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“To become more conscious is the greatest gift anyone can give to the world; moreover, in a ripple effect, the gift comes back to its source.”— Dr. David Hawkins …my teacher.

Intro. On-Line Only In-Call Special 1 1/4 hr $50.00 (1st time client’s) Mon – Fri

 

plus  offering senior and  veteran  in-call discounts with id.   Policies

 

Please call for an Appointment: 805-637-7482   Please no texts

 

Save Time and Download 1st Visit Intake Form HERE

 

 

Any of the modalities or bodywork listed below can help Neck Pain, Headaches, Migraines, Shoulder & Arm Pain, Carpal Tunnel Relief, Upper Back, Low Back Spasms, Sciatica, Torso Pain, Hip Pain, Thigh, Hamstring and Calf Injuries, Leg Pain, Knee Pain, Achilles and Foot Pain, Chronic Pain, Stress Relief, Myofascial Pain and Dysfunction, Therapeutic Pain Relief, Psoas and Illpsoas Pain, Scalenes Pain, Trapezius Pain, OM / Orthopedic Massage Relief, Lymphatic Drainage and any other muscle injuries, strains, pulls and related injuries for pain relief and stress relief.

 

Nicola’s Modalities:  Deep Tissue Massage,  Barefoot Deep Tissue Massage, Ashiatsu, ShiatsuCompression Massage, Sports and Injury Massage, Therapeutic Massage, Orthopedic Massage  (OM)  Myofascial Release, Trigger Point MassageNeuromuscular ReleaseSwedish Massage, Relaxing Massage, Reflexology Massage, Chair Massage, Lymphatic Drainage and some Asian bodywork in the Goleta and Santa Barbara, Ca  area’s. He also offers Stress Relief Massage,Healing Massage for Depression and Anxiety.

 

Nicola is a practicing licensed and insured professional LMT ( Licensed Massage Therapist) ( State Certification # 7239 ) and fine artist based in Goleta and Santa Barbara, CA. Nicola has a wide range of female and male clients from athletes, artists, landscapers, UCSB, SBCC, Brooks students and faculty,  business people, educators, construction workers, elderly clients, house wives and tourists. He is very flexible in scheduling appointments either at his studio which is located in the Goleta, Ca area now.  He can also make professional appointments at Holistic Centers in Santa Barbara, Buellton, Key2Fitness or can make home or out call or mobile massage visits in the Tri – Counties area. He also works with other local area professional massage therapists and can offer couples massages and can schedule male and female therapists to come to your home for a amazing couple’s massage. Maybe you own a business with a large group of people or have a large party of people.  Nicola can organize as many therapists as you need to accommodate your specific needs.

 

A mandala containing symbols from 16 of our world`s many spiritual traditions, designed for honoring all paths to truth. Includes the Jewish Star of David, Buddhist Prayer Wheel, Native  American Medicine Wheel, Christian Cross, Hindu Om, Great Goddess, Taoist Ying Yang, Islamic Moon  and Star, Winged Sufi Heart, Sikh Symbol, Baha`i Star, African Goddess, Zoroastrian Flame, Confucian  Circle and Dot, Wiccan Pentacle and Egyptian Ankh.

 

 

 

 

 

 

 

 

A mandala containing symbols from 16 of our world`s many spiritual traditions, designed for honoring all paths to truth. Includes the Jewish Star of David, Buddhist Prayer Wheel, Native American Medicine Wheel, Christian Cross, Hindu Om, Great Goddess, Taoist Ying Yang, Islamic Moon and Star, Winged Sufi Heart, Sikh Symbol, Baha`i Star, African Goddess, Zoroastrian Flame, Confucian Circle and Dot, Wiccan Pentacle and Egyptian Ankh.

Therapeutic Healing Bodywork by NiCoLa!

 

Santa Barbara Massage. Nicola Bandak is a California State Licensed and Insured CMP (Certified Massage Practitioner) Professional BODY WORKER, by APPOINTMENT ONLY, Last Minute Appointments are OK.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Warning-Massage can become Addicting!

 

Warning- Good Bodywork can become Addicting!

If you appreciate high quality bodywork or just want to RELAX and go to “LA LA LAND” call Nicola.  Are you a serious athlete and need EXTREME bodywork or “FIX IT” work, weekend warrior with injuries or just want to keep that body tuned up? Then you have finally found your Santa Barbara Licensed and Insured Massage Therapist.

Nicola (aka – Nick, Chris or Banduechy…so named by his handball buddies) is a California State Licensed and Insured LMT (Licensed Massage Therapist) Professional Body Worker, by APPOINTMENT ONLY, Last Minute Appointments are OK!

 

 
Get into the ZONE…the PARASYMPATHETIC Zone
Click this link for a diagram  that explains the parasympathetic nervous system
 
 

 

Before you continue PLEASE watch this video called " The Wounded Healer"....
.. fantastic.

http://www.youtube.com/watch?v=TDLUR15Z9o8

My style of Deep Tissue Massage releases the body’s natural painkillers whereby it stimulates the release of endorphins, the morphine-like substances that the body manufactures into the brain and nervous system. Once that happens (your now in a parasympathetic state  (“rest and digest”) I then go to work on your sore or injured areas to break up the damaged fibrous adhesion’s which are spread randomly though out a muscle’s tissue thus increasing blood flow, oxygen, strength, flexibility and tissue re-building. I use a variety of modalities to accomplish this: Swedish: This is your basic massage modality which incorporates long gentle strokes to increase blood flow to and from the muscles. Myofascial Release: This technique involves slower and deeper pressure into the muscle tissue to assist in breaking up adhesions and scar tissue in the muscle. Neuromuscular Release, NMT, Neuromuscular Re-Education, Body Pattern Synchronization (Call it what you want… everybody gives it their own name but we are all trying to do the same thing): This technique is “point-specific” work which targets muscle adhesion’s, muscle spindles in the belly of the muscle, trigger points that restrict normal flow of the nervous system to the muscles. Once the adhesion’s are broken up the client usually experiences an increase in range of motion, strength, and speed. ActiveRange of Motion:This technique is a stretching modality which takes the client through his or her normal range of motion to assist motor control and aids in the reduction of scar tissue and muscle adhesions. Active Isolated Stretching: This technique involves stretching which incorporates a process called reciprocal inhibition  (RI) to stretch the muscle as well as increase kinesthetic awareness of the body.

The key to “My STYLE” is an aggressive approach combined with sustained pressure ( increasing Ischemic blood supply) over time and a spiritual component.

(This diagram link explains this process)

 

 

 

 

 

 

 

What does Riktr mean?

Derived from “Off the Richter Scale” meaning that something is excellent, very good, over the top, on the edge, awesome, cool, da bomb, fantastic, hot or amazing.

Nice Quotes:

The strongest of all warriors are these two: Time and Patience.– Leo Tolstoi Patience, persistence and perspiration make an unbeatable combination for success.- Napolean Hill If only we arrange our life according to that principle which counsels us that we must always hold to the difficult, then that which now still seems to us the most alien will become what we most trust and find most faithful. – Rilke (Rilke on love an other difficulties-translations and considerations of Rainer Maria Rilke by John J. L. Mood) I tell you that I have a long way to go before I am –where one begins… – Rilke Resolve to be always beginning—to be a beginner. -Rilke ” The harder you work, the luckier you get.” – Gary Player, golfer “Nothing happens until something moves.” Albert Einstein As Dr. Rolf said, “Put the tissue where it should be and then ask for movement.” Our sorrows and wounds are healed only when we touch them with compassion. – Buddha Once you label me you negate me.  -Søren Kierkegaard I must find a truth that is true for me. -Søren Kierkegaard   Click here for: other nice quotes

FYI: Where does Riktr’s healing energy come from: These pictures say it all.

God’s Universal Energy or Chi, Ki, Ka, Xi, Netter, Ihund, Life Force, Prana, Holy Spirit, Ruhuh, Biomagnetic Energy or Innate Intelligence starts here. Click these links for more on Universal Energy.

Check out this video called “Angelic Human Race”   http://www.youtube.com/watch?v=TDLUR15Z9o8   (See 101 Names of God)  

The Earth is part of  universal energy.

Check out this video called “Healing the Hearts of Humanity”   http://www.youtube.com/watch?v=7aKcvgTvIMQ&feature=related

The earth captures Universal magnetic energy in many different ways and stores it.

Check out this video called “The Awakening of The Cosmic Heart (The Core Rainbow)”   http://www.youtube.com/watch?v=es-YbHlBKtU&NR=1

Magnetic universal energy is stored in the earth’s core and then is released.

The earth unleashes it’s energy in different ways.

Keeping your third eye open lets all the magnetic energy flow in and out of your body.

Human beings collect, store and release the magnetic energy.

Human beings collect, store and release magnetic energy some more than others.

 

Check out these links for Healing Sounds!

http://www.youtube.com/watch?v=URFnBeW423E http://www.youtube.com/watch?v=73J05gjmMgw http://www.youtube.com/results?search_query=HEALING+SOUNDS&aq=f

MASSAGE IS

M—Message of caring A—Aesthetics for the body S—Sacred touch S—Soothing of tension A—Anthology for the body G—General healing E—Energy balanced Massage Is a … Healing time for regeneration. Special time for individuation. Quiet time for imagination. Restful time for gratification. Sacred time for reflection. Sensational time with an exclamation!

by Joan Donato 

CitySlick local ads and coupons. Find Health Care Deals Deals!

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader.

 

MSN Business Directory  

 

Massage for Leg Pain Therapeutic Relief Santa Barbara Goleta Massage, Trigger Point, Riktr Pro Deep Tissue Massage, Nicola, LMT, 805-637-7482

 

“To become more conscious is the greatest gift anyone can give to the world; moreover, in a ripple effect, the gift comes back to its source.”— Dr. David Hawkins …my teacher.

Intro. On-Line Only In-Call Special 1 1/4 hr $50.00 (1st time client’s) Mon – Fri

 

plus  offering senior and  veteran  in-call discounts with id.   Policies

 

Please call for an Appointment: 805-637-7482   Please no texts

 

Save Time and Download 1st Visit Intake Form HERE

 

 

Any of the modalities or bodywork listed below can help Neck Pain, Headaches, Migraines, Shoulder & Arm Pain, Carpal Tunnel Relief, Upper Back, Low Back Spasms, Sciatica, Torso Pain, Hip Pain, Thigh, Hamstring and Calf Injuries, Leg Pain, Knee Pain, Achilles and Foot Pain, Chronic Pain, Stress Relief, Myofascial Pain and Dysfunction, Therapeutic Pain Relief, Psoas and Illpsoas Pain, Scalenes Pain, Trapezius Pain, OM / Orthopedic Massage Relief, Lymphatic Drainage and any other muscle injuries, strains, pulls and related injuries for pain relief and stress relief.

 

Nicola’s Modalities:  Deep Tissue Massage,  Barefoot Deep Tissue Massage, Ashiatsu, ShiatsuCompression Massage, Sports and Injury Massage, Therapeutic Massage, Orthopedic Massage  (OM)  Myofascial Release, Trigger Point MassageNeuromuscular ReleaseSwedish Massage, Relaxing Massage, Reflexology Massage, Chair Massage, Lymphatic Drainage and some Asian bodywork in the Goleta and Santa Barbara, Ca  area’s. He also offers Stress Relief Massage,Healing Massage for Depression and Anxiety.

 

Nicola is a practicing licensed and insured professional LMT ( Licensed Massage Therapist) ( State Certification # 7239 ) and fine artist based in Goleta and Santa Barbara, CA. Nicola has a wide range of female and male clients from athletes, artists, landscapers, UCSB, SBCC, Brooks students and faculty,  business people, educators, construction workers, elderly clients, house wives and tourists. He is very flexible in scheduling appointments either at his studio which is located in the Goleta, Ca area now.  He can also make professional appointments at Holistic Centers in Santa Barbara, Buellton, Key2Fitness or can make home or out call or mobile massage visits in the Tri – Counties area. He also works with other local area professional massage therapists and can offer couples massages and can schedule male and female therapists to come to your home for a amazing couple’s massage. Maybe you own a business with a large group of people or have a large party of people.  Nicola can organize as many therapists as you need to accommodate your specific needs.

 

Adductor Muscle-Tendon Injuries

adductors

Great article by Ben E. Benjamin
Originally published in Massage Bodywork magazine, March/April 2010. Associated Bodywork and Massage Professionals. All rights reserved.

A strained adductor muscle or tendon can be a tenacious, enduring injury, causing persistent pain in the inner thigh. If a person feels pain high up near the groin, he or she has injured the tendon of one of the four primary adductor muscles: the gracilis, adductor longus, adductor brevis, or adductor magnus. If the pain is toward the mid-thigh, the muscle fibers are injured. Pain in both places indicates damage to both tendon and muscle fibers.

More localized pain felt high up on the pubic ramis suggests an injury to the pectineus–another muscle-tendon unit that assists in adduction, especially when the hip is flexed.

In severe cases, even walking hurts, but more commonly, the person feels pain only during vigorous activity or when stretching the inner-thigh muscles. Proper treatment can eliminate this injury in a relatively short period of time, but without treatment, it can plague the person for many years.


How and Why These Injuries Occur
The adductor muscles function to draw the legs together and help stabilize them in walking or running, working especially hard during side-to-side movements. The adductor muscles are anchored into the pubic bone and run to either the mid-thigh or the medial knee at the distal end.

These structures can be injured easily while running, especially in sports that require sudden, quick, side-to-side movements, such as tennis, squash, and basketball. The adductors are also vulnerable in a sport like soccer, where the medial aspect of the foot is used extensively in kicking the ball. During this type of a kick, the adductor muscles provide the primary force. When two players kick the ball simultaneously in that way, this creates a great strain on these structures. The adductors can also be injured by vigorous dancing.

Most frequently, however, these injuries result from forced stretching, overuse, or straining while using an adduction machine improperly at the gym. The average person’s adductor muscles are not very flexible or strong. As you may recall from previous articles, limitations in the range of motion of muscles or joints makes these structures more vulnerable to injury. In addition, all of our muscles are naturally weaker near the end of their range of motion. As a result, when individuals start to use an adductor machine with the legs spread far apart at the end of their range of motion, they often injure themselves severely the moment they begin to draw their legs together.


Injury Verification

There are a number of positions in which you can test the adductors. We will move from the easiest to the most stressful.

Test 1
With the client lying supine on the table, place your fist between the client’s knees, with the sides of your fist (the soft part) against the bony portions of the knees. Now, ask the client to squeeze your fist by drawing the knees together. If this causes pain anywhere in the medial thigh, an adductor strain is present.

Test 2
If there is no pain in Test 1, ask the client to bend the knees and place the feet flat on the table, with the knees 10-12 inches apart. Now, apply pressure to the medial aspects of the knees and have the client draw the knees together as you resist with equal and opposite force (see image above). If that causes no pain, move the knees apart another foot and try again. If this causes no pain, allow the knees to drop out as far as they can toward the table and repeat the same test.

Test 3
This final test is the most efficient way to assess the pectineus muscle-tendon unit. Ask the client to raise the knees toward the chest, with the legs splayed open as far as possible. Now, place your hands on the medial aspects of each knee and ask the client to draw the knees together, as you resist with equal and opposite force.


Palpation Testing
Because adductor strains do not cause any referred pain, the location of the pain tells you exactly where the injured tissue is located. Very medial pain indicates the gracilis, while slightly more anterior pain suggests the adductors magnus, longus, and brevis. If the pectineus is injured, the pain will be felt a bit higher up on the pubic ramus, lateral to the pubic symphysis. Following the client’s lead, palpate the adductor muscle-tendon unit to determine where the pain is most acute. Start in the middle of the thigh, even if the injury is in the groin. (Sudden or unexpected contact high up on someone’s thigh can feel uncomfortable or invasive.) Now, begin tracing your way up the structure until you reach the portion that is tender to the touch. This may be just below the attachment to the pubis or right on the pubis itself. Be careful to drape the client appropriately.


