapezoid, capitate, hamate) bones. The Carpal Tunnel is small, and when the tissues that pass through it become inflamed, that inflammation can impinge the median nerve.

Area of hand innervated by median nerve.

Area of hand innervated by median nerve.

As seen in the photograph, the median nerve powers the lateral half of the hand. Numbness, pain, and muscle weakness can sometimes be ascribed to impingement of the median nerve in the wrist.

When the median nerve is impinged in the carpal tunnel, symptoms  can make it very difficult to have good hand function.

Other RSI Injuries

The hand can have symptoms in the other parts of the hand not innervated by the median nerve.  For instance the medial half of the hand - that is the other half of the fourth finger, the fifth finger, and the palm not powered by the median nerve - are innervated by the ulnar nerve, and the muscles that move those two fingers and help bring the pinky finger against the thumb in opposition can exhibit similar symptoms to carpal tunnel syndrome.  The difference, though, is that the ulnar nerve does not pass through the carpal tunnel, and treatment of carpal tunnel syndrome will not have an effect.  The ulnar nerve can be impinged in the wrist in the ulnar canal, or further up in the elbow at the cubital fossa.

The radial nerve innervates the forearm extensors, as well as the nerve endings in the dorsal (back) of the hand.  The radial nerve also innervates the triceps in the upper arm, so impingement in the shoulder and neck can have an effect on the functioning of the upper arm and elbow as well.

The Brachial Plexus

The brachial plexus is the bundle of nerves that emerges from the sides of the vertebra in the neck upper chest between the vertebra named C4, C5, C6, C7 in the neck, and T1 in the chest.  The nerves pass through the anterior and medial scalene muscles in the neck before passing down between the first rib and the clavicle, and from there down into the arm  The scalene muscles are often tight from holding the head forward and still for long periods of time of sitting at a computer.   This tightness can cause the first rib to pull up against the clavicle, which can impinge the brachial plexus and subclavian artery.  When these nerves and arteries are impinged, they can cause some of the pain symptoms farther down the line of the nerves.  So it’s a good idea to get the entire nerve pathway checked out when there are pain and numbness in the arm.

How can massage help?

Massage can help by creating relaxation in the muscles along the route of the nerves of the arm.  In a study by the Touch Research Institute at the University of Miami School of Medicine, researchers found that massage was able to bring a significant reduction in pain and other symptoms of carpal tunnel syndrome.  Skilled massage can bring about relief from the numbness, pain, and tingling associated with carpal tunnel syndrome and other repetitive stress injuries.

A trained massage therapist can test of various nerve entrapment locations and craft the necessary treatment plan to release the muscle tension, and free the nerve.

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Eggplant and Tomato Gratin

With the end of summer upon us, eggplant and tomatoes are looking really delicious in the markets, and maybe in your garden, too.  Check out this recipe from the New York Times Health section for a delicious, low-fat way to prepare an eggplant parmesan.  Both eggplant and tomato are full of antioxidants and other vitamins and minerals, and they are delicious, to boot!

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First Client on the 800

Wow. Just wow. Beside going back to school for more training in 2006, this is absolutely the best investment I’ve made in my business.

Being able to adjust the table height in the fly was utterly incredible; it let me put the client at the perfect height for whatever I was doing to him at that particular moment. I got to use my legs for more power and less for my positioning in relation to a stationary client. My body was much more comfortable as a result and I used less energy to accomplish the same work. So that’s a big win right there.

But it was the mid-split that really made the session outstanding. The front of the table opens up to forty degrees from flat. At around 9 or so degrees, the lower back is put in a mechanically neutral position, and decompresses the lumbar spine. So I started out there for the first part of the session, then increased the angle more and more. I strapped his legs to the table and went all the way open, which took him into a nearly fully inverted position. I could see his back pull apart, and did some deep work that way. Wow, it was incredible to open his back up like that.

All the while he was inverted, his arms were fully supported on the adjustable arm rests, and his head cradled in the sliding head rest, so his neck vertebrae never got compressed at all.

My mind is racing with the possibilities of how to use this incredible tool.

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