Category Archives: therapy info

Treatment Reactions

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.

Thoracic Outlet Syndrome

Your thoracic outlet is located at the junction of your shoulder and torso, it is the internal opening where the nerves and blood vessels enter your arm from your body. Thoracic Outlet Syndrome (TOS) is a condition where the thoracic outlet becomes constricted which creates pressure on the nerves and blood vessels that pass through it. This pressure creates localised pain in your neck, shoulder and upper back accompanied by pain, numbness, weakness and tingling in your arm and hand.

When TOS occurs 95% of the time it is the result of pressure on the nerves in the thoracic outlet rather than on the veins and arteries. The most common causes of TOS are trauma to the shoulder and neck, from poor postural habits and from sport and other activities that  strain the neck.

In the case of trauma a broken collar bone might bend downwards at the fracture line creating pressure on the thoracic outlet. A whip-lashed neck, particularly from a side on impact can create inflammation and swelling that likewise pressurises the nerves, veins and arteries in your shoulder.

When TOS is caused by poor posture and repetitive strain the scalenes (muscles at the side of your neck)  stiffen to the point where they start to occlude the thoracic outlet  thus creating symptoms in your arm and hand.

Less commonly a minor deformity of the vertebrae (bone) in your neck might create TOS taking the form of a false short rib.

The symptoms and causes of TOS are similar in many ways to that of carpel tunnel syndrome (CTS), with the important distinction that CTS can be exclusively a problem of repetitive strain to the muscles of the forearm.  CTS also affects the whole hand whereas TOS affects only the little finger side of your hand.

Sport and other physical activity that requires repetitive raising of your arms above your head can cause TOS, these activities include weight lifting, swimming, volleyball and working above your head as often experienced by plumbers and electricians. Avoidance of these activities lessen the likelihood of getting TOS.

Sitting for long periods infront of your computer screen can give you TOS, always remember that your body is made to move, that is why we have muscles and joints. Doing regular neck stretching exercises can go a long way to protect you from getting TOS.

TOS is described as being positional or static. If your symptoms only occur when you arm is held in a particular position your TOS is positional. If your TOS is constant it is static.

The most effective therapies for treating TOS include osteopathy, chiropractic, physiotherapy, acupuncture, massage and stretching. Avoiding activities that have caused the symptoms are obviously helpful too but if you cannot do this because it is part of your job you are best advised to get regular preventive treatment and exercise.

If your TOS is the result of a deformed vertebrae or depressed fracture of the collar bone you may require surgery.

Rheumatoid Arthritis

Rheumatoid Arthritis (RA) afflicts approximately 1 in every 100 people, it is 3 times more prevalent in women than it is in men and usually has an onset of symptoms between 40 and 50 years of age though sufferers as young as 15 have been recorded. RA is usually diagnosable through blood tests and like other forms of arthritic disease will not manifest exactly the same in all people who have it.

RA mainly affects the small joints in the body, in our hands, feet and neck but can  affect the larger joints too. RA causes painful swelling in the lining  (synovium) of the joints, often (but not always) producing painful nodules under the skin that can vary in size from a few millimeters to a few centimetres over the bony protruberances of the joints.

RA is an auto immune disease with no definate and definable cause but medical science has establiushed that sufferers tend to have relatives who also suffer from RA. RA is three times more common in smokers, it may be triggered by an immune response to another illness and recent studies suggest that vitamin D deficiency may cause people to be more susceptible to it.

Physical activity is greatly curtailed by a flare up of symptoms which tend to be more intense first thing in the morning for an hour or more. Many sufferers find hot weather particularly distressing and find cooler climates more agreeable. RA increases the risk of cardio vascular disease, anaemia and lung fibrosis.

Part of the difficulty of treating RA is that the drugs used to controll it’s symptoms often have undesirable and confusing side effects. Prednisone for instance can lessen the severity of RA symptoms but prolonged use can cause osteoporosis which can in itself be a consequence of lowered physical activity because exercise is difficult and painful.

In recent times fish oil and krill oil containing omega 3 fatty acids have been found effective in lessening RA symptoms. I have met several people over the years who have claimed that alkaline diets have been helpful in treating their own RA, a therapy that most medical authorities do not recommend whether because they do not think it works or that most people do not have the necessary discipline to strictly follow it.

Gentle massage and joint mobilisation can be helpful in treating the symptoms of RA but. An increasing number of RA sufferers find medical marajuana helpful in making their lives more comfortable which is clearly not a legal option in most countries, for a health practitioner to even suggest it’s use in such places may be a crime in itself.