Signs of An Avulsion Fracture
If the pain is fairly severe, especially in the groin area near the attachment to the pubis, it’s possible that the person has an avulsion fracture–a condition in which the tendon, or a piece of the tendon, pulls away from the bone and takes a small piece of bone with it. Young people in their teens sometimes get avulsion fractures right at the attachment to the pubis. Although this is relatively uncommon, it can prove serious if not attended to properly; therefore, be sure to have the client see a doctor to get an X-ray or an MRI.


Treatment Choices
Self-Treatment
If you catch an adductor injury early, self-treatment can be quite effective. In the early phase of this injury, it is essential to rest and do no stretching for a week to 10 days. As the pain subsides, the client should begin very gently stretching the adductors, as indicated in the exercises described below. As the condition improves, the person can participate in athletic activity, provided no pain is felt during it or immediately afterward. (Begin with some moderate activity, such as walking, swimming, Pilates, or yoga–not basketball or running.) If the client experiences any pain or discomfort, it’s important to pull back and go slower. After two weeks have passed with no pain, the client can slowly resume his or her normal activities.

Friction Therapy and Massage
A combination of friction therapy and massage is typically quite effective in treating this injury. The friction therapy breaks apart the adhesive scar tissue that has formed in the injured tissues, and the massage supports the healing process by enhancing circulation. If the injury is recent, it should heal within about eight sessions (two sessions per week over the course of a month). For an older injury, the treatment process will likely take eight or 10 weeks or longer. Adding the exercise program will help to reduce the recovery time. Teach your client the protocol described in the next section after the second or third treatment.

Location and friction of the adductors at the pubis. The most common location of injury is right at the attachment to the pubis. This is a very personal and vulnerable area of the body, so be very careful when performing your treatment. Be sure to obtain explicit consent from the client before you begin. To get access to the adductor tendon, ask the person to bend the knee of the injured leg and let it drop out to the side. Place a pillow under the lateral thigh and knee, making sure this position feels comfortable, and then palpate the adductor tendon, beginning at least a few inches distal to the pubis. Work your way up slowly until you are on the injured portion of the tendon. Now, place your index and middle finger on the injured structure, move across the tendon at a 90-degree angle with moderate pressure, and then move back to your original position with no force. After you have frictioned in this manner for five minutes, take a break, followed by another five minutes of friction.

This treatment should cause mild discomfort, but no pain. It is normal for the client to be sore for 24-48 hours following the treatment, but if the discomfort lasts longer than that, you have used too much pressure. Go lighter the next time.

Location and friction of the adductor tendon body and muscle belly. Perform the palpation testing described earlier to locate the painful area(s). There will often be one primary area of pain and one or two secondary areas. Using the pads of your fingers, move through the muscle belly structure at a 90-degree angle, using moderate pressure. Apply pressure repeatedly in one direction for five or six minutes, take a short rest, and then repeat.

Location and friction of the pectineus at the pubis. After obtaining permission from the client to work in this sensitive area, use the tips of your middle three fingers to apply friction along the broader bony attachment to the lateral edge of the pubic bone. Apply pressure in one direction for only five or six minutes, then rest and repeat.

Massage Therapy
Massage the entire thigh, anterior and posterior, accenting the adductors on the medial aspect. Be sure to include some transverse massage on the adductors as well. Also, work the entire kinetic chain, including the lower leg and the buttock.

Exercise Program
The exercise program for the adductors has five steps and should be done daily for six to eight weeks, or until the client is pain-free for two weeks. Give your client the following instructions:

1. Warm up the leg for two to three minutes, either walking or swinging the leg from side to side.

2. Lie on your back, bend your knee, and place your hand on the inner surface of the knee. Allow the leg to open out to the side and stretch gently for 20-30 seconds. You should feel only a slight pull; use no extra force beyond the weight of the leg. Rest the leg for a moment and repeat four more times.

3. Lie on your side with the injured leg on the bottom and bend the top leg, placing that foot on the floor in front of the other knee. Lift your bottom leg off the floor about 8-10 inches, and then lower it so that it is an inch above the ground. Repeat this 10 times. Now lower the leg to the ground for a brief rest. Repeat this action for three sets of 10 repetitions. The goal is to feel fatigue at some point in the last set of 10 repetitions. If you do not feel any fatigue, add a 1-pound ankle weight. Continue with the same amount of weight for a week or so. When the exercise no longer creates fatigue, increase the weight by half a pound or a pound and proceed for another week. Continue increasing the weight until you can do the exercise with the same amount of weight on your injured leg as on your uninjured leg (a minimum of 8 pounds). If you feel fatigue in the first or second set of 10 before you add any weight, modify the exercise by bending your knee to a 90-degree angle. It is much easier to raise the thigh without the weight of the lower leg. As you get stronger, straighten the leg a little bit more each week.

4. Repeat the stretch from Step 2.

5. Place an ice pack or heating pad on the injured area for five minutes.

Be sure to educate the client about the importance of regular exercise, including a warm-up procedure, stretching, and strengthening of not only the adductor muscles (which have likely atrophied), but also the hamstrings, abductors, and quadriceps muscles. All three types of exercise are important for maintaining the health of the thigh, and should be done at least three times a week.


Safety In Strength
For athletes who perform any sport or other activity that involves running, having very strong adductors is an absolute necessity. The average person should be strong enough to do whatever he or she wants to do in life, plus a bit of extra strength. Flexibility is also extremely beneficial. Regular stretching that achieves maximum flexibility in the thigh gives protection against future injuries to the thigh and to the low back as well, making it an excellent investment in the continuing health of the lower body.

Thanks to : Ben E. Benjamin, PhD, holds a doctorate in education and sports medicine. He is founder of the Muscular Therapy Institute. Benjamin has been in private practice for more than 45 years and has taught communication skills as a trainer and coach for more than 25 years. He teaches extensively across the country on topics including SAVI communications, ethics, and orthopedic massage, and is the author of Listen to Your Pain, Are You Tense? and Exercise Without Injury, and coauthor of The Ethics of Touch.

Sports massage for the thigh muscles

groin-muscles Anterior_tendon

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Sports massage for the thigh muscles which can be used for injuries such as contusions and strains but only when the acute period has passed.

In particular for a thigh contusion of dead leg it is vitally important that massage does not begin too early otherwise Myositis ossificans can develop which is bone growth within the muscle. Before beginning any massage your therapist will check for contraindications which mean massage is not suitable or could cause harm.

Technique 1: Effleurage to the thigh

Aim – light stroking to warm up the area in preparation for deeper techniques.
  • With the hands stroke lightly but firmly upwards from just above the patella to to the top of the thigh. Try to cover as much of the surface as possible with the hands.
  • Always stroke upwards towards the heart in the direction of blood flow. Veins have valves which prevent blood from flowing back the wrong way. Forcing it through with massage can damage the veins.
  • Then lightly bring the hands down the outside of the leg keeping them in contact but do not apply pressure.
  • Use slow, smooth movements. Many beginners tend to rush the massage techniques.
  • Repeat the whole movement using slow stroking techniques, trying to cover as much of the leg as possible.
  • Repeat this technique for about 2 to 5 minutes, gradually applying deeper pressure on the up strokes.

Technique 2: Petrissage

Aim – To start to loosen the muscles and really increase the warmth.

  • A kneading type technique.
  • Move the muscles one way with one hand and the other way with the other.
  • Try to cover the whole area of the thigh.
  • Gradually apply more pressure.

Techniques 3 and 4: Stripping the muscle and Circular frictions.

Aim – to apply sustained pressure to the muscle, ironing out any lumps, bumps and knots.

  • With the thumb of the right hand (for the left leg), apply deep sustained pressure along the full length of the muscle.
  • This technique should be slow and deliberate to ‘feel’ the muscle underneath. A good therapist will gradually build up a mental picture of exactly where the tension and scar tissue is in the muscle.
  • The thumb can be reinforced using the thumb or two fingers of the other hand.
  • Repeat this 3 to 5 times in a row, alternating with petrissage for 5 to 10 minutes.
  • If the therapist comes across any tight, tender knots in the muscle (usually at the point of strain or rupture), these can be worked out with deep circular frictions to the knot.
  • Massage should be deep but not so deep that the athlete tightens up with pain.

Technique 4: Stripping the Iliotibial Band

  • Apply sustained pressure with the heel of the hand along the length of the iliotibial band. This technique can be uncomfortable or even painful so start gently.

Technique 5: Trigger points

  • Any lumps and bumps or particularly sensitive spots can be treated with deep, sustained pressure to these points using the thumbs. Increase the pressure on the spot until it ranks 7/10 on the pain scale (10 being painful). Hold this pressure until it eases off to 4/10 on the pain scale (usually about 5 seconds).
  • Without easing off with the pressure, increase again until it reaches 7/10 on the pain scale once more. Hold until it eases, repeat once more.
  • This technique is very hard on the thumbs. It is important to keep the thumb slightly bent (flexed) when applying pressure to avoid damaging the joints. Finger nails need to be short to apply this technique correctly.

Finishing off

  • The therapist can finish off with more petrissage techniques and then finally effleurage again. The whole process need not last more than half an hour.
  • Massage therapy can be applied every day if it is performed lightly however deeper techniques may result in a days recovery period to allow tissues to ‘recover’ just like they would after a training session.
  • For rehabilitation of muscle strains, sports massage is very important in softening / preventing scar tissue forming at the site of injury and re-aligning the new healing fibres in the direction of the muscle fibres. This will help prevent re-injury.

Massage Therapy & Hamstring Injuries

groin-muscles hamstringtears hamstring_injury hamstring-muscles200

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

| By Ramona French

Massage Therapy & Hamstring Injuries
Hamstring injuries make a stretch like this painful and difficult. Photo Credit Thinkstock/Comstock/Getty Images

The hamstrings are three muscles on the back of your thigh. Hamstring injury is due to overuse or trauma. One of the factors in hamstring strain is an imbalance between the hamstrings and the quadriceps muscles. Massage can help to prevent hamstring injuries by balancing the muscles on the front and back of the leg. If you have a hamstring injury, massage can speed the healing, reduce pain and minimize scar tissue.

Hamstrings

The hamstrings are three muscles in the back of your thigh: the semitendinosus, semimembranosus and biceps femoris muscles. All three are anchored on the ischium, the “sitting bone.” The semimembranosus and semitendinosus muscles insert on the medial, or inside, side of your leg below the knee. The biceps femoris inserts on the outside of your leg, below the knee. Together the three muscles bend your knee and extend your hip. Picture the movement your leg makes when you draw it backward before swinging it forward to kick a ball. The backward movement is controlled by the hamstrings.

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Injuries

Hamstring injuries are graded into three categories: minor tears within the muscle, a partial tear of the muscle or a severe tear or rupture. Strain, or minor tears, will feel somewhat painful but not interfere significantly with movement. A muscle tear will be more painful, there may be swelling, and bending or straightening the knee will be difficult. If there is a severe tear or rupture, there will be immediate swelling and bruising, severe pain and you may need to use crutches to walk. You will be able to feel a depression in the muscle where the rupture occurred.

Treatment

The usual treatment for hamstring injuries is rest, ice, compression, elevation and massage. People with minor hamstring strains or tears often won’t see a doctor but will self-treat or seek out a massage therapist for treatment. A severe tear or rupture often requires surgery to reattach the muscle and tendon. If the pain is severe, your movement is significantly limited and the condition is not improving, see a physician to rule out a ruptured muscle or a fracture before having massage.

Massage

The goal of massage is to speed healing, reduce muscle tightness and build healthy scar tissue. Once the injury has been examined to rule out any contraindications, the therapist begins with gentle massage to reduce swelling and speed healing using lymph drainage massage or gentle Swedish massage to stretch the muscle fibers. After stretching the entire muscle, the therapist will work to soften and mobilize tissues in the injured area.

Rehabilitation

As the injury heals the therapist will switch to deeper work, including transverse friction, across the injured muscle fibers, to help build healthy scar tissue. The massage therapist will use deep lengthwise strokes and kneading to make the muscle more pliable, and will move the leg to engage the muscles while simultaneously massaging the injured muscle, mimicking the effects of exercise.

 *Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.

Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader.

Calf Injuries Pain Therapeutic Relief Santa Barbara Goleta Massage, Trigger Point, Riktr Pro Deep Tissue Massage, Nicola, LMT, 805-637-7482

 

“To become more conscious is the greatest gift anyone can give to the world; moreover, in a ripple effect, the gift comes back to its source.”— Dr. David Hawkins …my teacher.

Intro. On-Line Only In-Call Special 1 1/4 hr $50.00 (1st time client’s) Mon – Fri

 

plus  offering senior and  veteran  in-call discounts with id.   Policies

 

Please call for an Appointment: 805-637-7482   Please no texts

 

Save Time and Download 1st Visit Intake Form HERE

 

 

Any of the modalities or bodywork listed below can help Neck Pain, Headaches, Migraines, Shoulder & Arm Pain, Carpal Tunnel Relief, Upper Back, Low Back Spasms, Sciatica, Torso Pain, Hip Pain, Thigh, Hamstring and Calf Injuries, Leg, Knee, Achilles and Foot Pain, Chronic Pain, Stress Relief, Myofascial Pain and Dysfunction, Therapeutic Pain Relief, Psoas and Illpsoas Pain, Scalenes Pain, Trapezius Pain, OM / Orthopedic Massage Relief, Lymphatic Drainage and any other muscle injuries, strains, pulls and related injuries for pain relief and stress relief.

 

Nicola’s Modalities:  Deep Tissue Massage,  Barefoot Deep Tissue Massage, Ashiatsu, ShiatsuCompression Massage, Sports and Injury Massage, Therapeutic Massage, Orthopedic Massage  (OM)  Myofascial Release, Trigger Point MassageNeuromuscular ReleaseSwedish Massage, Relaxing Massage, Reflexology Massage, Chair Massage, Lymphatic Drainage and some Asian bodywork in the Goleta and Santa Barbara, Ca  area’s. He also offers Stress Relief Massage,Healing Massage for Depression and Anxiety.

 

Nicola is a practicing licensed and insured professional LMT ( Licensed Massage Therapist) ( State Certification # 7239 ) and fine artist based in Goleta and Santa Barbara, CA. Nicola has a wide range of female and male clients from athletes, artists, landscapers, UCSB, SBCC, Brooks students and faculty,  business people, educators, construction workers, elderly clients, house wives and tourists. He is very flexible in scheduling appointments either at his studio which is located in the Goleta, Ca area now.  He can also make professional appointments at Holistic Centers in Santa Barbara, Buellton, Key2Fitness or can make home or out call or mobile massage visits in the Tri – Counties area. He also works with other local area professional massage therapists and can offer couples massages and can schedule male and female therapists to come to your home for a amazing couple’s massage. Maybe you own a business with a large group of people or have a large party of people.  Nicola can organize as many therapists as you need to accommodate your specific needs.

 

Calf Muscle Tear

What is a Calf Muscle Tear?

calf muscle tear

Calf Trigger Points

 

Gastrocnemius

 

 

 

 

How to Care for a Calf Muscle Tear

Pain that occurs in the calf muscle on the lower part of the leg often is the result of a pulled or torn calf muscle.

A torn calf muscle is similar to an Achilles tendon tear or rupture, but occurs higher up in the back of the leg. A sign of a torn calf muscle is similar to that of an Achilles tendon rupture. You may think you’ve just been hit in the leg and potentially hear a “pop.” There is sudden pain at the back of the calf. Then you’ll experience pain, swelling or bruising in the calf muscle, and you’ll have difficulty walking properly or standing on your toes.

Calf muscle tears usually occur during acceleration or changes in direction. However, we have known people to tear their calf muscle by simply walking across the road.

Calf strain may be minor or very severe. Your physiotherapist will grade the injury accordingly:

Grade 1:

The muscle is stretched causing some small micro tears in the muscle fibres. Recovery takes approximately 2 to 4 weeks if you do all the right things.

Grade 2:

There is partial tearing of muscle fibres. Full recovery takes approximately 4 to 8 weeks with good rehabilitation.

