Massage therapy can help with the muscle strain that happens during delivery, as well as work on compensations patterns that happen in posture. The focus of treatment is on back, neck, hips and hamstrings. Abdominal massage can be started anywhere from 2-4 weeks after vaginal birth and 4-6 weeks after a caesarean birth. If the birth was caesarean working on a scar can begin as soon as the wound is closed. At first gentle techniques are used such as lymphatic drainage to soften the tissue. As the scar matures myofascial techniques are used to decrease the constrictions. Then frictions are used to decrease scar tissue and adhesions. Vitamin E or castor oil can be used on scar to soften it.
After giving birth the core is weakened. Core muscles include: diaphragm, multifidus, pelvic floor and transversus adbominis. Referral to pelvic floor physiotherapist is made for assessment and strengthening of the pelvic floor muscles. Most common types of dysfunction of pelvic floor are: urinary/fecal incontinence, pelvic girdle pain, pelvic organ prolapse, Diastasis Rectus Abdominis and painful intercourse. Pelvic floor dysfunction can cause low back and pelvic girdle pain.
If you have pelvic floor dysfunction massage can focus on compensating areas. The treatment would include working on low back, hip, inner thigh, hip flexors and abdominal muscles.
Contraindications to massage therapy following giving birth are fever, infection, unstable blood pressure and increased risk of blood clotting.
What is it?
It is a compression of the sciatic nerve by the piriformis muscle, caused by any shortening or contraction of the muscle. Sciatic nerve is responsible for motor and sensory function to the muscles and skin of the back of thigh, most leg and foot. Piriformis muscle is located in the gluteal region, inserts to front of sacrum and attaches to greater trochanter of femur. It rotates the femur externally with hip extension, restrains quick internal rotation of hip, and abducts the femur with hip flexion. Sacroiliac joint can be displaced due to increased tension in piriformis, which then forms trigger points in the muscle. These trigger points refer to buttocks and hip travelling down to posterior thigh. Piriformis trigger points cause muscle shortening and compression of sciatic nerve. Pain from the sciatic nerve compression goes down the posterior thigh to the calf and sole of the foot. There can also be numbness in the foot.
How can Massage Therapy help?
Massage will address the low back, gluteal muscles and leg muscles. First the muscles are warmed up with lighter massage techniques. Then the fascial restrictions can be treated. After that Trigger Point Therapy is used to release the tension from the piriformis muscle. Stretching is incorporated as well. Treatment frequency is twice per week for few weeks following by once a week for four to six weeks. Patient recovery is usually very good. Homecare is an important factor in the recovery. The therapist will advise on stretches and exercises.
Carpal tunnel is a result of a median nerve compression at the wrist. The tunnel is formed by the bones of the wrist and a ligament. The median nerve along with some of the flexors’ tendons pass through it. The compression happens as the tunnel decreases in size or the structures that pass through the tunnel increase in size. Increase in size of structures happens with repetitive actions of wrist that cause swelling which then leads to fibroses and thickening of tendons. Scar tissue formed in the ligament or any condition that leads to swelling and water retention can also cause the increase of pressure.
It is the most common nerve compression in the arm. It causes numbness and tingling in the first three and one-half fingers. As the condition progresses muscle weakness occurs as well. There is tension in the forearm muscles and adhesions can develop in the tendons of forearm muscles that pass through the tunnel. Carpal Tunnel is most prevalent in jobs with repetitive flexion and extension of wrist. Many times, only the dominant hand will be affected, but it can affect both hands as well.
Usually a splint is worn for several weeks especially at night to keep the wrist in neutral position. Massage therapy can address the swelling, fascial restrictions, tension in the muscles and trigger points. Massage works best for carpal tunnel that is caused by overuse and repetitive strain activity. At first treatments are more frequent. For best outcomes massage is performed two times a week for few weeks followed by once a week for four weeks.
It is a condition, in which there is inflammation of a tendon. It is an overuse injury, caused by chronic overload of a tendon. Muscle imbalance, decreased flexibility, poor biomechanics, improper techniques and training errors, as well as chronic degenerative changes are contributing factors for tendonitis.
At the beginning of this condition pain is felt after activity only, following by pain at beginning and after activity, progressing to pain at beginning, during and after activity ending with pain with activities of daily living.
Tendonitis starts with microscoping tearing of tendon due to overloading, which results in inflammation. Whereas tendinosis is caused by degenerative changes with chronic overuse tendon injuries. For example, “golfers elbow”. There is no sign of inflammation in the tendon, but there is changes in collagen of tendon. As it progresses it may cause partial or complete tendon rupture. In chronic stage, there is chronic inflammation, adhesions and fibrosis present. Tendon can thicken and there is decreased range of motion and decreased strength.
Tendons most affected are: supraspinatus tendon, infraspinatus tendon, subscapularis tendon, Biceps tendon, common extensor tendon, common flexor tendon, abductor pollicis longus and extensor pollicis brevis tendon, patellar tendon and achilles tendon.
At first the inflammation is controlled through ice, rest and non-steroidal anti-inflammatory drugs. Following by stretching, strengthening and slow return to activity.
In acute stage, techniques to decrease swelling are used. Also, trigger point therapy is used on muscles, that refer pain to the affected area. The muscles that opposes action of affected muscles are treated to decrease tension. Tension in affected muscles is treated through Golgi tendon organ release technique on the unaffected tendon. Compensatory muscles are also treated for tension and trigger points.
In chronic stage the treatment can be more aggressive. Fascial techniques are used to decrease fascial restrictions. Trigger point therapy and techniques that decrease tension are used in affected and opposing muscles. Frictions technique is used on affected tendon to decrease adhesion in a tendon. M2T blade can be used as well to decrease the adhesion. Treatment is followed by applying ice.
Treatment frequency is three times per week for two to three weeks, then twice a week for one week and once a week at the end. Treatment length depends on the amount of time tendonitis has been present. If the treatment is started on onset of symptoms, it can take four weeks to resolve. However, if tendinitis has been left without treatment for long time it can take up to six months.
Both compartment syndrome and periostitis can occur on the front or back of the lower leg, causing pain and tightness. Symptoms increase with exercise and decrease with rest. But, while they can both occur in the same locations and have similar symptoms, they aren't quite the same.
Compartment syndrome is caused by an increase in the pressure within compartments of the lower leg. This can affect blood flow to muscles, causing pain. Because compartment syndrome commonly occurs on the front of the lower leg, it is often confused with periostitis. Periostitis is inflammation of the periosteum, a thin membrane that covers most bones. Periostitis is more common on the back of the lower leg, but can also occur on the front of your tibia, or shin bone, where it is referred to as shin splints.
Shin splints can be caused by overuse, such as overtraining, or a number of other factors, such as improper footwear, improper technique, and running on uneven or hard surfaces. Some other predisposing factors are tight calf muscles, excessive pronation (where your foot rolls inward), and excessive lateral rotation of your hip.
If you suffer from shin splints or compartment syndrome, massage therapy treatment can help bring balance to the affected and compensating muscles. Therapy treats the lower back, hip, and upper legs to address the compensating muscles. Affected muscles are treated with fascial work, Swedish techniques, and stretches to decrease muscle and fascia tension.