Category Archives: head, neck and back

Ligament

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The function of ligament is to join bone to bone, without ligament our joints would have no stability. All joints (this includes the vertebrae in your spine) have ligament, the ligaments of the knee tend to be the most spoken about  because they are often traumatised in sport. Knee ligaments sprain and tear when the joint is put in positions under force that it is not naturally designed to move in- sideways and backwards.

Ligament is a tough fibrous tissue that is flat on the outside of the joint beneath the skin such as in the medial knee ligament or cord like when it is stabilizing the inside of the joint as with the anterior cruciate ligament. Whether the ligament is flat or cord-like they are painful when sprained or torn and the joint loses stability. A sudden tearing of ligaments can even produce an audible snapping noise.

Ligaments are slow to heal which is why surgery is performed. Ligaments are strained when joints dislocate too, as happens with the shoulder. After multiple dislocations ligaments weaken which undermines the general stability of the joint which makes re-dislocations more likely. Artificial ligament is used to reinforce shoulders that are prone to dislocation.

When people stretch too far ligaments can be damaged though muscle tearing is more likely to happen first. Ligaments and muscles may be both injured at the same time. Ligament and muscle tearing is unlikely to happen when you are doing regular age appropriate stretching exercises, when tension is gradually applied to any joint during a stretch you will feel it is about to reach an uncomfortable point before damage is caused. So long as your balance is controlled stretching will usually be safe.

If you are recovering from a ligament injury re-introducing the affected joint to stretching exercise must be gradual and preferably under professional supervision atleast to start with, especially after surgery. Specific stretching exercises post-operative tend to be different to the ones illustrated in Self Massage.

Ligament is present in the parts of the joint that are not meant to bend. Using the example of the knee joint you will find ligament on the inside and outside of the joint because knees due to their structure cannot and should not bend sideways. Ligaments are also located on the back of the knee because knees cannot and should not bend backwards.

You will commonly see footballers with strapped knees, the strapping helps compensate weakened and damaged knee ligaments. Due to the nature of competative sport even with strapping your knees will heal more slowly and re-injure more easily until healing occurs. Unfortunately many sporting careers prematurely end when ligaments become damaged beyond full repair.

Strapping of an injured ankle ligaments might get you through an important game at the end of the season but using strapping as an ongoing method of protecting an unstable ankle will only undermine the health of your knee joint long term.

Damaged ligaments in your leg can create lower back pain because of the lop sided effect on your stride, Self Massage of the lower back and hips can help keep the symptoms under control. 

 

Cartilage

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Cartilege occurs in many parts of the body, the cartilege in the septum of your nose (middle part) and your ears is called elastic cartilage because of it’s flexability. There is cartilage between your ribs and sternum, in your airways and your spine between the discs. The cartilage that lines the ends of your bones, articular cartilage is what today’s post is about.

Articular cartilage exists in 4 layers and it’s function is to cushion shock, distribute weight evenly and allow the smooth gliding motion of healthy joint action. Articular cartilage is found in the joints of your hands, wrists,  feet, ankles, knees, elbows and hips. It is white, rubbery and slippery when wet, the “grissle” in chicken and lamb legs is articular cartilage.

When cartilage is worn it can feel and even sound like sandy grits are moving in the joint, when wear becomes extreme as in the case of advanced osteo arthritis a painful grinding bone on bone sensation that sounds like the timber on an wooden ship can be quite audible. I once nursed an elderly female patient whose OA was so extreme I could feel her knees vibrate all the way to her wrists when I helped her stand up. OA is very painful when it gets to that point.

Excess body weight, poor nutrition and hydration, bad posture, lack of exercise, genetic factors and trauma all take a toll on articular cartilage. For as long as the surface of joint cartilage is intact the it will bend and straighten smoothly (provided the other tissues of the joint are working).

Kneeling down on hard surfaces pressurizes and can progressively damage the cartilage behind your knee cap. Bending any joint too far or in the wrong direction can damage cartilage too. Auto immune diseases such as  rheumatoid arthritis and polymyalgia rheumatica can make cartilage swell and make the joint weak and painful. Costochondria can result from a rib cartilage injury and make breathing painful. Shoulder dislocations can damage cartilage too.

Cartilage contains no blood, it’s nutrition occurs through cellular food and waste leeching back and forth through it’s outer membrane. This makes cartilage slow to heal, knee meniscus, shoulder rotator cuff and hip labrum are all terms describing cartilage of different locations.

Joint replacement (and partial replacement) is most often performed because of irreparable cartilage damage. Stem cell injection at the time of writing has produced some very promising results but does not work as well on everybody and steroids can reduce cartilage inflammation.

Sports clinics are kept very busy with cartilage injuries, particularly of the knee. Cartilage trauma is often accompanied by by ligament and tendon trauma too particular when the joint twists too far.

There was an American rheumatologist who got interested in the apparent benefits of consuming shark fin cartilage as a cure for arthritic pain. He ran a trial of 15 OA patients who had not responded that well to the drugs he gave them so he ground down ordinary chicken cartilage and put it in capsules that his trial patients took 3 times a day. He reported that after 6 weeks 13 of them had noted improved symptoms.

Not all things work as well for all people, but keeping your weight down and having good balance and posture will all help sustain healthy cartilage. Damaged leg cartilage may cause you to limp and this can create lower back pain, Self Massage to the back and hips can help keep you going.

Bells Palsy

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Bell’s Palsy is a spontaneous paralysis of one side of your face with no known cause with viral and autoimmune causes being suspected (see TCM explanation ). The eyebrow, eye and mouth on the affected side droops down and the eyelid wont close properly, sometimes people may dribble from the side of the mouth. Pain or numbness may be present too.