Grade 3:

This is the most severe calf strain with a complete tearing or rupture of muscle fibres in the lower leg. Full recovery can take 3-4 months and, in some instances, surgery may be needed.

How to Treat a Calf Muscle Tear

Calf muscle tears are one of the most common problems that we see and it is unfortunately an injury that often recurs if you return to sport too quickly – especially if a thorough rehabilitation program is not completed.

Researchers have concluded that there are essentially 6 stages that need to be covered to effectively rehabilitate these injuries and prevent recurrence – these are:

Phase 1 – Early Injury Protection: Pain Reduction & Anti-inflammatory Phase

As with most soft tissue injuries the initial treatment is RICE – Rest, Ice, Compression and Elevation.

Your calf muscle is a large powerful group of muscles that can produce sufficient force to run, jump and hop. In the early phase you’ll be unable to walk without a limp, so your calf needs some rest from weight-bearing loads. You may need to be non or partial-weight-bearing, when crutches or a wedged achilles walking boot may be the best treatment.

Ice is a simple and effective modality to reduce your pain and swelling. Please apply for 20-30 minutes each 2 to 4 hours during the initial phase or when you notice that your injury is warm or hot.

Anti-inflammatory medication (if tolerated) and natural substances eg arnica may help reduce your pain and swelling. However, it is best to avoid anti-inflammatory drugs during the initial 48 to 72 hours when they may encourage additional bleeding. Most people can tolerate paracetamol as a pain reducing medication.

As you improve a compressive bandage, supportive taping or an elastic calf support will help to both support the injured soft tissue and keep the blood from pooling in your foot.

Keep your foot elevated above your heart (where possible) to allow for gravity to help drain your calf and lower leg swelling.

Phase 2: Regain Full Range of Motion

If you protect your injured calf appropriately the torn muscle will successfully reattach. Mature scar formation takes at least six weeks. During this time period you should be aiming to optimally remould your scar tissue to prevent a scar that will re-tear in the future.

It is important to lengthen and orientate your healing scar tissue via massage, muscle stretches and neurodynamic mobilisations. Signs that your have full soft tissue extensibility includes being able to walk without a limp and able to perform calf stretches with a similar end of range stretch feeling.

Phase 3: Restore Concentric Muscle Strength

Calf strength and power should be gradually progressed from non-weight bear to partial and then full weight bear and resistance loaded exercises. You may also require strengthening for other leg, gluteal and lower core muscles depending on your assessment findings.

Phase 4: Restore Eccentric Muscle Strength

Calf muscles work in two directions. They push you up (concentric) and control you down (eccentric). Most calf muscle tears occur during the controlled lengthening phase. Your physiotherapist will guide you on an eccentric calf strengthening program when your injury healing allows.

Phase 5: Restore High Speed, Power, Proprioception & Agility

Most calf injuries occur during high speed activities, which place enormous forces on your body (contractile and non-contractile). In order to prevent a recurrence as you return to sport, your physiotherapist will guide you with exercises to address these important components of rehabilitation to both prevent a recurrence and improve your sporting performance.

Depending on what your sport or lifestyle entails, a speed, agility, proprioception and power program will be customised to prepares you for light sport-specific training.

Phase 6: Return to Sport

Depending on the demands of your chosen sport, you will require specific sport-specific exercises and a progressed training regime to enable a safe and injury-free return to your chosen sport.

The perfect outcome will have you performing at full speed, power, agility and function with the added knowledge that a through rehabilitation program has minimised your chance of future injury.

Summary

There is no specific time frame for when to progress from each stage to the next. Your injury rehabilitation status will be determined by many factors during your physiotherapist’s clinical assessment.

You’ll find that in most cases, your physiotherapist will seamlessly progress between the rehabilitation phases as your clinical assessment and function improves.

It is also important to note that each progression must be carefully monitored as attempting to progress too soon to the next level can lead to re-injury and frustration.

For more specific advice about your calf injury, please contact your PT physiotherapist.

 

lower-leg-calf-muscles muscle-injury-tissue PULLED-HAMSTRING

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Calf tears

They start as a cramp, and as one continues to run on it the muscle fibers tear in the area around the cramp. This leads to even more muscle damage. The day after, the calf is very painful to the touch and I can hardly walk on it. The pain can last for a while and the site of the injury becomes a locus for future injuries to the muscle.

When you injure the muscle tissue the body attempts to heal it. There is an inflammatory reaction around the site of injury and sometimes even bruising. As the body heals the damage, scar tissue can be laid down. You can feel this scar tissue with your fingers in the weeks after the injury as a painful knot deep in the muscle. In can sometimes feel like a hard marble imbedded in your calf. This is a knot of scar tissue and the remains of the inflammatory material. Even after there is no pain and you can run, if this knot is present it will be a site that re injures again. The idea is to get rid of this knot so the muscle can function more normally.

What to do

If you feel your calf cramp up and it becomes painful try these steps.

The best thing to do is to go see a physical therapist so they can give real professional help.

 

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader.

Hamstring Pain Injuries Therapeutic Relief Santa Barbara Goleta Massage, Trigger Point, Riktr Pro Deep Tissue Massage, Nicola, LMT, 805-637-7482

 

“To become more conscious is the greatest gift anyone can give to the world; moreover, in a ripple effect, the gift comes back to its source.”— Dr. David Hawkins …my teacher.

Intro. On-Line Only In-Call Special 1 1/4 hr $50.00 (1st time client’s) Mon – Fri

plus  offering senior and  veteran  in-call discounts with id.   Policies

Please call for an Appointment: 805-637-7482   Please no texts

 

Save Time and Download 1st Visit Intake Form HERE

 

 

Any of the modalities or bodywork listed below can help Neck Pain, Headaches, Migraines, Shoulder & Arm Pain, Carpal Tunnel Relief, Upper Back, Low Back Spasms, Sciatica, Torso Pain, Hip Pain, Thigh, Hamstring and Calf Injuries, Leg, Knee, Achilles and Foot Pain, Chronic Pain, Stress Relief, Myofascial Pain and Dysfunction, Therapeutic Pain Relief, Psoas and Illpsoas Pain, Scalenes Pain, Trapezius Pain, OM / Orthopedic Massage Relief, Lymphatic Drainage and any other muscle injuries, strains, pulls and related injuries for pain relief and stress relief.

❶Nicola’s Modalities offered:  Deep Tissue Massage,  Barefoot Deep Tissue Massage, Ashiatsu, ShiatsuCompression Massage, Sports and Injury Massage, Therapeutic Massage, Orthopedic Massage  (OM)  Myofascial Release, Trigger Point MassageNeuromuscular ReleaseSwedish Massage, Relaxing Massage, Reflexology Massage, Chair Massage, Lymphatic Drainage and some Asian bodywork in the Goleta and Santa Barbara, Ca  area’s. He also offers Stress Relief Massage,Healing Massage for Depression and Anxiety.

Nicola is a practicing licensed and insured professional LMT ( Licensed Massage Therapist) ( State Certification # 7239 ) and artist based in Goleta and Santa Barbara, CA. Nicola has a wide range of female and male clients from athletes, artists, landscapers, UCSB, SBCC, Brooks students and faculty,  business people, educators, construction workers, elderly clients, house wives and tourists. He is very flexible in scheduling appointments either at his studio which is located in the Goleta, Ca area now.  He can also make professional appointments at Holistic Centers in Santa Barbara, Buellton, Key2Fitness or can make home or out call or mobile massage visits in the Tri – Counties area. He also works with other local area professional massage therapists and can offer couples massages and can schedule male and female therapists to come to your home for a amazing couple’s massage. Maybe you own a business with a large group of people or have a large party of people.  Nicola can organize as many therapists as you need to accommodate your specific needs.

Resolving Hamstring Injuries

Hamstring injuries are a common problem that affects a large number of athletes. These injuries can be slow to heal with a very high rate of recurrence or re-injury. Hamstring injuries are often associated with sports that require fast acceleration and deceleration such as running (intervals), football, soccer, handball and rugby.

Among medical researchers, there is a considerable lack of consensus in regards to what precipitates a hamstring injury. Some of the more common theories are lack of strength, flexibility, muscle imbalances, and not warming up before an athletic event. However, it is agreed upon that hamstring injuries are usually not the result of a direct trauma, referred to as a “Non Contact Event”.


Hamstring Anatomy

hamstring-muscles

 

 

 

 

 

 

 

 

 

The hamstrings are called bi-articular muscles because they cross both the hip and knee joints. This is an important consideration because a hamstring injury can affect your hips, low back, knees, and the motion patterns of the entire lower extremity. If we consider fascial connections (posterior line), we will see that a hamstring injury can affect a very large area.

The hamstrings are composed of three muscles in the back of your thigh. They are called the:

Semitendinosus

This muscle originates in the lower pelvis (ischial tuberosity) and runs down the back of the leg to an area just below the inside of the knee (Anteroromedial surface of the tibia, in an area called the Pes Anserinus).

Three muscles insert into the pes anserinus: The Gracilis, Sartorius, and semiTendinosis (GST – Just remember sales tax). The pes anserinus is a common area to feel knee pain when the bursa that is under these muscles becomes inflamed.

Semimembranosus

This muscle also originates in the lower pelvis (ischial tuberosity) and runs down the back of the leg to an area below the knee on the posterior medial side (posterior medial tibia).

Inflammation of the semimembranosis is often confused with an injury of the medial meniscus. Removing a restriction from the semimembranosus can have a positive effect on meniscus function.

Biceps femoris

Numerous studies have shown that the biceps femoris is the most common site of hamstring injury (myotendinous junction). The biceps femoris has both a long and a short head. The long head originates in the lower pelvis (ischial tuberosity, common tendon of semitendinosis, and lower part of sacrotuberous ligament). It is easy to understand how low back pain can be also be referred from the hamstring with direct fascial attachments that run from the long head of the biceps femoris directly into the sacrotuberous ligament.

The short head originates on the outside and of the leg (posterolateral femur). Both heads insert just below the knee on the lateral side (head of fibula and lateral condyle of tibia).


Hamstring Biomechanical Analysis

HamstringQuad

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

The hamstring muscles are multifunctional. They are powerful hip extensors, second only to the gluteus maximus muscle, as well as knee flexors, medial and lateral rotators, and important stabilizers of the knee.

From a biomechanical perspective the hamstrings function in several ways depending on leg position:

  • All of the hamstring muscles extend the thigh at the hip joint, flex the leg at the knee, and tilt the pelvis in a posterior direction.
  • The semimembranosus and semitendinosis rotate the leg inward (medially rotate).
  • The biceps femoris rotates the leg outward (laterally rotates).
  • Note: The short head of the biceps femoris is not involved in hip motion directly because it does not cross the hip joint.

Some researchers have placed more emphasis on certain hamstring actions dismissing other actions as secondary or less important functions. For example, some researchers have shown that the hamstrings can act as knee flexors, but only in nonfunctional settings. Consequently, only the so-called primary tasks, such as extension, of the hamstrings are considered in training or rehabilitative routines.

Hamstrings are a multifunctional complex performing numerous tasks, full of neurological receptors that relay information to other muscles.

Running Biomechanics

When running, your hamstrings function as shock absorbers, force generators and stabilizers. Shock absorption is achieved through eccentric contraction of the hamstring muscles, which is an efficient way of absorbing the kinetic energy of foot impact. This mechanism of shock absorption can be extremely effective if the hamstrings are strong, flexible, and not compromised by scar tissue from previous injuries.

The hamstrings are also a key component of force generation because of their synergistic action with the gluteal muscles in hip extension.

The hamstrings act as a stabilizer when running in several ways. On foot strike, the hamstrings act as a dynamic stabilizer. They decelerate the forward movement of the shin bone (tibia) during knee extension. This is similar to the action of the anterior cruciate ligament (ACL), except that the ACL is a passive stabilizer.

After initial contact with the ground, the hamstrings lengthen. This also has the effect of stabilizing the knee. When we push off with the foot, the hamstrings contract (in conjunction with the quadriceps) to provide propulsion.


Hamstring Tears

hamstringtears

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

After the initial tear of the hamstring muscle, there is usually some bleeding which may show up as a small to large bruise over the hamstrings.

The bleeding from a hamstring tear is followed by an inflammatory response with an increase in cells called fibroblasts. Fibroblasts are cells that are involved in the synthesis of collagen, which is the structural framework for all tissues. Fibroblasts are also involved in wound healing and the formation of scar tissue.

As the inflammatory process of a hamstring injury begins to resolve, scar tissue is often formed. Scar tissue is a weak, inflexible, easily re-injured tissue that can decrease range of motion and create abnormal motion patterns. It is scar tissue that most likely accounts for the high rate of recurrence of hamstring injuries.

From a symptomatic perspective, most hamstring injuries seem to resolve with time. In reality these injuries often do not completely heal, but are the catalyst for a series of injuries due to residual scar tissue and compensations that this tissue creates.

Grading a Hamstring Injury

muscle-strain

muscle-injury-tissue-

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

It is important to evaluate the degree of hamstring injury so that appropriate treatments can be implemented. Hamstring strains are graded from 1 to 3, 3 being the most severe.

Grade 1 Strain

The injured person can still walk though with some degree of difficulty. There may be minor swelling, stiffness, and pain. In a grade 1 strain there is only minor tearing of the hamstring muscle. A common analogy is comparing a muscle to a piece of tissue paper. In a grade one injury there are only minor tears in the tissue. There should be only minor pain on hamstring resistance with no significant loss of strength.

Grade 2 Strain

The injured person may have difficulty walking and could be in considerable pain. There may be swelling, and some degree of bruising. In a grade 2 strain there is moderate tearing of the muscle. To use the tissue analogy there would be a significant amount of tears in the tissue, compared to a grade one sprain.
The patient may not be able to straighten their knee. There also may be considerable pain on hamstring resistance.

Grade 3 Strain

A grade three strain is a severe or complete tearing of the muscle. To use the tissue analogy, the tissue could now be torn in two pieces. This type of strain may require surgical intervention to reattach the muscle.

Any action that causes the hamstrings to contract will cause severe pain. Walking will be extremely difficult; the injured person will require crutches. There could be a complete loss of function.


Treatment of Hamstring Injuries

Trigger Points


Biceps Femoris, Semitendinosus, Semimembranosus

 

 

 

 

 

 

 

 

Initial Acute Injury

Right after the injury in the acute stage you should use RICE, the acronym for rest, ice, compression and elevation. If you have access to laser therapy this will also reduce the inflammation and speed the healing process.

Medication

NSAID’s are often immediately prescribed for hamstring injuries. For short periods of time, these medciations may be beneficial. Taking NSAID’s for longer than seven days is generally not advised, as they can slow the healing response and decrease the overall quality of tissue leading to further injury.

Steroid injections at one time were often used to treat hamstring injuries, but these injections are no longer advised by many practitioners. Corticosteroids have been linked to poor healing, infections, and even ruptures of the tissue.

There are several natural alternatives that can be used to decrease inflammation without inhibiting the healing process or causing further injury.

Start Treatment ASAP

Mobilization of the injured hamstring as soon as possible is essential in achieving a speedy recovery. This would include passive stretching and strengthening exercises that should be performed in a pain free range of motion. This treatment would be done by your PT.

Initially isometric strengthening exercises are recommended, followed by a gentle progression into isotonic exercises. Isometric exercises use static contraction of a muscle without any noticeable movement in the angle of the joint. In an isotonic exercise, tension remains unchanged but the muscle’s length changes. An example would be weight lifting.

Upper body exercises should also be performed to maintain physical conditioning. Aerobic exercise should also be performed. Aerobic exercise will speed the healing process by increasing cellular energy (ATP production) and increasing circulatory function. Improving circulation will increase oxygen input to the muscles and increase the removal of waste byproducts. Swimming is an excellent exercise for a hamstring injury (Stay within a pain free range of motion).

Manual Therapy

Manual therapy can reduce the formation of scar tissue and speed the overall healing. The longer that the injured person waits for therapy to begin the longer the resolution time may be.

