The Problems with Sitting...

I was at a programming conference last month providing seated chair massage to alleviate aches and pains in necks/backs/shoulders and to give people a bit of relaxation time. Almost all of the people taking up the offer of massage pointed in between their shoulder blades, to the tops of their shoulders, or their necks and complained of pain. As I looked around the room, this was a common sight...

Recognise this in yourself? Do you often find yourself sitting slumped with bad posture in front of a laptop or a computer? When sitting like this for any length of time, your body starts to change. Your shoulders round forward, the pectoral muscles in your chest become short and tight. Opposing muscles in your back, in between your shoulder blades become taut and stretched and can't work as effectively. Hip flexors tighten up and muscles such as your gluteus maximus get lazy and sluggish, putting the muscles in your lower back under strain. Not only that, it can cause all sorts of other physiological effects. This animation summarises it better than I can.

We are not designed to be sitting at a desk for hours on end. You can easily spend 8 hours a day at a desk. If you commute by car, bus or train, add more time sitting. If you go home and slump in front of the TV in the evening, that's even longer just sitting around. Our bodies just don't like doing it. If this all sounds very familiar, there are some things that you can do to help ease the aches and pains. 

One of the most important things that you can do is to move around more often. Set an alarm on your phone or your computer, get up every hour and walk around, have a stretch, shrug your shoulders up and down and roll them forwards and backwards, rotate your neck around, run up and down the stairs a couple of times, do a few squats, jump up and down on the spot.... you get the idea, just move! It will get the blood circulating properly again, wake up those lazy muscles, stretch out the bits that have got tight. It might sound a little bit impractical but building a couple of minutes of movement into your day every hour will start to make you feel much better. 

The next most important thing that you can do is ensure that you are sitting correctly and comfortably, minimising the strain on your body. If you use a laptop, watch this short animation to give you ideas about how to help set yourself up better. 

For using a PC, this guide from BackCare is useful as it tells you the best way to set up your desk and equipment. A lot of people don't realise that if you use DSE (Display Screen Equipment) for a large part of your day, your employers must

• analyse workstations to assess and reduce risks
• make sure controls are in place
• provide information and training
• provide eye and eyesight tests on request, and special spectacles if needed
• review the assessment when the user or DSE changes.

See the Health and Safety Executive guide for more information. Don't be scared to approach your line manager or H&S department to request a DSE assessment and if you need special equipment such as lumbar support or foot rests, they can source those for you. 

If you drive for a living or spend a long time commuting, don't neglect your car - this guide will help you look at how you set up your car seat and give you tips on a comfortable driving position.

Now that you are set up properly when sitting, and you are moving more often, you can also try some stretches and strengthening exercises. 

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STRETCHES

1. Lying Chest Stretch

• Roll up a towel or pillow and place on floor
• Lie down, placing upper back over the towel
• Relax over the towel, allowing arms to open and feel the stretch across the chest
• Adjust position of arms to change where you feel the stretch if you need to
• Chill out there for a while and allow the muscles to relax

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2. Doorway Stretch

• Using a doorway, place both your arms against the walls on each side of the door
• Shoulders and elbows should be at 90 degrees
• Step through the doorway with one leg so your arms are drawn back, or keeping your body straight, lean forward, and you should feel a stretch through the front of your shoulders and chest
• Raise or lower the elbows to change to focus of the stretch on the muscle fibres in the pecs as they run at different angles. You can also stretch one side at a time.
• Hold for 20-30 seconds, repeat 2-3 times
• A similar stretch can be done using the walls in the corner of a room

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3. Upper Trapezius Stretch

• Sit upright and tall on a chair, with your shoulders back.
• Reach one arm behind your back and use the other arm to gently pull your head to the opposite side as if you are trying to bring your ear to your shoulder.  Keep your chin level and head back. 
• Once you feel a comfortable stretch, hold for 20-30 seconds.  Repeat both side 2-3 times each.

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4. Levator Scapula Stretch

• This stretch is more focused on the back of the neck.
• Sit upright and tall on a chair, with your shoulders back.
• Reach one arm behind your back as if you are trying to reach in between your shoulder blades.  
• From here, rotate your head to the opposite side, then using your free hand, place it on the back of your head and pull down gently as if you are looking down toward your hip.  
• Hold 20-30 seconds.  Repeat both sides 2-3 times each.