About 90% of sufferers get better within a year with  the remaining 10% being permanently affected. To diagnose Bell’s Palsy other possibilities must be ruled out like stroke (stroke usually affects the arm and leg on affected side too), injury or facial tumour.

The young are more affected than the old with males and females being evenly represented. The facial nerve is thickened where it exits the upper spinal cord and this thickening is suspected to cause the symptoms because the nerve is pinched and not conducting normally.

Corticosteroids are commonly prescribed for Bells Palsy which is claimed to usually work in the majority of cases. For those who the steroids do not work on acupuncture and massage can give relief too.

In Chinese medicine (TCM) Bells Palsy is known as Wind Stroke, as it’s name suggests cold breezes on your neck are seen as a likely cause of Bells Palsy, I have met several sufferers of Bells Palsy who claim that their neck was uncomfortably  exposed to cold breezes immediately before the onset of symptoms. medical doctors do not agree with this as a likely cause.

In TCM it is believed that as we age or we are run down, our Wei Chi, which is the most superficial layer of energy in the body weakens. This makes us more sensitive to wind exposure, in the TCM view covering your neck if you feel even slightly cold can prevent Bells Palsy. In the TCM view covering your neck with a scarf or high collar can not only prevent Bells Palsy but also stop it from worsening. In TCM stress is also suspected of playing a part particularly repressed anger.

If your Bells Palsy persists long term Self Massage of your neck can keep the symptoms under control and keeping wind and breezes off your neck is important too.

Periodic acupuncture can keep the symptoms of Bells Palsy under control and facial muscle exercises can help rehabilitate the affected facial muscles.

The most distressing symptoms of Bells Palsy is how it looks and eye dryness because the eye will not close properly. Many sufferers find taping their eyelid shut while they are asleep helps as does the application when needed of liquid tear eye drops.

Massage Tools

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Hands that are not accustomed to kneading tight muscles can tire long before the muscles they are working on soften, whether they are your own or someone else’s. This is why we use massage tools.

There are plenty of hand held massage tools that are commercially available, from cheap plastic moulded dolphins  to expensive vibrating electrical  massage tables.

Then their are improvised massage tools such as tennis balls that you can roll your body against on the floor or walls.

Massage tools are good way to protect finger and thumb joints from repetitive strain. If you have never received professional massage training it is easy to make the mistake of over using your thumbs in particular.

Thumbsavers are a moulded plastic massage aid that costs less than $20 and are available online. I mainly use my thumbsaver on my own neck but they are useful for Self Massaging your hands and feet too.

If you have some experience and training in therapuetic massage, you will  recognize a hand-held massage tool as an extension of your own body. If you have never learned to massage nor  have ever even received one start out using Self massage gently and as instructed.

Massage over only your muscles never over your windpipe, breast tissue, on top of a bone or firmly over internal organs in your abdomen. The correct pressure to apply has a relaxing effect on the muscle. If you cannot relax into the pressure  you are going too hard.

Nothing beats a pair of skilled strong hands but massaging yourself costs you nothing and is way better than going without. It is good to know how to make yourself feel better in a healthy way, knowledge is power.

Massage tools do not have the be hard objects pressed firmly into tight muscles. A soothing, soft caressing massage can be given and received with a dermal brush or even a fur glove to relax you.

Massage tools are more effective for massaging yourself than massaging others because you cant really be sure how much pressure you are applying when using it on someone else. Using a massage tool on your own body lets you know straight away if you need to go firmer or softer.

If you have any numbness in your body from disease or injury make sure you are not chafing your skin by rubbing too hard or too long.

 

Treatment Reactions

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When we go and have remedial treatment for a painful musculo-skeletal injury or condition there is sometimes discomfort in the following few days afterwards, this can happen whether it is from a massage, from spinal manipulation or assisted stretching. Generally this is more likely to happen if it is your first treatment or the first you have had for a long while and usually it is nothing to worry about.

One of the reasons that post treatment discomfort occurs is that you might have left getting treatment way longer than you should have which has caused greater resistance to the normal movement in your body, comparing this to a nut that has partially rusted on to a bolt is not entirely wide of the mark.

Another cause of post treatment pain is seeing a therapist who is completely new to you, it can take a little while for the new practitioner to work out what your tolerances are, it is not just a simple case of  big strong guys getting big and strong treatments and smaller lighter clients getting soft treatment. Over the years I have been surprised on many occasions by small petite women asking for and responding well to very firm massage. Likewise I have also treated some big men who have surprisingly low pain thresholds.

The nature of the physical problem ofcourse matters alot. A fresh injury for instance that has localised redness and swelling is often best treated indirectly and around the actual trauma site, atleast to start with anyway. A more familiar recurring sore lower back or neck problem that you experience a “good pain” from when pressed on the other hand, is usually treated directly from the outset.

It is important that you tell the practitioner if he or she is taking you too firmly, usually a practitioner can tell by the way your body reacts to being touched if they are going too hard or not but if they don’t it is no use waiting till the end of the treatment and then complain to the practitioner about it. Worse still saying nothing to the therapist and then telling everybody how rough they were afterwards is not fair on either you or the therapist. Don’t be shy, how you feel matters so tell us.

If you are concerned about how you feel afterwards you can always phone your therapist or send an email and ask them if what you are experiencing is normal or not. It is  not usually a good idea to go prodding and poking it yourself if you don’t think it feels right.

Finally it is a good idea to reflect on the event/s that occurred in between your visit to your practitioner and the pain you felt afterwards because if you decided to run around the block because you felt a bit better after having your lower back massaged it might be your fault, treatment cannot replace common sense. If you really want to know if and when it is safe to try a particular activity again just ask.