The removal of any physical restrictions that form in the hamstrings, or other related areas, is essential for a full resolution. Some of these restrictions can be removed through the process of self-myofascial release (foam rollers, self massage, and gentle stretching). If the restrictions are severe enough then a manual therapy practitioner (ART, Graston, Massage) will be needed to break the restrictions.

It is important to note that any time a restriction is removed from one muscle, the antagonistic and synergist muscles must also be assessed for restrictions. This is a key point that many manual therapists overlook. For a full resolution of a hamstring injury, myofascial adhesions must be removed from the entire kinetic chain not just at the site of pain. Many of these restrictions will only be found with a more in depth biomechanical analysis and palpatory examination.

The following list of structures are common sites where restrictions are formed. These restrictions can form in a very short period of time. Common restriction sites are:

Hamstrings

  • Biceps Femoris (Long head)
  • Semimembranosis
  • Semitendinosis

Antagonistic Muscles

  • Quadriceps
  • Iliopsoas

Synergist Muscles

  • Gluteus Maximus
  • Sartorius
  • Gracilis
  • Gastrocnemius

Myofascial Considerations

The previous list of structures focused on restrictions primarily in muscles, and their tendons. Another key area we must consider in any hamstring injury is fascia. Fascia is everywhere, weaving through, and interconnecting every component of our body.

Muscle fibers originate from, and insert into, fascial fibers. These fascial fibers, in turn, insert into multiple regions of the bone, and even into adjacent muscles. These additional points of contact and control provide the muscle with the ability to generate force in multiple directions.

Only certain sections of the muscle contract when performing an action. Force is not generated from just the origin and insertion points, but also through the numerous fascial connections.

Muscles work together as functional units that coordinate their actions across multiple joints. Depending on the degree of motion required, and amount of force that is needed, each muscle will contract only specific areas of the muscle, rather than the entire muscle. These very specific motions are largely coordinated by the neurological receptors embedded in the fascia, and not by the brain.

Fascia is full of two types of neurological receptors – mechanoreceptors and proprioceptors. A mechanoreceptor is a sensory receptor that responds to mechanical pressure or distortion. A proprioceptor is a sensor that provides the brain with information about joint angle, muscle length, and tension.

Motion is coordinated by the feedback of the neurological receptors in the fascia when tension is transferred from one area to the next. (Previously these receptors were only thought to be located within just the muscles).

Fascial Lines and a Hamstring Injury

When we evaluate a hamstring injury, we must also take into consideration all the fascial connections to the structures that are involved in performing and coordinating motion. It is important to look at the big picture, and take into consideration that multiple muscles, working across multiple joints (all of which are interconnected by fascia) are all required to coordinate these motions.

In the case of a hamstring injury, the fascial connections we should consider are in the Superficial Back Line (see Anatomy Trains by Thomas Meyers). The following is a short synopsis of the posterior line.

Superficial Back Line

  • Beginning at the bottom of the foot with the plantar fascia. This fascia passes over the heel bone (calcaneus) and inserts into the Achilles tendon.
  • The Achilles tendon is formed by the calf muscles (gastrocnemius and Ssleus). There are direct fascial connections into the hamstrings.
  • There are fascial connections directly into the sacrotuberous ligament, which runs into the sacral fascia.
    Connections from the sacral fascia run directly into the back muscles (erector spinae) from the low back (lumbar spine) up through the mid back (thoracic spine) into the neck (splenius and semispinalis capitus).
  • Fascial connections then continue up the neck to the fascia on the skull (nuchal line). This continues along the scalp fascia to the forehead just above the eyes.

You can try treating a hamstring injury with all the right techniques (ART, Graston, Massage etc.) and find that you still have not resolved a chronic problem you need to consider, and treat, the fascial interconnections.


Exercise is Essential

It is very important that the hamstrings are trained in same manner that they function during real life activities. The hamstrings work in synergy with multiple muscles and do not act as a singular isolated muscle. For example, to mimic hamstring muscle function during running the hamstrings need to be training in both open and closed kinetic chain movements. Closed chain exercise will mimic the stance phase of running, and open chain exercises can mimic the swing phase of running (eccentric actions).

These are exercises where, in the case of the lower extremity, the foot is in constant contact with the ground. Examples would be: Lunges, squats, dead lifts, power cleans. These exercises focus on the co-contraction of multiple groups of muscles at the same time. They also involve multiple joints at the same time: those being the ankles, knees and hips.

Open kinetic chain exercises – These are exercises where the leg/foot is free to move and is not in contact with a surface. These exercises are usually non-weight bearing.

Numerous researchers recommend that your hamstrings should be 60 to 80% as strong as your quadriceps.

Strengthening Your Hamstrings

Strengthening your hamstrings is an essential component in reaching a full recovery from an injury. These are only a few of the strengthening exercises we recommend to our patients.

Romanian Dead Lift- This is a great closed kinetic chain exercise for training the hamstrings in eccentric contraction. Starting with low loads, for rehabilitation training, then building up to higher levels for athletic training.

  • Stand straight with your lumbar spine in slight extension, with a barbell or dumbbells in your hands. Feet should be shoulder width apart, legs are straight, but not hyper extended.
  • Flex forward from the hips moving the barbell or dumbbells down the front of your legs. Do not bend your knees all motion needs to come from the hips.
  • As you lean forward, the hamstrings will lengthen, placing them under considerable eccentric load.
  • Continue to lower the weight until you can no longer hold your back in the extension position. This will probably be when the weight is at the middle of your shins.

Single Leg Dead Lift – This is a similar exercise to the Romanian dead lift but is performed one leg at a time holding a dumbbell with both hands.

The same procedure is used except that the back leg can be raised off of the ground for balance.

Stretching Your Hamstrings

Stretching after a hamstring injury is extremely important. Initially, stretching may have to be done passively within a pain free range of motion. To get a better idea of why stretching is so important, consider this. During the first two days to six weeks after an injury, collagen is formed and laid down to repair the injured area. If an injured person is performing the correct stretching exercises, the majority of the collagen will be laid down in the same direction as the tissue being repaired. This makes the repaired tissue stronger and more capable of performing its function. If the individual is not stretching, the tissue will be laid down in more random patterns, leading to the development of weaker tissue that is easily re-injured (scar tissue).

Be careful not to be too aggressive with stretches after an injury. Do not stretch past the point of mild discomfort, doing so may delay healing and cause further injury.

Psoas Stretch

The psoas is a very important muscle to stretch if you have had a hamstring injury or wish to prevent one from occurring. There is an antagonistic relationship between the psoas muscle and your gluteal muscles. Essentially when the psoas become short and contracted it turns off your glute muscles. Your glutes and your hamstrings are your primary hip extensors. Therefore when your glutes get turned off, more of the load is placed on your hamstrings which then become susceptible to injury.

There are several ways that you can stretch out the psoas with either static or dynamic stretches.

Note that after the psoas muscle is stretched out, the gluteal muscles should be worked to regain activation of the muscle. This will help to take stress off of the hamstring.

Balance and Proprioceptive Training

Whenever a sprain/strain injury occurs it is not just the ligament, tendon, or muscle fibers that are damaged. Often, the embedded neurological structures within these soft-tissue structures are also damaged. These neurological structures (golgi tendon organs, muscle spindles, and joint receptors) are essential for postural control.

Both Golgi Tendon Organs and Muscle Spindle Cells are sensory neurons (proprioceptors). Sensory neurons monitor muscle and tendon motion (contraction and stretching) and relay this information back to your brain. This creates a feedback loop system that allows your body to discern its position and postural orientation. Joint receptors are located in joint capsules and respond to deep pressure and to other stimuli such as stress or change in position. They are also part of your body’s neurological feedback loop system.

What appears to be just a simple hamstring tear often involves some damage to several neurological structures. The good news is that the nervous system is very good at repairing itself given the right type of exercises.

That is why every patient that comes to us for a hamstring tear is also given exercises that involve balance training. Balance training helps to repair neurological damage, substantially decreasing the chance of re-injury.

 

 

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader.

 

Massage for Thigh Pain Therapeutic Relief Santa Barbara Goleta Massage, Trigger Point, Riktr Pro Deep Tissue Massage, Nicola, LMT, 805-637-7482

 

“To become more conscious is the greatest gift anyone can give to the world; moreover, in a ripple effect, the gift comes back to its source.”— Dr. David Hawkins …my teacher.

Intro. On-Line Only In-Call Special 1 1/4 hr $50.00 (1st time client’s) Mon – Fri

plus  offering senior and  veteran  in-call discounts with id.   Policies

Please call for an Appointment: 805-637-7482   Please no texts

 

Save Time and Download 1st Visit Intake Form HERE

 

 

Any of the modalities or bodywork listed below can help Neck Pain, Headaches, Migraines, Shoulder & Arm Pain, Carpal Tunnel Relief, Upper Back, Low Back Spasms, Sciatica, Torso Pain, Hip Pain, Thigh, Hamstring and Calf Injuries, Leg, Knee, Achilles and Foot Pain, Chronic Pain, Stress Relief, Myofascial Pain and Dysfunction, Therapeutic Pain Relief, Psoas and Illpsoas Pain, Scalenes Pain, Trapezius Pain, OM / Orthopedic Massage Relief, Lymphatic Drainage and any other muscle injuries, strains, pulls and related injuries for pain relief and stress relief.

❶Nicola’s Modalities offered:  Deep Tissue Massage,  Barefoot Deep Tissue Massage, Ashiatsu, ShiatsuCompression Massage, Sports and Injury Massage, Therapeutic Massage, Orthopedic Massage  (OM)  Myofascial Release, Trigger Point MassageNeuromuscular ReleaseSwedish Massage, Relaxing Massage, Reflexology Massage, Chair Massage, Lymphatic Drainage and some Asian bodywork in the Goleta and Santa Barbara, Ca  area’s. He also offers Stress Relief Massage,Healing Massage for Depression and Anxiety.

Nicola is a practicing licensed and insured professional LMT ( Licensed Massage Therapist) ( State Certification # 7239 ) and artist based in Goleta and Santa Barbara, CA. Nicola has a wide range of female and male clients from athletes, artists, UCSB, SBCC, Brooks students and faculty,  business people, educators, construction workers, elderly clients, house wives and tourists. He is very flexible in scheduling appointments either at his studio which is located in the Goleta, Ca area now.  He can also make professional appointments at Holistic Centers in Santa Barbara, Buellton, Key2Fitness or can make home or out call or mobile massage visits in the Tri – Counties area. He also works with other local area professional massage therapists and can offer couples massages and can schedule male and female therapists to come to your home for a amazing couple’s massage. Maybe you own a business with a large group of people or have a large party of people.  Nicola can organize as many therapists as you need to accommodate your specific needs.

Hip and Thigh Pain: The Tensor Fascia Latae Connection

Great article by David Kent, LMT, NCTMB

Patients will describe referral patterns from myofascial trigger points in the tensor fascia latae muscle, as pain in the hip and down the front side of their thigh (Images 1A and 2).

tensor fascia latae - Copyright – Stock Photo / Register Mark

Other symptoms include tenderness and pain, from the pressure of the patient’s own body weight, which prevents them from laying on the effected side. Patients can lay on their opposite side by placing a pillow between their knees. The pillow prevents the tensor fascia latae, and the other hip abductors on the painful side from being lengthened, which can activate trigger points. If both sides are too painful, the patient will sleep on their back with a pillow under their legs or in a reclining chair.

Patients will also report experiencing pain when standing up straight after being in a hip flexed position from activities such as driving, sitting, sleeping in a fetal position or on their back with support under their legs. Movements of the hip, including walking, will also produce pain in the hip and or lateral thigh. They may have received a diagnosis of trochanteric bursitis or iliotibial band friction syndrome.

pain referral areas - Copyright – Stock Photo / Register Mark

Educate

While you may know the location of trigger points and their specific pain referral patterns, your patients do not. They are in pain and looking to you for answers and relief. It only takes a minute to educate your patients about trigger points and it’s a great way to build your practice. Explain to patients that if you press on a trigger point, it will produce a referred phenomena that is typically described as pain, burning, tingling or pressure in a region away from the location of the trigger point.

educate your patients - Copyright – Stock Photo / Register Mark

Charts are great visual educational tools (Images 1 and 3). Show patients how your charts work and what they may expect if you palpate a trigger point. For example, in image 4, “X” indicates the common location of trigger points within the muscle. Solid red areas indicate an essential pain zone or area of pain experienced by every patient that had that trigger point activated during research studies. The red dots indicate spillover pain zones. These are areas of pain experienced by some, but not all, patients outside of the essential pain zones.

gluteus minimus - Copyright – Stock Photo / Register Mark

Check

Besides the tensor fascia latae, there are numerous other muscles that commonly have trigger points that also refer pain into the hip and lateral thigh. Laminated charts allow you to use a wet-erase marker to circle trigger points that may be involved. This process lets you educate the patient while creating a visual checklist of the muscles you will isolate during the treatment. After the therapy session, you can wipe the chart clean with a little water on a towel (Image 3).

gluteus medius - Copyright – Stock Photo / Register Mark

Deep to the tensor fascia latae, the anterior fibers of gluteus minimus can have trigger points (Image 4a). (See “Pseudo-Sciatica and Gluteus Minimus Trigger Points,” MT, May 2011). Trigger point 2 (TrP2) in the gluteus medius is positioned just belong the iliac crest, mid way along the crest (Image 5b). (See “Back Pain: Often a Pain in the Gluteus Medius,” MT, March 2009). All five of the trigger points in the vastis lateralis can refer pain into the hip, the lateral thigh and lateral knee (Images 6 and 7). Trigger points in the more lateral fibers of quadratus lumborum also refer pain into the hip (Image 8)

vastus lateralis - Copyright – Stock Photo / Register Mark

Anatomy

The shape of the tensor fascia latae is wide in the middle and tapered on each end (fusiform). It is approximately 15cm (5.9 inches) long. The tensor fascia latae attaches proximally to the anterior superior iliac spine (ASIS) and the anterior part of the external lip of iliac crest. Distally it attaches into the iliotibial tract which continues to attach into the lateral condyle of the tibia (Image 1). These attachment points allow the muscle to abduct, medially rotate and flex the thigh. It also helps to keep the knee extended and to stabilize the trunk on the thigh.

vastus lateralis - Copyright – Stock Photo / Register Mark

Findings

Trigger points and the pain they refer are symptoms, our goal is to treat the causes. Trigger points form for many reasons, from direct trauma during an accident, to poor posture habits and more. Information from the patient history forms, subjective complaints, postural analysis, orthopedic assessments and tests (Ober’s), joints range of motion (ROM), length and strength of muscles and palpation exam will guide us to design the most effective treatment plan.

Photos

A picture is worth a thousand words and a great way to document posture while educating the patients. Posture photos are simple, cost-effective tools that set your practice apart from your competition and should be included as part the initial treatment or package of treatments.

quadratus lumborum - Copyright – Stock Photo / Register Mark

Just like doctors use x-rays and MRIs to give a report of findings, you can use pictures to show and tell patients how their posture is causing the pain. Simply take postural analysis photos using the camera in your iPhone, smart phone, tablet or iPad and show the obvious distortions to your patients on the screen. Visual aids help patients see how their posture is perpetuating the formation of trigger points and how your treatments can help. No special software is needed, you just take the pictures and look at them. A postural analysis grid chart make it easier for the patient’s untrained eyes to see the distortions in the photos (Image 3). (See “Practice Building with Postural Analysis,” MT, January 2012 and “Practice Building: Getting Inside Your Patient’s Head,” MT, January 2011).

 

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader.

Massage for Hip Pain Therapeutic Relief Santa Barbara Goleta Massage, Trigger Point, Riktr Pro Deep Tissue Massage, Nicola, LMT, 805-637-7482

 

“To become more conscious is the greatest gift anyone can give to the world; moreover, in a ripple effect, the gift comes back to its source.”— Dr. David Hawkins …my teacher.