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STRENGTHENING EXERCISES

1. Posture Correction - Shoulder Position

• Sit on the edge of a chair and make sure that your spine is in a good comfortable position and your feet are flat on the floor
• Engage your abdominals with your arms relaxed at your sides 
• First, think about drawing your shoulder blades down your back, making sure your shoulders are relaxed and not up by your ears
• Then, gently squeeze your shoulder blades together, using the muscles in between them
• Breathing deeply, hold for around 30 seconds
• Repeat 3-4 times

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2. Posture Correction - Neck Position

• Sit in a relaxed position with head upright and shoulders back
• Keep your chin level, eyes forward, and draw your chin in towards your neck (a chin tuck), the motion might give you a double chin
• Try to keep the head level, don't tilt it up or down, think about keeping the length in the back of your neck
• Hold for 10 seconds, repeat 10 times

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3. Wall Slides

• Keep your back and shoulders against the wall, you may need to step your feet forward a little
• Set your shoulder blades back and down
• Place your arms against the wall in a Y shape, palms facing outwards. If the arms don't lie against the wall, widen the Y shape. Keep your shoulders relaxed
• Engage the abdominal muscles
• Keeping the arms against the wall and shoulders relaxed, slide the arms into a W shape, squeezing the shoulder blades down and back
• Slide the arms back up into a Y shape, again keeping shoulders relaxed and down
• Repeat a few times (try 3 sets of 10), keeping the movements slow and controlled
• Stay in the range of motion that allows you to keep contact with the wall and build up to a full range of motion if not possible to start with

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There are many other stretches and strengthening exercises but these are really good starting points for upper back, neck and shoulder pain.

If you are still experiencing issues, then a sports massage/soft tissue therapist can assess your posture and movement patterns, help to release shortened tight muscles, areas of tension and trigger points to give relief from the pain. A massage may sort your issues in one session, however for long standing chronic pain issues you may need more sessions. It is also important to say that massage is much more effective as part of a more complete package of change - changing your workstation, changing your posture, changing your habits and ensuring you move around more often and doing those stretches and strengthening exercises. 

If you want more information on this blog, want to know how a soft tissue therapy treatment can help you, or want to book in for a massage, contact info@vssportsmassage.com or 07527154675. 

Massage for Runners/Triathletes/Cyclists

We are now well and truly into the start of marathon/triathlon season and after fielding many similar questions from clients and potential clients about the benefits and the recommended frequency of massage, I thought I’d write a bit about it.

What are the benefits of massage specifically for people training for big events like a marathon or a triathlon?

Massage/soft tissue therapy

-       Improves circulation, bringing fresh nutrients to the muscle tissue and aiding the removal of waste products, keeping the muscles in good condition

-       Eases muscular tension allowing freedom of movement

-       Allows you to keep on top of any niggles or issues that arise in training before they become injuries

-       Can offer pain relief (pain changes the way we move, can cause compensatory movement patterns and be a source of stress if it prevents you from training)

-       Aids relaxation (stresses from everyday work and life can impact your training)

-       Can improve recovery times allowing you to train hard again sooner

If you are having any injury problems then I can do relevant assessments and advise stretching, mobility and strengthening exercises to help to sort the source of the problem out.

Clients that have had massages before training runs or big events have reported feeling lightness in their legs, have said that it felt easier and took less effort to run and more than one person has reported a PB!

How often/when should I get a massage?

This largely depends on your budget and how much the competition means to you. It can depend on whether it is your first big event or if you are a seasoned pro. It can depend on how injury prone you are and if you are getting lots of niggles. It can depend on how a massage affects you and how long you feel the benefits for afterwards.

I would say that if you’ve never had a massage before, and want to have one before your big event, having a massage some time beforehand, maybe before a big training run, to get some information about your recovery time and how the massage affects you is a very good idea. It provides information you can feed back to your therapist about the depth and duration of massage that is likely to work best for you.

If you feel that you want to, aiming for weekly massages at the peak of your training will keep you in good shape. I can definitely feel the difference in the muscles of someone who has regular massage – they feel softer and more pliable and are less painful to apply deep massage techniques to.

I would then recommend having your pre-event massage around 3-5 days before the event. You can have one 1-2 days before but let your therapist know and the massage will be gentler to avoid any post massage soreness.

For post event massage, if there is somewhere you can get a massage immediately after your event (a lot of events have massage therapists on site that do quick 10-15 massages) this will help to kick-start the recovery process. Booking in for a longer massage 2-3 days after that will further aid your recovery.