Meditation can help RA sufferers cope with their disease, it costs nothing and will not make the symptoms worse if it doesn’t work for you.

In more severe cases joint replacement surgery is used when disablement and pain becomes intolerable.


Yoga has been around for a long time and there are many different styles, Ashtanga yoga for instance is quite strenuous and alot of it is done standing up whereas Sachananda yoga is more meditative and passive. Within each yoga style individual teachers will go about teaching their classes differently to one another so rather than being fixated on a particular style it is generally more useful to find a teacher who you feel comfortable with. Someone perhaps close to your own age and who is familiar with the type of health and fitness issues that you are subject to.

Where ever you learn yoga it is important that the teacher gives you useful one on one advice and feedback, if you are a nervous beginner all forgotten about at the back of a packed ashram, you will not progress as fast as you will in a smaller beginner-friendly class. It is even better still if you get one-on-one tuition in your own home, it will be more expensive but you will learn much faster. Home tuition is particularly useful if you cannot make it to class or are shy about learning infront of a class full of strangers, it is also good if you have the necessary discipline and motivation to do it by yourself.

If you need to learn yoga as a part of a large group to keep motivated and perhaps to make new friends,  home tuition may be less attractive but whether you go solo or not, practising between lessons will get you the results you are looking for much faster. If you have had a yoga teacher highly recommended to you by someone whose judgement you trust it is a good starting point to find the right teacher. If such guidance is not available to you google where ever is closest and ask about attending casually until you are ready to make a longer term commitment.

The best stretching exercises in the world will not work if your body is too stiff to do them, getting a course of massages, acupuncture, osteopathy or chiropractic will give you a good head start to a more flexible, energised and calmer mind and body.

If you at first do not find a teacher you are comfortable with try another one, there may be a Pilates teacher with a strong background in yoga who may be worth trying. Not all yoga postures (asanas) are suitable for all people, if you have had neck problems for instance or you have a large body headstands might not be a good idea, if you have doubts about doing particular exercises discuss it with the teacher, there are usually several different ways to achieve better flexability using yoga.

Please be patient for results, years of neglect cannot be fixed in a few months. Once you start to get into the right stretching positions and learn to relax into them you will really start feeling the benefits. Compare how a stiff old body moves to a supple young body, it is flexibility that produced fluid motion.

I was once told by an older more experienced nurse that she found that people who had stiff bodies often lacked mental flexibility too…..refusing to do stretching exercise is a good example 🙂


If you have ever been to the beach and saw somebody walking around with a pattern of large round bruises on their back they have probably been treated by an acupuncturist with cupping.

Cupping is a procedure that uses suction cups to help draw the extra fluid that is present in sore and stiff muscles closer to the surface. When this happens relief is experienced because pressure is removed from the nerves in the muscle tissue. Lactic acid contained in the fluid is likely to be drawn out of the muscle tissue through this suction action also.

Bruising does not always result from getting Cupped but if you are quite fair or anemic it is likely to show more and this can put people off getting it which is a shame because when used appropriately cupping brings relief of muscle pain and stiffness.

The use of cupping is common in Chinese Medicine but cupping has been used a long time in Eastern Europe too and in recent times has been discovered by many physio therapists.

Cupping is also commonly used in TCM (and Eastern Europe) to treat colds and flu, the cups are commonly placed on the upper back to do this. The rationale that is offered for this practise is that perverse energy enters the body through wind exposure which can give you a cold. By literally sucking out the pathogenic energy the symptoms are claimed to be reduced.

Whether you are employing the use of cupping to sooth over-exercised muscles or to alleviate the symptoms of a cold the results are often quite impressive, it usually does seem to work.

As already stated Cupping can leave bruises that might not go very well with your new backless ball gown but otherwise the appropriate skilled use of Cupping is quite side effect free, non-invasive and only mildly uncomfortable (if uncomfortable at all).

Bamboo or glass cups are briefly heated on the inside then quickly placed on the skin, as the air inside the cup cools a suction is formed, this is how Cupping is traditionally performed. In more recent times small pistol-grip styled hand pumps and plastic suction cups with valves have been designed to do Cupping, they both work quite well.

It is no doubt easier for many to visualize excess fluid being sucked out from stiff muscle than it is to think about invisible pathogenic energy being physically drawn from your upper back but there are many things in health science that we are yet to learn about. Whatever the case Cupping really does seem to help people feel better.

Cupping can be easily used with other types of therapy, after a Cupping is applied for instance it is easier to make an impression on stiff muscles with massage, stretching and manipulative techniques.