Intro. On-Line Only In-Call Special 1 1/4 hr $50.00 (1st time client’s) Mon – Fri

plus  offering senior and  veteran  in-call discounts with id.   Policies

Please call for an Appointment: 805-637-7482   Please no texts

 

Save Time and Download 1st Visit Intake Form HERE

 

 

Any of the modalities or bodywork listed below can help Neck Pain, Headaches, Migraines, Shoulder & Arm Pain, Carpal Tunnel Relief, Upper Back, Low Back Spasms, Sciatica, Torso Pain, Hip Pain, Thigh Pain, Hamstring and Calf Injuries, Leg, Knee, Achilles and Foot Pain, Chronic Pain, Stress Relief, Myofascial Pain and Dysfunction, Therapeutic Pain Relief, Psoas and Illpsoas Pain, Scalenes Pain, Trapezius Pain, OM / Orthopedic Massage Relief, Lymphatic Drainage and any other muscle injuries, strains, pulls and related injuries for pain relief and stress relief.

❶Nicola’s Modalities offered:  Deep Tissue Massage,  Barefoot Deep Tissue Massage, Ashiatsu, ShiatsuCompression Massage, Sports and Injury Massage, Therapeutic Massage, Orthopedic Massage  (OM)  Myofascial Release, Trigger Point MassageNeuromuscular ReleaseSwedish Massage, Relaxing Massage, Reflexology Massage, Chair Massage, Lymphatic Drainage and some Asian bodywork in the Goleta and Santa Barbara, Ca  area’s. He also offers Stress Relief Massage,Healing Massage for Depression and Anxiety.

Nicola is a practicing licensed and insured professional LMT ( Licensed Massage Therapist) ( State Certification # 7239 ) and artist based in Goleta and Santa Barbara, CA. Nicola has a wide range of female and male clients from athletes, artists, UCSB, SBCC, Brooks students and faculty,  business people, educators, construction workers, elderly clients, house wives and tourists. He is very flexible in scheduling appointments either at his studio which is located in the Goleta, Ca area now.  He can also make professional appointments at Holistic Centers in Santa Barbara, Buellton, Key2Fitness or can make home or out call or mobile massage visits in the Tri – Counties area. He also works with other local area professional massage therapists and can offer couples massages and can schedule male and female therapists to come to your home for a amazing couple’s massage. Maybe you own a business with a large group of people or have a large party of people.  Nicola can organize as many therapists as you need to accommodate your specific needs.

 

Massage Therapy for Back Pain, Hip Pain, and Sciatica

Perfect Spot No. 6, an area of common trigger points in the gluteus medius and minimus muscles of the hip

1,100 words, updated 2012
Another great article by Paul Ingraham, Vancouver, Canadabio


illustrations by Paul Ingraham, Lindsay McGee

 

Trigger points (TrPs), or muscle knots, are a common cause of stubborn and strange aches and pains, and yet they are under-diagnosed. The 13 Perfect Spots (jump to list below) are trigger points that are common and yet fairly easy to massage yourself — the most satisfying and useful places to apply pressure to muscle. For tough cases, see the advanced trigger points treatment guide.

 

Pain Location Problems Related Muscles
in the low back, hip, buttocks (especially immediately under the buttocks), side of the thigh, hamstrings sciatica, trochanteric bursitis, low back pain gluteus medius and minimus
“Big Red Books” Reference: Volume 2, Chapters 8 & 9
see chart of all spots below

When you have back pain, buttock pain, hip pain, or leg pain, much or even all of your trouble may well be caused by trigger points in the obscure gluteus medius and minimus muscles, a pair of pizza-slice shaped muscles a little forward of your hip pocket. Other muscles in the region are usually involved as well, such as the gluteus maximus, piriformis, and the lumbar paraspinal muscles. However, the gluteus medius and minimus are a bit special: their contribution to pain in this area is particularly significant, and yet people who have buttock and leg pain rarely suspect that much of it might be radiating from muscle knots so high and far out on the side of the hip.

The leg pain that they produce can be so nasty that health professionals mistake it for sciatica,1 a compression of the large sciatic nerve that passes through the buttocks and into the leg. Don’t be fooled. Sciatica is often an incorrect diagnosis for pain in this area.

One trigger point therapy treatment completely relieved a nasty stubborn hip pain that I’d had for five months!

Jan Campbell

What does Perfect Spot No. 6 feel like?

Even without nasty symptoms, pressure on these muscles can still feel important, as they usual harbour TrPs that aren’t obvious until they are poked (known as “latent” trigger points), but which are routinely responsible for stiffness, “heavy”-ness, vague discomfort, and aching throughout the hip and buttocks and descending into the leg. Their importance is often unsuspected because the key gluteus medius and minimus TrPs actually live way out on the side of the hip, but the discomfort they produce spreads inwards and downwards. Known as “referred pain,” this is the same phenomenon as the pain of a heart attack spreading into the shoulder and arm. In particular, it’s common for this referred pain to be strongest right under the butt cheek, which is why it is so often mistaken for sciatica.

Given their stealthy nature, massaging these muscles can really feel like a surprising and satisfying discovery of the true source of stiffness you did (or didn’t) know that you had — perfect characteristics for a Perfect Spot!

The deltoid of the butt: anatomy and function of the lateral gluteal muscles

The gluteus medius and minimus together are “the deltoid of the butt.” Just as the deltoid muscle lifts the arm out to the side, these lateral glutes lift the leg. They are small cousins of the more famous gluteus maximus, the big muscle that gives shape to the buttocks (and the home of very nearby Perfect Spot No. 12). Medius and minimus are very much a pair — almost one muscle in two parts — so I’m going to stop saying “medius and minimus” every time. They have a nearly identical shape, location, and function, both acting as lateral stabilizers, preventing the hips from swinging too far from side to side as you walk and balance. You can activate them easily just by standing on one leg and lifting the other out to the side several times. When you start to feel a burn on the sides of your hips, you are feeling your lateral glutes.

ZOOM

The deltoid of the butt

The gluteus minimus and medius muscles are shaped like slices of pizza. (The minimus is hidden here: it is the same shape as the medius, but smaller and lying directly under it.) Perfect Spot No. 6 is usually found halfway down the lateral edge, right on the side of the hip, in the meaty area between the ridge of the pelvis and the big bone on the side of the hip (greater trochanter). But rather than being “soft,” the edge of the gluteus medius is usually quite rigid — almost as hard as the bones above and below!

These muscles really have evolved for all-terrain activity. A life lived mostly on the flat and stable surfaces of a city offers little challenge to them, so they are weak and easily exhausted by weekend skiing trips, a walk on the soft sand of a beach, or really anything that requires more balancing than usual. The combination of chronic mild weakness with erratic stressful challenges may be the reason they tend to get polluted with TrPs. (But that’s just an educated guess. It’s generally impossible to know exactly why individual TrPs come and go.)

Both the medius and minimus are shaped just like a wide slice of pizza; the points converge downwards on the bony projection on the side of your hip, the greater trochanter at the top of the femur. Their “crust” follows the iliac crest, a bony ridge at the top of the pelvis that defines the waist. The medius completely covers the minimus, and the maximus covers most of the medius — but you can still easily reach these muscles simply by pressing into the soft tissue just below the waist at the side and back.

Where exactly is this perfect trigger point?

As with most of the spots, Perfect Spot No. 6 is not so much a single specific trigger point as a small area where you are likely to find a significant trigger point — if not several of them. This area is on the side of the hip behind it. Or, to use the pizza as a guide, it is roughly the forward half of the slice, and especially in the half near the tip of the slice. Start at the greater trochanter and explore up and back from there: all over the side of the hip, right where the seam of your pants would be.

Self-massage tools that are particularly useful in this location

Trigger points in this area are easy enough to find, but not particularly easy to massage on your own body. It is a spot that cries out for a massage tool, more so than many other areas: something to trap between your hip and the floor. Tennis ball massage is always a great option for this, of course — and most people already have one around — but there are some other excellent choices as well.

The KONG® dog toy is an amazingly good self-massage tool!

The KONG® dog toy is an amazingly good self-massage tool!

For instance, a KONG® dog toy is a surprisingly useful (and quirky) self-treatment tool; its unusual wedge shape allows you to roll the side of your hip onto it, the pressure increasing as you roll further. This is a difficult (and slightly absurd) process to describe, so all I can do is encourage you to take my word for it and experiment — your dog may get jealous, though.

Balls and other “pointy” tools are often too intense for the sensitive trigger points in the gluteus medius and minimus muscles. Tubes and rollers fit more naturally into the space between the bones on the side of the hip: you can settle your weight onto them and roll back and forth quite cozily. There are countless foam rollers available — but don’t spend too much, because there are plenty of cheaper and even free improvised options (e.g. pool noodles!). With a foam roller, it’s easier to just settle your weight onto the roller.

Foam rollers work well on the side of the hip.

For a super firm roller, I particularly like the spinal rollers handmade by Allan Saltzman, creator of YogaTools.com — Relieve Tension, Stiffness, and Physical Distortions with Yoga Tools. His spinal rollers are just extremely hard tubes padded with a dense, rubbery foam: simple but very handy, and very sturdy.

Spinal rollers by Allan Saltzman

Allan Saltzman’s simple but sturdy “spinal rollers,” built for the spine but recommended here for the side of the hip. Available at YogaTools.com.

Last but not least, for the best in a pokier self-massage, I recommend The Knobble, a massage tool classic from Pressure Positive.

ZOOM

The Knobble

The Knobble is the best possible tool for applying a focussed pressure to a specific spot on the side of the hip. This is the best tool for the long term, once you know where to aim it, and have worked your way up to tolerating stronger pressures.

 

 

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
 Please consult your healthcare provider with any questions or concerns you may have regarding your condition. 
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader.

Massage for Torso Pain Therapeutic Relief Santa Barbara Goleta Massage, Trigger Point, Riktr Pro Deep Tissue Massage, Nicola, LMT, 805-637-7482

 

“To become more conscious is the greatest gift anyone can give to the world; moreover, in a ripple effect, the gift comes back to its source.”— Dr. David Hawkins …my teacher.

Intro. On-Line Only In-Call Special 1 1/4 hr $50.00 (1st time client’s) Mon – Fri

plus  offering senior and  veteran  in-call discounts with id.   Policies

Please call for an Appointment: 805-637-7482   Please no texts

 

Save Time and Download 1st Visit Intake Form HERE

 

 

Any of the modalities or bodywork listed below can help Neck Pain, Headaches, Migraines, Shoulder & Arm Pain, Carpal Tunnel Relief, Upper Back, Low Back Spasms, Sciatica, Torso Pain, Hip, Thigh, Hamstring and Calf Injuries, Leg, Knee, Achilles and Foot Pain, Chronic Pain, Stress Relief, Myofascial Pain and Dysfunction, Therapeutic Pain Relief, Psoas and Illpsoas Pain, Scalenes Pain, Trapezius Pain, OM / Orthopedic Massage Relief, Lymphatic Drainage and any other muscle injuries, strains, pulls and related injuries for pain relief and stress relief.

❶Nicola’s Modalities offered:  Deep Tissue Massage,  Barefoot Deep Tissue Massage, Ashiatsu, ShiatsuCompression Massage, Sports and Injury Massage, Therapeutic Massage, Orthopedic Massage  (OM)  Myofascial Release, Trigger Point MassageNeuromuscular ReleaseSwedish Massage, Relaxing Massage, Reflexology Massage, Chair Massage, Lymphatic Drainage and some Asian bodywork in the Goleta and Santa Barbara, Ca  area’s. He also offers Stress Relief Massage,Healing Massage for Depression and Anxiety.

Nicola is a practicing licensed and insured professional LMT ( Licensed Massage Therapist) ( State Certification # 7239 ) and artist based in Goleta and Santa Barbara, CA. Nicola has a wide range of female and male clients from athletes, artists, UCSB, SBCC, Brooks students and faculty,  business people, educators, construction workers, elderly clients, house wives and tourists. He is very flexible in scheduling appointments either at his studio which is located in the Goleta, Ca area now.  He can also make professional appointments at Holistic Centers in Santa Barbara, Buellton, Key2Fitness or can make home or out call or mobile massage visits in the Tri – Counties area. He also works with other local area professional massage therapists and can offer couples massages and can schedule male and female therapists to come to your home for a amazing couple’s massage. Maybe you own a business with a large group of people or have a large party of people.  Nicola can organize as many therapists as you need to accommodate your specific needs.

Massage Therapy for Neck Pain, Chest Pain, Arm Pain, and Upper Back Pain

Perfect Spot No. 4, an area of common trigger points in the odd scalene muscle group in the neck

2,750 words, updated Mar 15th, 2015
Another great article by Paul Ingraham, Vancouver, Canadabio


illustrations by Paul Ingraham, Gary Lyons, Jim Smith, Elizabeth Boylan

Trigger points (TrPs), or muscle knots, are a common cause of stubborn and strange aches and pains, and yet they are under-diagnosed. The 13 Perfect Spots (jump to list below) are trigger points that are common and yet fairly easy to massage yourself — the most satisfying and useful places to apply pressure to muscle. For tough cases, see the advanced trigger points treatment guide.

 

Pain Location Problems Related Muscles
in the upper back (especially inner edge of the shoulder blade), neck, side of the face, upper chest, shoulder, arm, hand thoracic outlet syndrome, lump in the throat, hoarseness, TMJ syndrome the scalenes (anterior, middle, posterior)
“Big Red Books” Reference: Volume 1, Chapter 20
see chart of all spots below

Deep within the Anatomical Bermuda Triangle, a region on the side of the neck, is the cantankerous scalene muscle group. Massage therapists have vanished while working in this mysterious area, never to be seen again. The region and its muscles are complex and peculiar, and many less-trained massage therapists have low confidence working with them. This article explains how the scalene muscles are involved in several common pain problems in the neck, chest, arm, and upper back, and how to treat pain in these areas by massaging the scalenes. The scalenes are a difficult muscle group to work with, but rewarding!

The scalenes are a strange muscle group

The scalenes are often involved in common neck pain and headaches, but that’s just the tip of the iceberg. Seriously, this is a weird area: the scalenes often harbour TrPs with more diverse and peculiar symptoms than any other muscle tissue in the body. The primary mechanism for this strangeness is the phenomenon of “referred pain.” Pain in the scalenes is often felt just about anywhere but the scalenes themselves. Instead of your scalenes, your arm or chest might hurt instead.1

Referred pain effects are par for the course with all muscle pain or any other internal pain — for instance, heart attacks are felt in the shoulder and arm — but the scalene muscles consistently produce unusually complex, variable, and extensive patterns of referred pain. The results can be a bit bizarre, causing symptoms that most people never guess are coming from the scalenes, even doctors and therapists.

ZOOM

[Diagram showing areas of pain referred from the scalene muscle group. This diagram shows the possible involvement of scalenes in chest pain, upper back pain, jaw pain, face pain, headache, arm pain and hand pain.]

Spreading pain

Just like the pain of a heart attack spreads from the heart into the shoulder and arm, the pain of painful scalene muscles spreads throughout the chest, upper back, and chest, the arm and hand, and the side of the head. Pain referred to the back may feel like a penetrating pain stabbing through the torso.

And scalene TrPs can also have several other “interesting” (in the sense of the Chinese curse2) effects: on your voice, on swallowing, on emotions, on sensations that sweep through the entire head, the sinuses, hearing, and teeth. I have found scalene TrPs to be obviously clinically relevant to conditions as seemingly unrelated as:

So scalene trigger points are “drama queens,” with symptoms and consequences that seem out of proportion to such small and obscure muscles. They are usually making at least some contribution to anything else that goes wrong in the whole region. Like a gang, scalene TrPs can be counted on to mess up the neighbourhood. The anterior scalene in particular is a trouble-maker, causing and complicating many other problems.

The anatomy of the Anatomical Bermuda Triangle

The scalenes fan out from the sides of the neck bones to attach to the ribs.4 The scalene group consists of three muscles: the anterior, middle, and posterior scalenes. They generally attach to the sides of the neck vertebrae at the top and to the uppermost ribs at the bottom. So the scalenes are mostly head pullers: they pull the head from side to side. And although they certainly do move the neck, they are also breathing muscles, because of the way they pull up on the ribs.