How much does it cost?

-       £50 for 60 minutes,

-       £35 for 30 minutes

How do I book?

Contact me on info@vssportsmassage.com, 07527154675 or visit my website for more information (www.vssportsmassage.com) 

Taking My Own Advice - Treating Soft Tissue Injuries

I had a lovely few days hiking up in the Peak District over New Year but at the end of a long day, I felt a twinge in my lower calf and it suddenly hurt quite a bit to walk on it (and I still had to walk 2 miles up hill to get back to the cottage we were staying at). It's always annoying to pick up injuries, especially doing something as innocuous as walking, but it has given me a chance to practice what I preach in terms of treating minor soft tissue injuries! 

What should you do if you find yourself with a similar injury? A muscle strain is a tearing of the muscle fibres, typically caused by overloading or overusing the muscle. Strains can classed according to their severity, with symptoms and healing times increasing the more severe they are. Symptoms can include a sharp stabbing pain at the point of injury and there may be pain when you try to contract the affected muscle. You may be able to palpate a lump in the muscle where the torn fibres have recoiled and bunched up. You may have localised pain and swelling, bruising may appear and there may be loss of strength to the tissue and a limited range of motion.

The guide below is a great summary of the best way of treating a soft tissue injury such as a sprain or strain in the first 72 hours and why each action is important. If you would like a copy emailing to you, just let me know. The important thing to know is that the sooner you treat soft tissue injuries, the better the healing response. 

Massage therapists don't treat soft tissue injuries with massage in the first 72 hours (the acute phase). This is because the damage is only just starting to heal and applying pressure via massage techniques to the affected area could cause further and more extensive damage (imagine getting a wound to your skin - in the first few days, the scab is delicate and if disrupted, the wound starts to bleed again). However, massage can be used on surrounding tissues to help to improve the blood flow and to promote the removal of excess inflammatory exudate to reduce swelling. 

As the soft tissue repair progresses into the sub-acute phase (3-21 days post injury) and the signs of inflammation have gone down (reduced redness, heat, swelling, pain and dysfunction), the therapist can start to work into the area. The new tissue is fragile and easily damaged so gentle massage over the injury site can be applied initially, with deeper massage and light frictions possible from around 7 days after injury. Swelling can be reduced by using lymphatic drainage massage to aid the removal of accumulated fluid and damaged cells from the area. 

At this stage of the healing process, collagen fibres are being laid down in a random configuration . Gentle frictions help to encourage the remodelling and optimal alignment of the collagen fibres, avoiding abnormal crosslinks that may restrict normal movement. Muscle/joint mobilisation can be used to improve the range of motion in the joint and load tissues functionally to encourage healing of fibres in the direction of stress. Soft tissue therapy on other areas of the body could be beneficial at this time to ease imbalance, for example, in the case of an ankle sprain, the client could be putting more weight through the uninjured leg (limping) and those muscles could be painful due to overcompensation.

Moving into the chronic phase of healing (3 weeks onwards), the aim of soft tissue therapy treatments is to restore muscle strength, function and proprioception. The new tissue is maturing and has enough strength to withstand deeper massage. More vigorous frictions can be applied to break down excessive scar tissue and a combination of massage techniques will ensure good circulation, assist with healing and promote venous and lymph return. They also ensure the collagen fibres in the scar tissue realign in an optimal orientation and the scar has good tensile strength. If not appropriately treated, scar tissue can cause weaknesses in the tissue and are a major cause of reinjury, even many years later. Mobility work will gradually increase the load on the tissue to return it to full function. 

Postural and functional assessments can be performed to identify root causes of injury or potential risk factors and training advice and preventative treatment may help to prevent additional injuries from occurring. 

So, with my calf strain on day 19 of injury, I have had a 3 treatments on the injury itself and the surrounding lower leg muscles and I've been able to continue to train on it without any issue. Further treatments will ensure that it doesn't become a problem as I increase the intensity and frequency of my training. 

If you have picked up a niggle or a more serious sprain or strain, why not book in to see me and ensure you give it every chance of healing properly? Contact me on 07527154675 or info@vssportsmassage.com to book.

References: Acute Soft Tissue Injury Management Update (Sport EXSport medicine 2013, 58 (October) 16-20); Remedial Massage Therapy, Mel Cash; Evidence Based Massage: Part 1, Nick Dinsdale (SportEX dynamics 2009; 22 (Oct) 12-17).