Understanding Muscle Knots

Just about anyone has experienced muscle tension at some point.  We often call this ‘muscle knots’  because they literally feel like knots in our muscles.  For some people muscle knots are occasional, for others, a daily condition that really takes away from the fun in life.

Muscles are a funny business because they are probably less well understood than other body parts like skin or our eyes and ears.   What is behind our muscle knots?  Well, muscle knots can be the result of trigger points or adhesions, different in cause but leaving us equally frustrated.  Triggger points are a type of spasm or contraction that radiates to other parts of the body whereas, adhesions are essentially a restriction to free muscle motion because the muscle, or the membrane surrounding the muscle, is literally stuck somewhere.

Treating muscle knots with massage is a common practice because it is highly effective. Stretching or yoga are also highly beneficial.   For those that are curious about what causes the knots in the first place, Nicole Mosier, in her article “Knots, Adhesions and Trigger Points” does a nice job discussing the anatomy of our so called muscle knots!

To schedule a massage for your knots at one of our clinics, please visit our Online Scheduling page.

Dry Needling for the Management of Muscle Pain

Adult male physiotherapist is doing acupuncture on the back of a female patient. Patient is lying down on a bed and is covered with royal blue towels.

Known by many different names, dry needling is a variation of acupuncture that’s recently been gaining popularity in Western cultures. The difference between the two treatments comes down to the philosophy. Unlike traditional acupuncture, which uses energetic pathways called meridians to improve the flow of qi, dry needling incorporates the scientific study of the musculoskeletal system. Instead of inserting needles into acupoints that correspond to the area being treated, needles are inserted into tender and irritated muscle tissue. When stimulated, these trigger spots (known as “ashi” points) are released.

Here’s how it works: When the needle is inserted into the tissue, the tiny injury causes the body to produce a local healing response. This prompts the production of chemicals in the the neural pathways, which block the pain by disrupting the messages that are sent to the central nervous system. The trigger points, in turn, are able to relax and the tissue is restored to normal function.

The effectiveness of the treatment has been confirmed by numerous studies. A review of these studies, published in the Journal of Orthopaedic & Sports Physical Therapy in 2014, found that dry needling can decrease pain immediately after treatment and possibly up to four weeks. It can address several conditions, including tendonitis, headaches, whiplash, lower back pain, and sports-related injuries. In fact, it’s been found to be so effective that NFL teams are even incorporating it into their sports therapy routines.

While dry needling is effective in addressing muscular pain, during the treatment the trigger point are may feel somewhat uncomfortable, indicating that the therapy is working. “Generally speaking, the greater the injury, the more intense the treatment will be,” writes Andrew Nugent-Head in the Journal of Chinese Medicine. The muscles may be slightly weakened directly after treatment, but the patient will see immediate improvement in range of motion and joint use.

Physical therapists and other health professionals have used dry needling for many years with good results and  Acupuncturists are specifically licensed in the use of acupuncture needles to perform dry needling.  In Washington State, there is new legislation restricting Physical Therapists from doing dry needling, although this may not be so in other states.  If you are unable to receive dry needling at a facility where you have done so in the past, look for a licensed Acupuncturist.  If you think you may benefit from the treatment and have not tried it in the past, it’s important to search out a qualified practitioner who has the breadth of training and education to provide treatment that’s effective and safe.  Schedule an appointment today to have a plan designed for your needs.

Frozen Shoulder is Unlocked with Bodywork

by Diana Khoury

Frozen shoulder is a disabling condition characterized by pain, inflammation, stiffness and limited range of motion in the shoulder joint. The first symptoms are pain and an inability to perform daily tasks such as reaching or lifting. Shoulder function may be restricted for months or years, depending on the severity and course of treatment sought. Triggered by minor injury or improper movement (such as reaching backward from an abnormal position), the onset of frozen shoulder is gradual. Bodywork is often recommended as primary treatment for frozen shoulder – to improve function of the joint, reduce pain and facilitate increased range of motion.
Frozen shoulder currently affects around 5% of the population. However, the condition is 5 times more common in Type I and II Diabetics, possibly due to elevated blood sugar levels, which cause increased stiffness (glycosylation) in connective tissues over time.1

Those additionally at risk for incidents of frozen shoulder include:

  • Individuals between the ages of 40-65
  • Women (60-70% of cases)
  • People with poor posture
  • Those engaged in regular overuse of shoulder muscles (in sports, manual labor, etc.)
  • People with recent shoulder injuries
  • Patients recovering from shoulder or reconstructive breast surgeries
  • Family members with a history of frozen shoulder issues (genetic component)1

The onset of frozen shoulder is gradual and symptoms may last from 1-2 months to over 3 years, depending on treatment. Once a frozen shoulder is treated and healed, recurrence is uncommon. However, a small percentage of patients develop it in the opposite shoulder within 5 years.

There are three identified stages of frozen shoulder:

The acute stage (lasting 2-9 months), is characterized mainly by pain, limited range of motion, and interruption of sleep due to increased pain at night.2

The subacute or “frozen” stage (4-12 months) is marked by reduction in pain, increased stiffness and severely restricted range of motion.

The chronic or “thawing” stage (12-42 months) is the beginning of recovery, where pain is gone and range of movement gradually starts to improve.3

Since many shoulder problems are misdiagnosed as frozen shoulder, a proper evaluation should be performed by a medical professional to determine the most appropriate course of treatment.4

The standard medical treatment approach may include anti-inflammatory medications, cortisone injections, forced shoulder joint manipulations under anesthesia, or in the most extreme cases, surgery.3

A more conservative approach to frozen shoulder treatment includes manual therapy, bodywork and exercises, and is often recommended as a primary course before more invasive treatments are entertained.

Acupuncture used in conjunction with exercises have been shown to be an effective treatment for frozen shoulder.5Acupuncture releases endorphins which act as pain inhibitors, and stimulates the body’s natural healing abilities. The Healthcare Medicine Institute reports new research out of China and Germany that concludes acupuncture can release frozen shoulder pain and improve joint function and range of motion by targeting specific points related to muscle release in the shoulder capsule.6

Therapeutic massage techniques such as trigger point therapy, myofascial release, stretching and joint mobilization can be applied individually or in combination to address frozen shoulder, with positive results.7

For maximum effectiveness, therapeutic massage techniques are applied in moderation to break down adhesions (stiffness) in the shoulder joint, increase circulation (of blood, oxygen, synovial fluid), release locked muscles, and facilitate movement. Depending on which phase of frozen shoulder the patient is in, the massage therapist can design a series of therapeutic sessions to continue to unlock and unwind the stiffness in the shoulder, improve function and gradually restore normal range of motion.

This is an original article from Dreamclinic, Inc. Dreamclinic is a Health and Wellness company committed to sharing information about commonly experienced health conditions and how they may be impacted through the use of bodywork and other natural approaches. Dreamclinic offers massage, acupuncture, and Reiki sessions at its Greenlake and Queen Anne clinics, as well as onsite massage at workplaces around Puget Sound. Contact us to learn more about how Dreamclinic can help you, your family or your workplace experience greater health.

1. www.frozenshoulder.com
2. http://www.massageworld.co.uk/articles/sports-massage-getting-the-frozen-shoulder
3. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0047043/
4. http://www.massagetoday.com/mpacms/mt/article.php?id=10941
5. http://www.ncbi.nlm.nih.gov/pubmed/11773673
6. http://www.healthcmi.com/Acupuncture-Continuing-Education-News/1214-acupuncture-unlocks-frozen-shoulder-pain-new-research
7. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3096148/

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