And here’s some more weirdness that makes this muscle group quite interesting: in some people the scalene muscles even reach down between the ribs and attach directly to the top of the lungs, In some people the scalene muscles even reach down between the ribs and attach directly to the top of the lungs. the only muscles that attach directly to the lungs other than the diaphragm. They pull up on the membrane that surrounds the lungs. A strange muscle group indeed! Such anatomical variability is actually fairly common throughout our bodies.5

The scalenes as a group are not hard to find, but they are intricate in their details. The scalenes fill the space between three obvious structures: your collarbone, your trapezius muscle on top of your shoulder, and the long V-shaped throat muscles (sternocleidomastoid or, if that’s too much of a mouthful, just the SCM). These three structures form the (Bermuda!) triangle in which the scalenes live.

Where is Perfect Spot No. 4 and the scalene muscle group?

Perfect Spot 4 is “somewhere in the triangle.” There is indeed one particular spot, in the belly of the middle scalene, that I believe to be the most common clinically significant trigger point — the spot most likely to feel important to the patient — but I don’t want to throw you off with that and send you on a wild goose chase trying to locate exactly that spot. Virtually any location within the triangle could prove to be a nemesis, so you should definitely explore. Things change, too: Perfect Spot 4 might be in one corner of the triangle one day, and in another corner the next. Precise self-treatment isn’t necessary — a willingness to gently experiment is.

The best way to approach this area as a therapist is from above the head, with your partner face up. Without a massage table, it works well to place his or her head in the corner of a bed. Sitting at the corner, hold your fingers flat and place the pads of your fingertips in the hollow of the triangle: above the collarbone, in front of the massive trapezius muscle along the top of the shoulder, and to the outsides of the prominent V-shaped sternocleidomastoid muscles of the throat.

In this position, your hands will be angled inward a bit, and roughly pointing at the sternum. Now press down and perhaps a little inwards with a fairly broad pressure — finger pads, not finger tips — on the ropy muscles that fill the triangle. By using a broad pressure, you can easily stimulate some TrPs and stiff muscle without having to worry about being too accurate.

Explore in the triangle with your fingertips, using small circles to find the ropy bands of muscles, gently strumming across them. The area is a rich minefield of trigger points, any of which might be worthwhile and interesting.

How should scalene massage feel?

Massage feels better on some muscles than others.6 The scalenes are not really pleasurable to massage, in general. The throat is a vulnerable body part, so many people feel threatened by pressure here — beware of underestimating it,7 and all the more so if you aren’t confident that massage is safe, or if you don’t understand the strange sensations that are so common in this area. That vulnerability seems to translate into sensitivity, so even a gentle approach may feel a bit hot, nasty, and dodgy at first — not really the kind of trigger point you want to mess around with for fun.

Wow, sign me up! Sounds great, doesn’t it? But it’s not all bad news.

Some people enjoy scalene massage right out of the box, and others can come to appreciate it after a period of “working through” and getting used to the uglier sensations. But the best case scenario is when you are actually solving a problem: if your scalenes are in distress and causing a chronic pain problem, then it’s going to feel more like you’re finding the right place to scratch an itch that you couldn’t reach before.

Maximize your chances of a positive experience by moving slowly and respectfully, and massaging the scalenes with broader, less “poky” pressure. Such pressure is more likely to produce the best case scenario: a peculiar deep ache spreading into the head, chest, back, and/or arm. At its best, scalene massage feels challenging but “profound.” The spectacular referral patterns make the scalenes feel important, the key to the region. No muscle produces more amazed comments. As an entire limb “lights up” with referred pain from a light pressure in the neck, many people will say something like, “Holy $%!@$#$!, what the hell is that?” As an entire limb “lights up” with referred pain from a light pressure in the neck, many people will say something like, “Holy $%!@$#$!, what the hell is that?” This is generally true of all referred pain, and it’s equally true of all the Perfect Spots, but “some trigger points are more equal than others.” The scalenes may be awkward and uncomfortable to massage at first, but this Perfect Spot can be very impressive in the end.

So be prepared for anything, and take it easy.

Although you might have to “work through” a little unpleasant sensation to get to the better sensations, this doesn’t mean “no pain, no gain” — do not be brutal in this area. Patients need a little time to adjust and “accept” the stimulation in this area. Persist respectfully, and there is a fair to middling chance that the sensation will change from hot to warm, from sharper to achier. It might make the transition in five minutes, or it might take a few days of sweet-talking the area. But there is a reasonable limit to how much you should try. If the effort doesn’t start to develop a bright side after a reasonable amount of time, then this Perfect Spot isn’t so perfect, and you should let it go.

The respiration connection (theoretical but plausible)

Many common aches and pains, particularly around the head, neck and shoulders, may be caused in part by inefficient breathing. It’s just a theory, but the connection between dysfunctional breathing and pain is straightforward in principle: if the diaphragm doesn’t do its job well, muscles in the upper chest (pectoralis minor) and throat (sternocleidomastoid and scalenes) try to take over. Unfortunately, these muscles just aren’t built for routine respiration, and they can exhaust themselves to the point of irritation and injury. A cascade of consequences may result, from garden variety stiffness to seemingly unlikely and severe consequences such as rotator cuff injuries, whiplash and thoracic outlet syndrome — a constellation of painful upper body conditions.

And the strange, cranky scalenes are the most likely muscles to cause symptoms in this scenario.

For more information, see The Respiration Connection.

The connection

If it exists, the connection between dysfunctional breathing and pain is straightforward in principle: if the diaphragm doesn’t do its job well, muscles in the upper chest (pectoralis minor) and throat (sternocleidomastoid and scalenes) try to take over. Unfortunately, these muscles aren’t built for routine respiration, and they exhaust and eventually injure themselves. A cascade of potential consequences results.

Anything that makes breathing more difficult could easily provoke over-use of the scalenes. There are many possibilities, but probably the most common and preventable is smoking — which is also risk-factor for chronic pain independently,8 so it’s a double whammy. This is pure speculation, but smokers could not only have more trigger points in their accessory respiratory muscles, but nastier ones, more painful and persistent.

A surprising relationship between the scalenes and tennis elbow

This tennis elbow connection is a good example of how odd and clinically relevant the scalenes can be to conditions they don’t seem to have anything to do with at first.

The scalene muscle group has surprising importance to a condition called “tennis elbow” or lateral epicondylitis, which commonly afflicts typists as well as racquet sports players. It is generally characterized as an inflammatory condition, but it is rarely that simple.9 It is likely that myofascial TrPs, particularly Perfect Spot No. 5 in the muscles of the forearm, play a significant role in any case of tennis elbow.

And Perfect Spot No. 4 seems, in turn, to significantly affect Perfect Spot No. 5. Travell and Simons write, “Scalene muscle trigger points are frequently the key to [treatment of] forearm extensor digitorum trigger points.” That is, trigger points on the back of the forearm.10 So an interesting benefit to treating Perfect Spot No. 4 is that it may be a key to treating Perfect Spot No. 5!

Appendix A: Is trigger point therapy too good to be true?

Trigger point therapy isn’t too good to be true: it’s just ordinary good. It can probably relieve some pain cheaply and safely in many cases. Good bang for buck, and little risk. In the world of pain treatments, that’s a good mix.

But pain is difficult and complex, no treatment is perfect, and there is legitimate controversy about the science of trigger points. Their nature remains somewhat puzzling, and the classic image of a tightly “contracted patch” of muscle tissue may well be wrong. What we do know is that people hurt, and it can often be helped.

The Perfect Spots are based on a decade of my own clinical experience as a massage therapist, and years of extensive science journalism on the topic.

Appendix B: Quick Reference Guide to the Perfect Spots

1Perfect Spot No. 1 — Massage Therapy for Tension Headaches

Under the back of the skull must be the single most pleasing and popular target for massage in the human body. No other patch of muscle gets such rave reviews. It has everything: deeply relaxing and satisfying sensations, and a dramatic therapeutic relevance to one of the most common of all human pains, the common tension headache. And no wonder: without these muscles, your head would fall off. They feel just as important as they are. Read more 

for pain: almost anywhere in the head, face and neck, but especially the side of the head, behind the ear, the temples and forehead related to: headache, neck pain, migraine muscle(s): suboccipital muscles (recti capitis posteriores major and minor, obliqui inferior and superior)

2Perfect Spot No. 2 — Massage Therapy for Low Back Pain

This Perfect Spot lives in the “thoracolumbar corner,” a nook between your lowest rib and your spine — right where the stability of the rib cage gives way to the relative instability of the lumbar spine. Muscle tends to bunch up around this joint between the last of the thoracic vertebrae and the first of the lumbar. The sweet spot consists of trigger points in the upper-central corner of the quadratus (square) lumborum muscle and in the thick column of muscle that braces the spine. Read more 

for pain: anywhere in the low back, tailbone, lower buttock, abdomen, groin, side of the hip related to: low back pain, herniated disc muscle(s): quadratus lumborum, erector spinae

3Perfect Spot No. 3 — Massage Therapy for Shin Splints

Perfect Spot No. 3 is in your shins — seemingly an unlikely place for muscle knots! But there is meat there, and if you’ve ever had shin splints then you know just how vulnerable that meat can be. Even if you’ve never suffered so painfully, your shins probably still suffer in silence — latent trigger points in the upper third of the shin that don’t cause symptoms, but are plenty sensitive if you press on them. Read more 

for pain: in the shin, top of the foot, and the big toe related to: shin splints, drop foot, anterior compartment syndrome, medial tibial stress syndrome muscle(s): tibialis anterior

4Perfect Spot No. 4 — Massage Therapy for Neck Pain, Chest Pain, Arm Pain, and Upper Back Pain

Deep within the Anatomical Bermuda Triangle, a triangular region on the side of the neck, is the cantankerous scalene muscle group. Massage therapists have vanished while working in this mysterious area, never to be seen again. The region and its muscles are complex and peculiar, and many lesser-trained massage therapists have low confidence working with them. Read more (this page!)

for pain: in the upper back (especially inner edge of the shoulder blade), neck, side of the face, upper chest, shoulder, arm, hand related to: thoracic outlet syndrome, lump in the throat, hoarseness, TMJ syndrome muscle(s): the scalenes (anterior, middle, posterior)

5Perfect Spot No. 5 — Massage Therapy for Tennis Elbow and Wrist Pain

Just beyond your elbow, all the muscles on the back of your forearm converge into a single thick tendon, the common extensor tendon. At the point where the muscles converge, in the muscles that extend the wrist and fingers, lies one of the most inevitable myofascial TrPs in modern civilization: Perfect Spot No. 5. It is constantly and greatly aggravated both by computer usage today and by the use of a pen in simpler times — and by the occasional tennis match, then and now. Read more 

for pain: in the elbow, arm, wrist, and hand related to: carpal tunnel syndrome, tennis elbow (lateral epicondylitis), golfer’s elbow (medial epicondylitis), thoracic outlet syndrome, and several more muscle(s): extensor muscles of the forearm, mobile wad (brachioradialis, extensor carpi radialis longus and brevis), extensor digitorum, extensor carpi ulnaris

6Perfect Spot No. 6 — Massage Therapy for Back Pain, Hip Pain, and Sciatica

When you have back pain, buttock pain, hip pain, or leg pain, much or even all of your trouble may well be caused by trigger points in the obscure gluteus medius and minimus muscles, a pair of pizza-slice shaped muscles a little forward of your hip pocket. Other muscles in the region are usually involved as well, such as the gluteus maximus, piriformis, and the lumbar paraspinal muscles. However, the gluteus medius and minimus are a bit special: their contribution to pain in this area is particularly significant, and yet people who have buttock and leg pain rarely suspect that much of it is coming from muscle knots so high and far out on the side of the hip. Read more 

for pain: in the low back, hip, buttocks (especially immediately under the buttocks), side of the thigh, hamstrings related to: sciatica, trochanteric bursitis, low back pain muscle(s): gluteus medius and minimus

7Perfect Spot No. 7 — Massage Therapy for Bruxism, Jaw Clenching, and TMJ Syndrome

Your masseter muscle is your primary chewing muscle — not the only one, but the main one — and it covers the sides of the jaw just behind the cheeks. It’s also the main muscle that clenches your jaw and grinds your teeth, unfortunately, and it’s one of the most common locations for trigger points in the entire human body. It is probably an accomplice in most cases of bruxism (that’s Latin for “grinding your teeth”) and temporomandibular joint syndrome (a painful condition of the jaw joint), plus other unexplained painful problems in the area. Read more 

for pain: in the side of the face, jaw, teeth (rarely) related to: bruxism, headache, jaw clenching, TMJ syndrome, toothache, tinnitus muscle(s): masseter

8Perfect Spot No. 8 — Massage Therapy for Your Quads

A lot of quadriceps aching, stiffness and fatigue emanates from an epicentre of “knotted” muscle in the lower third of the thigh, in the vastus lateralis, a huge muscle — one of your biggest — that dominates the lateral part of the leg. Stretching it is effectively impossible, but massage is an option: although often shockingly sensitive, Perfect Spot No. 8 can also be quite satisfying. It also often complicates or contributes to other problems in the area, especially runner’s knee (iliotibial band syndrome). Read more 

for pain: in the lower half of the thigh, knee related to: iliotibial band syndrome, patellofemoral pain syndrome muscle(s): quadriceps (vastus lateralis, vastus lateralis, vastus medialis, rectus femoris)

9Perfect Spot No. 9 — Massage Therapy for Your Pectorals

The “pecs” are popular muscles. Of the 700+ muscles in the human body, the pectoralis major is one of the dozen or so that most people can name and point to. It also harbours one of the most commonly-encountered and significant — yet little known — trigger points in the human body, and can produce pain much like a heart attack in both quality and intensity. Read more 

for pain: anywhere in the chest, upper arm related to: “heart attack,” respiratory dysfunction muscle(s): pectoralis major

10Perfect Spot No. 10 — Massage Therapy for Tired Feet (and Plantar Fasciitis!)

The tenth of the Perfect Spots is one of the most popular of the lot, and right under your feet — literally. It lies in the center of the arch muscles of the foot. This is one of the Perfect Spots that everyone knows about. No massage is complete without a foot massage! Read more 

for pain: in the bottom of the foot related to: plantar fasciitis muscle(s): arch muscles

11Perfect Spot No. 11 — Massage Therapy for Upper Back Pain

This “spot” is too large to really be called a “spot” — it’s more of an area. The thick columns of muscle beside the spine are routinely littered with muscle knots from top to bottom. Nevertheless, there is one section of the group where massage is particularly appreciated: from the thick muscle at the base of the neck, down through the region between the shoulder blades, tapering off around their lower tips. There is no doubt that this part of a back massage feels even better than the rest — even the low back, despite its own quite perfect spots, cannot compete. Read more 

for pain: anywhere in the upper back, mainly between the shoulder blades related to: scoliosis muscle(s): erector spinae muscle group

12Perfect Spot No. 12 — Massage Therapy for Low Back Pain (So Low That It’s Not In the Back)

At the top of the gluteal muscles lies a Perfect Spot among Perfect Spots: a sneaky but trouble-making brute of a TrP that commonly forms in the roots of the gluteus maximus muscle, just below the pit of the low back, but experienced as low back pain. This is the kind of spot that the Perfect Spots concept is really all about — not only does it tend to produce a profound and sweet ache when massaged, but the extent of the pain that spreads out around it is almost always a surprise. Read more 

for pain: in the lower back, buttocks, hip, hamstrings related to: low back pain, sciatica, sacroiliac joint dysfunction muscle(s): gluteus maximus

13Perfect Spot No. 13 — Massage Therapy for Low Back Pain (Again)

Some of the Perfect Spots are perfect because they are “surprising” — they aren’t where you thought they’d be, and it’s delightful to discover the real source of pain. Others are perfect because they are exactly where you expect them to be — and what a relief it is to be able to treat them. Perfect Spot No. 13 is perhaps the ultimate, the quintessential “right where I thought it was” trigger point: right at the very bottom of the thick columns of muscle, in the “pit” of the low back. Read more 

for pain: in the low back, buttocks, hamstrings related to: low back pain, sciatica, sacroiliac joint dysfunction muscle(s): erector spinae muscle group at L5

14Perfect Spot No. 14 — Massage Therapy for Shoulder Pain

I avoided adding Spot 14 to this series for many years, because it’s a little tricky to find. But precision is not required: although there is one specific spot that’s especially good, nearly anywhere just under the ridge of bone on the shoulder blade is worthwhile, and often a surprising key to pain and stiffness everywhere else in the shoulder… but especially all the way around on the other side, facing forward. Read more 

for pain: any part of the shoulder, and upper arm related to: frozen shoulder, supraspinatus tendinitis muscle(s): infraspinatus, teres minor

Notes

  1. This is because our nervous systems generally struggle to isolate where pain is coming from when it’s deeper than the skin. A pinprick on the skin we can locate precisely, but the location of muscle pain often feels out of focus — we just don’t have the neurological “wiring” to get a clear signal. The net effect is sensory confusion. And the confusion seems to be greater with the scalenes than with other muscles. BACK TO TEXT
  2. “May you live in interesting times” is one part of a three-part curse that is supposedly “ancient Chinese,” but is probably actually English or American in origin. According to Wikipedia, “The Chinese language origin of the phrase, if it exists, has not been found, making its authenticity doubtful.” The other two parts of the curse are the less famous “may you come to the attention of those in authority” and “may you find what you are looking for.” BACK TO TEXT
  3. Finkenbine et al. Globus hystericus: a brief review. Gen Hosp Psychiatry. 2004. PubMed #14757307. BACK TO TEXT
  4. Yes, you heard me right: ribs! You actually have ribs above your collarbones. Most people don’t realize that. The rib cage and lungs are quite “tall,” and this area is the very top of your rib cage. In rare cases, people even have a small extra rib at the top, one vertebrae higher than normal. BACK TO TEXT
  5. PS Ingraham. You Might Just Be Weird: The clinical significance of normal — and not so normal — anatomical variations. PainScience.com. 2138 words. BACK TO TEXT
  6. PS Ingraham. An Open and Closed Case: An explanation for a strange duality of muscle sensation observed in massage therapy. PainScience.com. 2038 words. BACK TO TEXT
  7. The fear of throat touch can be severe, even phobic, with or without any obvious cause. But an obvious cause is that some victims of assault are choked, which may make massage in this area completely off-limits. An old friend and massage colleague of mine was extremely uncomfortable with throat massage. Despite making this clear, an instructor in our massage therapy college publicly attempted to “joke” about this during a massage demonstration, and touched my friend’s throat. She actually smacked his hands away and yelled at him, which he richly deserved. This was an extreme breach of ethics and professionalism on the part of the instructor, and a sad example of the poor quality of some massage training — we spent far too many hours learning massage therapy from that guy. BACK TO TEXT
  8. PS Ingraham. Smoking and Pain: The role of smoking in chronic pain. PainScience.com. 662 words. BACK TO TEXT
  9. Boyer et al. Lateral tennis elbow: “Is there any science out there?”. Journal of Shoulder And Elbow Surgery. 1999. “The term epicondylitis suggests an inflammatory cause; however, in all but 1 publication examining pathologic specimens of patients operated on for this condition, no evidence of acute or chronic inflammation is found.” This surprising lack of inflammation is actually typical of supposedly inflamed tendinitises. For much more information about that, see Repetitive Strain Injuries Tutorial: Five surprising and important facts about repetitive strain injuries like carpal tunnel syndrome, tendinitis, or iliotibial band syndrome. BACK TO TEXT
  10. Travell et al. Myofascial Pain and Dysfunction. 1999. Volume 1, p513. BACK TO TEXT

 

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader.

Sciatica Pain Therapeutic Relief Santa Barbara Goleta Massage, Trigger Point, Riktr Pro Deep Tissue Massage, Nicola, LMT, 805-637-7482

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Any of the modalities or bodywork listed below can help Neck Pain, Headaches, Migraines, Shoulder & Arm Pain, Carpal Tunnel Relief, Upper Back, Low Back Spasms, Sciatica, Torso Pain, Hip, Thigh, Hamstring and Calf Injuries, Leg, Knee, Achilles and Foot Pain, Chronic Pain, Stress Relief, Myofascial Pain and Dysfunction, Therapeutic Pain Relief, Psoas and Illpsoas Pain, Scalenes Pain, Trapezius Pain, OM / Orthopedic Massage Relief, Lymphatic Drainage and any other muscle injuries, strains, pulls and related injuries for pain relief and stress relief.

❶Nicola’s Modalities offered:  Deep Tissue Massage,  Barefoot Deep Tissue Massage, Ashiatsu, ShiatsuCompression Massage, Sports and Injury Massage, Therapeutic Massage, Orthopedic Massage  (OM)  Myofascial Release, Trigger Point MassageNeuromuscular ReleaseSwedish Massage, Relaxing Massage, Reflexology Massage, Chair Massage, Lymphatic Drainage and some Asian bodywork in the Goleta and Santa Barbara, Ca  area’s. He also offers Stress Relief Massage,Healing Massage for Depression and Anxiety.

Nicola is a practicing licensed and insured professional LMT ( Licensed Massage Therapist) ( State Certification # 7239 ) and artist based in Goleta and Santa Barbara, CA. Nicola has a wide range of female and male clients from athletes, artists, UCSB, SBCC, Brooks students and faculty,  business people, educators, construction workers, elderly clients, house wives and tourists. He is very flexible in scheduling appointments either at his studio which is located in the Goleta, Ca area now.  He can also make professional appointments at Holistic Centers in Santa Barbara, Buellton, Key2Fitness or can make home or out call or mobile massage visits in the Tri – Counties area. He also works with other local area professional massage therapists and can offer couples massages and can schedule male and female therapists to come to your home for a amazing couple’s massage. Maybe you own a business with a large group of people or have a large party of people.  Nicola can organize as many therapists as you need to accommodate your specific needs.

Massage Therapy for Back Pain, Hip Pain and Sciatica

Perfect Spot No. 6, an area of common trigger points in the gluteus medius and minimus muscles of the hip

1,100 words, updated 2012
Another great article by Paul Ingraham, Vancouver, Canadabio


illustrations by Paul Ingraham, Lindsay McGee

 

Trigger points (TrPs), or muscle knots, are a common cause of stubborn and strange aches and pains, and yet they are under-diagnosed. The 13 Perfect Spots (jump to list below) are trigger points that are common and yet fairly easy to massage yourself — the most satisfying and useful places to apply pressure to muscle. For tough cases, see the advanced trigger points treatment guide.

 

Pain Location Problems Related Muscles
in the low back, hip, buttocks (especially immediately under the buttocks), side of the thigh, hamstrings sciatica, trochanteric bursitis, low back pain gluteus medius and minimus
“Big Red Books” Reference: Volume 2, Chapters 8 & 9
see chart of all spots below

When you have back pain, buttock pain, hip pain, or leg pain, much or even all of your trouble may well be caused by trigger points in the obscure gluteus medius and minimus muscles, a pair of pizza-slice shaped muscles a little forward of your hip pocket. Other muscles in the region are usually involved as well, such as the gluteus maximus, piriformis, and the lumbar paraspinal muscles. However, the gluteus medius and minimus are a bit special: their contribution to pain in this area is particularly significant, and yet people who have buttock and leg pain rarely suspect that much of it might be radiating from muscle knots so high and far out on the side of the hip.

The leg pain that they produce can be so nasty that health professionals mistake it for sciatica,1 a compression of the large sciatic nerve that passes through the buttocks and into the leg. Don’t be fooled. Sciatica is often an incorrect diagnosis for pain in this area.

One trigger point therapy treatment completely relieved a nasty stubborn hip pain that I’d had for five months!

What does Perfect Spot No. 6 feel like?

Even without nasty symptoms, pressure on these muscles can still feel important, as they usual harbour TrPs that aren’t obvious until they are poked (known as “latent” trigger points), but which are routinely responsible for stiffness, “heavy”-ness, vague discomfort, and aching throughout the hip and buttocks and descending into the leg. Their importance is often unsuspected because the key gluteus medius and minimus TrPs actually live way out on the side of the hip, but the discomfort they produce spreads inwards and downwards. Known as “referred pain,” this is the same phenomenon as the pain of a heart attack spreading into the shoulder and arm. In particular, it’s common for this referred pain to be strongest right under the butt cheek, which is why it is so often mistaken for sciatica.

Given their stealthy nature, massaging these muscles can really feel like a surprising and satisfying discovery of the true source of stiffness you did (or didn’t) know that you had — perfect characteristics for a Perfect Spot!

The deltoid of the butt: anatomy and function of the lateral gluteal muscles

The gluteus medius and minimus together are “the deltoid of the butt.” Just as the deltoid muscle lifts the arm out to the side, these lateral glutes lift the leg. They are small cousins of the more famous gluteus maximus, the big muscle that gives shape to the buttocks (and the home of very nearby Perfect Spot No. 12). Medius and minimus are very much a pair — almost one muscle in two parts — so I’m going to stop saying “medius and minimus” every time. They have a nearly identical shape, location, and function, both acting as lateral stabilizers, preventing the hips from swinging too far from side to side as you walk and balance. You can activate them easily just by standing on one leg and lifting the other out to the side several times. When you start to feel a burn on the sides of your hips, you are feeling your lateral glutes.

ZOOM

The deltoid of the butt

The gluteus minimus and medius muscles are shaped like slices of pizza. (The minimus is hidden here: it is the same shape as the medius, but smaller and lying directly under it.) Perfect Spot No. 6 is usually found halfway down the lateral edge, right on the side of the hip, in the meaty area between the ridge of the pelvis and the big bone on the side of the hip (greater trochanter). But rather than being “soft,” the edge of the gluteus medius is usually quite rigid — almost as hard as the bones above and below!

These muscles really have evolved for all-terrain activity. A life lived mostly on the flat and stable surfaces of a city offers little challenge to them, so they are weak and easily exhausted by weekend skiing trips, a walk on the soft sand of a beach, or really anything that requires more balancing than usual. The combination of chronic mild weakness with erratic stressful challenges may be the reason they tend to get polluted with TrPs. (But that’s just an educated guess. It’s generally impossible to know exactly why individual TrPs come and go.)

Both the medius and minimus are shaped just like a wide slice of pizza; the points converge downwards on the bony projection on the side of your hip, the greater trochanter at the top of the femur. Their “crust” follows the iliac crest, a bony ridge at the top of the pelvis that defines the waist. The medius completely covers the minimus, and the maximus covers most of the medius — but you can still easily reach these muscles simply by pressing into the soft tissue just below the waist at the side and back.

Where exactly is this perfect trigger point?

As with most of the spots, Perfect Spot No. 6 is not so much a single specific trigger point as a small area where you are likely to find a significant trigger point — if not several of them. This area is on the side of the hip behind it. Or, to use the pizza as a guide, it is roughly the forward half of the slice, and especially in the half near the tip of the slice. Start at the greater trochanter and explore up and back from there: all over the side of the hip, right where the seam of your pants would be.

Self-massage tools that are particularly useful in this location

Trigger points in this area are easy enough to find, but not particularly easy to massage on your own body. It is a spot that cries out for a massage tool, more so than many other areas: something to trap between your hip and the floor. Tennis ball massage is always a great option for this, of course — and most people already have one around — but there are some other excellent choices as well.

The KONG® dog toy is an amazingly good self-massage tool!

The KONG® dog toy is an amazingly good self-massage tool!

For instance, a KONG® dog toy is a surprisingly useful (and quirky) self-treatment tool; its unusual wedge shape allows you to roll the side of your hip onto it, the pressure increasing as you roll further. This is a difficult (and slightly absurd) process to describe, so all I can do is encourage you to take my word for it and experiment — your dog may get jealous, though.

Balls and other “pointy” tools are often too intense for the sensitive trigger points in the gluteus medius and minimus muscles. Tubes and rollers fit more naturally into the space between the bones on the side of the hip: you can settle your weight onto them and roll back and forth quite cozily. There are countless foam rollers available — but don’t spend too much, because there are plenty of cheaper and even free improvised options (e.g. pool noodles!). With a foam roller, it’s easier to just settle your weight onto the roller.

Foam rollers work well on the side of the hip.

For a super firm roller, I particularly like the spinal rollers handmade by Allan Saltzman, creator of YogaTools.com — Relieve Tension, Stiffness, and Physical Distortions with Yoga Tools. His spinal rollers are just extremely hard tubes padded with a dense, rubbery foam: simple but very handy, and very sturdy.

Spinal rollers by Allan Saltzman

Allan Saltzman’s simple but sturdy “spinal rollers,” built for the spine but recommended here for the side of the hip. Available at YogaTools.com.

Last but not least, for the best in a pokier self-massage, I recommend The Knobble, a massage tool classic from Pressure Positive.

ZOOM

The Knobble

The Knobble is the best possible tool for applying a focussed pressure to a specific spot on the side of the hip. This is the best tool for the long term, once you know where to aim it, and have worked your way up to tolerating stronger pressures.

  1. Bewyer et al. Rationale for treatment of hip abductor pain syndrome. Iowa Orthop J. 2003. PubMed #14575251.

    Patients with lower back or buttock pain that radiates into the posterior or lateral leg are often referred to physical therapy with a diagnosis of sciatica. Often the physical exam does not reveal neurologic findings indicative of radiculopathy. Instead, there is hip abductor muscle pain and weakness. This syndrome involves muscle imbalances that result in overuse strain of the gluteus medius and gluteus minimus muscles, myofascial trigger points, and trochanteric bursitis. This paper describes hip abductor pain syndrome and provides a rationale for the diagnosis and treatment.

    BACK TO TEXT

Appendix A: Is trigger point therapy too good to be true?

Trigger point therapy isn’t too good to be true: it’s just ordinary good. It can probably relieve some pain cheaply and safely in many cases. Good bang for buck, and little risk. In the world of pain treatments, that’s a good mix.

But pain is difficult and complex, no treatment is perfect, and there is legitimate controversy about the science of trigger points. Their nature remains somewhat puzzling, and the classic image of a tightly “contracted patch” of muscle tissue may well be wrong. What we do know is that people hurt, and it can often be helped.

The Perfect Spots are based on a decade of my own clinical experience as a massage therapist, and years of extensive science journalism on the topic. Want to know more? This is the tip of the iceberg. I’ve written a whole book about it …

Appendix B: Quick Reference Guide to the Perfect Spots

1Perfect Spot No. 1 — Massage Therapy for Tension Headaches

Under the back of the skull must be the single most pleasing and popular target for massage in the human body. No other patch of muscle gets such rave reviews. It has everything: deeply relaxing and satisfying sensations, and a dramatic therapeutic relevance to one of the most common of all human pains, the common tension headache. And no wonder: without these muscles, your head would fall off. They feel just as important as they are. Read more 

for pain: almost anywhere in the head, face and neck, but especially the side of the head, behind the ear, the temples and forehead related to: headache, neck pain, migraine muscle(s): suboccipital muscles (recti capitis posteriores major and minor, obliqui inferior and superior)

2Perfect Spot No. 2 — Massage Therapy for Low Back Pain

This Perfect Spot lives in the “thoracolumbar corner,” a nook between your lowest rib and your spine — right where the stability of the rib cage gives way to the relative instability of the lumbar spine. Muscle tends to bunch up around this joint between the last of the thoracic vertebrae and the first of the lumbar. The sweet spot consists of trigger points in the upper-central corner of the quadratus (square) lumborum muscle and in the thick column of muscle that braces the spine. Read more 

for pain: anywhere in the low back, tailbone, lower buttock, abdomen, groin, side of the hip related to: low back pain, herniated disc muscle(s): quadratus lumborum, erector spinae

3Perfect Spot No. 3 — Massage Therapy for Shin Splints

Perfect Spot No. 3 is in your shins — seemingly an unlikely place for muscle knots! But there is meat there, and if you’ve ever had shin splints then you know just how vulnerable that meat can be. Even if you’ve never suffered so painfully, your shins probably still suffer in silence — latent trigger points in the upper third of the shin that don’t cause symptoms, but are plenty sensitive if you press on them. Read more 

for pain: in the shin, top of the foot, and the big toe related to: shin splints, drop foot, anterior compartment syndrome, medial tibial stress syndrome muscle(s): tibialis anterior

4Perfect Spot No. 4 — Massage Therapy for Neck Pain, Chest Pain, Arm Pain, and Upper Back Pain

Deep within the Anatomical Bermuda Triangle, a triangular region on the side of the neck, is the cantankerous scalene muscle group. Massage therapists have vanished while working in this mysterious area, never to be seen again. The region and its muscles are complex and peculiar, and many lesser-trained massage therapists have low confidence working with them. Read more 

for pain: in the upper back (especially inner edge of the shoulder blade), neck, side of the face, upper chest, shoulder, arm, hand related to: thoracic outlet syndrome, lump in the throat, hoarseness, TMJ syndrome muscle(s): the scalenes (anterior, middle, posterior)

5Perfect Spot No. 5 — Massage Therapy for Tennis Elbow and Wrist Pain

Just beyond your elbow, all the muscles on the back of your forearm converge into a single thick tendon, the common extensor tendon. At the point where the muscles converge, in the muscles that extend the wrist and fingers, lies one of the most inevitable myofascial TrPs in modern civilization: Perfect Spot No. 5. It is constantly and greatly aggravated both by computer usage today and by the use of a pen in simpler times — and by the occasional tennis match, then and now. Read more 

for pain: in the elbow, arm, wrist, and hand related to: carpal tunnel syndrome, tennis elbow (lateral epicondylitis), golfer’s elbow (medial epicondylitis), thoracic outlet syndrome, and several more muscle(s): extensor muscles of the forearm, mobile wad (brachioradialis, extensor carpi radialis longus and brevis), extensor digitorum, extensor carpi ulnaris

6Perfect Spot No. 6 — Massage Therapy for Back Pain, Hip Pain, and Sciatica

When you have back pain, buttock pain, hip pain, or leg pain, much or even all of your trouble may well be caused by trigger points in the obscure gluteus medius and minimus muscles, a pair of pizza-slice shaped muscles a little forward of your hip pocket. Other muscles in the region are usually involved as well, such as the gluteus maximus, piriformis, and the lumbar paraspinal muscles. However, the gluteus medius and minimus are a bit special: their contribution to pain in this area is particularly significant, and yet people who have buttock and leg pain rarely suspect that much of it is coming from muscle knots so high and far out on the side of the hip. Read more (this page!)

for pain: in the low back, hip, buttocks (especially immediately under the buttocks), side of the thigh, hamstrings related to: sciatica, trochanteric bursitis, low back pain muscle(s): gluteus medius and minimus

7Perfect Spot No. 7 — Massage Therapy for Bruxism, Jaw Clenching, and TMJ Syndrome

Your masseter muscle is your primary chewing muscle — not the only one, but the main one — and it covers the sides of the jaw just behind the cheeks. It’s also the main muscle that clenches your jaw and grinds your teeth, unfortunately, and it’s one of the most common locations for trigger points in the entire human body. It is probably an accomplice in most cases of bruxism (that’s Latin for “grinding your teeth”) and temporomandibular joint syndrome (a painful condition of the jaw joint), plus other unexplained painful problems in the area. Read more 

for pain: in the side of the face, jaw, teeth (rarely) related to: bruxism, headache, jaw clenching, TMJ syndrome, toothache, tinnitus muscle(s): masseter

8Perfect Spot No. 8 — Massage Therapy for Your Quads

A lot of quadriceps aching, stiffness and fatigue emanates from an epicentre of “knotted” muscle in the lower third of the thigh, in the vastus lateralis, a huge muscle — one of your biggest — that dominates the lateral part of the leg. Stretching it is effectively impossible, but massage is an option: although often shockingly sensitive, Perfect Spot No. 8 can also be quite satisfying. It also often complicates or contributes to other problems in the area, especially runner’s knee (iliotibial band syndrome). Read more 

for pain: in the lower half of the thigh, knee related to: iliotibial band syndrome, patellofemoral pain syndrome muscle(s): quadriceps (vastus lateralis, vastus lateralis, vastus medialis, rectus femoris)

9Perfect Spot No. 9 — Massage Therapy for Your Pectorals

The “pecs” are popular muscles. Of the 700+ muscles in the human body, the pectoralis major is one of the dozen or so that most people can name and point to. It also harbours one of the most commonly-encountered and significant — yet little known — trigger points in the human body, and can produce pain much like a heart attack in both quality and intensity. Read more 

for pain: anywhere in the chest, upper arm related to: “heart attack,” respiratory dysfunction muscle(s): pectoralis major

10Perfect Spot No. 10 — Massage Therapy for Tired Feet (and Plantar Fasciitis!)

The tenth of the Perfect Spots is one of the most popular of the lot, and right under your feet — literally. It lies in the center of the arch muscles of the foot. This is one of the Perfect Spots that everyone knows about. No massage is complete without a foot massage! Read more 

for pain: in the bottom of the foot related to: plantar fasciitis muscle(s): arch muscles

11Perfect Spot No. 11 — Massage Therapy for Upper Back Pain

This “spot” is too large to really be called a “spot” — it’s more of an area. The thick columns of muscle beside the spine are routinely littered with muscle knots from top to bottom. Nevertheless, there is one section of the group where massage is particularly appreciated: from the thick muscle at the base of the neck, down through the region between the shoulder blades, tapering off around their lower tips. There is no doubt that this part of a back massage feels even better than the rest — even the low back, despite its own quite perfect spots, cannot compete. Read more 

for pain: anywhere in the upper back, mainly between the shoulder blades related to: scoliosis muscle(s): erector spinae muscle group

12Perfect Spot No. 12 — Massage Therapy for Low Back Pain (So Low That It’s Not In the Back)

At the top of the gluteal muscles lies a Perfect Spot among Perfect Spots: a sneaky but trouble-making brute of a TrP that commonly forms in the roots of the gluteus maximus muscle, just below the pit of the low back, but experienced as low back pain. This is the kind of spot that the Perfect Spots concept is really all about — not only does it tend to produce a profound and sweet ache when massaged, but the extent of the pain that spreads out around it is almost always a surprise. Read more 

for pain: in the lower back, buttocks, hip, hamstrings related to: low back pain, sciatica, sacroiliac joint dysfunction muscle(s): gluteus maximus

13Perfect Spot No. 13 — Massage Therapy for Low Back Pain (Again)

Some of the Perfect Spots are perfect because they are “surprising” — they aren’t where you thought they’d be, and it’s delightful to discover the real source of pain. Others are perfect because they are exactly where you expect them to be — and what a relief it is to be able to treat them. Perfect Spot No. 13 is perhaps the ultimate, the quintessential “right where I thought it was” trigger point: right at the very bottom of the thick columns of muscle, in the “pit” of the low back. Read more 

for pain: in the low back, buttocks, hamstrings related to: low back pain, sciatica, sacroiliac joint dysfunction muscle(s): erector spinae muscle group at L5

14Perfect Spot No. 14 — Massage Therapy for Shoulder Pain

I avoided adding Spot 14 to this series for many years, because it’s a little tricky to find. But precision is not required: although there is one specific spot that’s especially good, nearly anywhere just under the ridge of bone on the shoulder blade is worthwhile, and often a surprising key to pain and stiffness everywhere else in the shoulder… but especially all the way around on the other side, facing forward. Read more 

for pain: any part of the shoulder, and upper arm related to: frozen shoulder, supraspinatus tendinitis muscle(s): infraspinatus, teres minor

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader.

Massage for Low Back Spasms, Pain Relief Santa Barbara Goleta Massage, Trigger Point, Riktr Pro Deep Tissue Massage, Nicola, LMT, 805-637-7482

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“To become more conscious is the greatest gift anyone can give to the world; moreover, in a ripple effect, the gift comes back to its source.”— Dr. David Hawkins …my teacher.

Intro. On-Line Only In-Call Special 1 1/4 hr $50.00 (1st time client’s) Mon – Fri

plus  offering senior and  veteran  in-call discounts with id.   Policies

Please call for an Appointment: 805-637-7482   Please no texts

 

Save Time and Download 1st Visit Intake Form HERE

 

 

Any of the modalities or bodywork listed below can help Neck Pain, Headaches, Migraines, Shoulder & Arm Pain, Carpal Tunnel Relief, Upper Back, Low Back Spasms, Sciatica, Torso Pain, Hip, Thigh, Hamstring and Calf Injuries, Leg, Knee, Achilles and Foot Pain, Chronic Pain, Stress Relief, Myofascial Pain and Dysfunction, Therapeutic Pain Relief, Psoas and Illpsoas Pain, Scalenes Pain, Trapezius Pain, OM / Orthopedic Massage Relief, Lymphatic Drainage and any other muscle injuries, strains, pulls and related injuries for pain relief and stress relief.

❶Nicola’s Modalities offered:  Deep Tissue Massage,  Barefoot Deep Tissue Massage, Ashiatsu, ShiatsuCompression Massage, Sports and Injury Massage, Therapeutic Massage, Orthopedic Massage  (OM)  Myofascial Release, Trigger Point MassageNeuromuscular ReleaseSwedish Massage, Relaxing Massage, Reflexology Massage, Chair Massage, Lymphatic Drainage and some Asian bodywork in the Goleta and Santa Barbara, Ca  area’s. He also offers Stress Relief Massage,Healing Massage for Depression and Anxiety.

Nicola is a practicing licensed and insured professional LMT ( Licensed Massage Therapist) ( State Certification # 7239 ) and artist based in Goleta and Santa Barbara, CA. Nicola has a wide range of female and male clients from athletes, artists, UCSB, SBCC, Brooks students and faculty,  business people, educators, construction workers, elderly clients, house wives and tourists. He is very flexible in scheduling appointments either at his studio which is located in the Goleta, Ca area now.  He can also make professional appointments at Holistic Centers in Santa Barbara, Buellton, Key2Fitness or can make home or out call or mobile massage visits in the Tri – Counties area. He also works with other local area professional massage therapists and can offer couples massages and can schedule male and female therapists to come to your home for a amazing couple’s massage. Maybe you own a business with a large group of people or have a large party of people.  Nicola can organize as many therapists as you need to accommodate your specific needs.

 

Study: Massage Helps Treat Low Back Pain

Researchers Say Massage Provides Pain Relief and Improves Daily Functioning
By Brenda Goodman, MA
WebMD Health News
Reviewed by Louise Chang, MD

July 5, 2011 — Massage may be serious medicine, at least when it comes to treating persistent low back pain, a new study shows.

Low back pain is one of the top reasons people seek medical attention in the U.S., and it is notoriously tough to treat. Studies show very few medical therapies, from medications to injections to surgeries, reliably relieve it, and some can aggravate the problem.

The new study randomly assigned 400 adults with moderate-to-severe low back pain lasting for at least three months to either weekly whole-body massages for relaxation, weekly massages that focused on specific muscle problems around the lower back and hips, or usual care.

People assigned to the usual care group were tracked by researchers, but they dealt with their back problems on their own. The approach could include, for instance, taking pain medications or muscle relaxants, seeing doctors or chiropractors, physical therapy, or simply not doing anything.

After 10 weeks, participants in both massage groups reported greater average improvements in pain and functioning compared to those in the usual care group. And the type of massage they received didn’t seem to matter.

That’s good news, researchers say, because relaxation, or Swedish-style, massage is the kind most commonly taught in massage schools and is thus widely available.

For most, the improvements seen with massage were modest.

Daily functioning, for example, improved, on average, between 2 to 4 points on a 23-point scale. Average pain improved about 2 points on a 10-point scale.

Experts say that’s a bit better than the degree of benefit that most people see from taking over-the-counter nonsteroidal anti-inflammatory drugs (NSAIDs), like ibuprofen, for low back pain.

But for a substantial minority, however, the improvements were much greater.

At the end of the 10-week intervention, 36% and 39% of patients in the massage groups said their pain was nearly or completely gone, compared to 4% in the usual care group.

“It’s not really harmful, and it does help a significant chunk of people who have not benefited from other treatments,” says study researcher Daniel C. Cherkin, PhD, associate director and senior scientific investigator with the Center for Health Studies at Group Health Cooperative in Seattle.

The study was funded by the National Center for Complementary and Alternative Medicine. It’s published in the Annals of Internal Medicine.

“I think this trial is good news in the sense that it suggests that massage is a useful option that helps some substantial fraction of these patients,” says study researcher Richard A. Deyo, MD, a professor in the department of family medicine at Oregon Health and Science University in Portland.

“Like in most other treatments, this is not a slam dunk, and it’s not like a cure,” Deyo tells WebMD, “But it’s something that seems to offer a significant benefit for a substantial number of patients.”

Modest, Short-Term Help

Experts who were not involved in the study agree.

Roger Chou, MD, an associate professor of medicine at Oregon Health and Science University, helped to write the 2009 American Pain Society guidelines for treating low back pain.

He says massage was recommended in those clinical practice guidelines, though the authors noted that the recommendation was based on a small number of studies and the benefits were likely to be modest.

“I think the study is quite consistent with what we have in our guideline, and it adds to the evidence that’s out there,” Chou says. “It strengthens the case to consider massage as one of the potential treatment options for chronic low back pain.”

But Chou, and others, including the study’s researchers, say exercise is likely to offer far greater benefits than massage for people who’ve been struggling with back pain for a long time, and they stress that people shouldn’t assume that massage alone will banish low back pain for good.

“Certainly, it’s not going to hurt,” says Fredrick P. Wilson, DO, director of the Cleveland Clinic Solon Center for Spine Health, in Ohio.

“But it’s a short-term improvement, and it’s certainly not a fix,” says Wilson, who reviewed the study for WebMD but was not involved in the research.

Wilson says he would have liked to have seen more objective measures of function included in the study, like spinal range of motion assessed by investigators, rather than just relying on self-reports from study participants.

But he says that on the whole, there’s little harm to be had with massage, and some evidence of help. So it might be worth a try, but he says it should be coupled with exercise.

“When we see patients, we push them toward active exercise rather than passive natural therapy kind of a thing. If they can have stronger core strength to support their spine, they’re going to be better off in the long run. So we’re trying to fix, rather than ease, their pain,” Wilson says.

Stubborn Low Back Pain

Studies estimate that as many as 80% of adults will experience an episode of low back pain in their lifetimes.

In most cases, the pain will go away without any treatment in two to four weeks. About 14% of the time, however, low back pain lingers, sometimes without a readily identified cause.

Relatively few medical interventions have been proven to reliably help back pain, and it is considered to be one of the most overtreated ailments in American medicine.

“Over the last 15 years or so, there’s been a steady increase in the use surgery, prescribing of opioids, in the use of injections in the use of spine imaging,” Deyo says, “and overall, population-wide, it doesn’t seem to have helped very much in reducing the impact of back problems.”

That’s why it’s especially promising to find benefit in a noninvasive therapy like massage, he says.

The study found that the 10 treatments received by study participants would have cost about $540 in the community. Massage isn’t typically covered by insurance.

The benefits appeared to persist for four months after the course of treatment was completed.

“I think it’s true that wherever we can find alternatives that seem to be helpful, it’s likely to be a useful thing for clinicians,” Deyo says.

Researchers recruited adults, mostly women, ages 20 to 65 who had visited the doctor at least once for their low back pain.

People were not included in the study if their back pain could be attributed to a specific cause like fractures, cancer or spinal stenosis, if they’d had surgery for their back problems in the last three years, or if they had an underlying medical condition like fibromyalgia or rheumatoid arthritis that would complicate pain treatment.

Study participants were randomly assigned to receive either Swedish massages for relaxation or a more targeted kind of “structural” massage that focused on specific muscle and connective tissue problems that might affect the low back.

“The treatment will go into the gluteal muscles and up in to the neck, but it’s not a fully body massage and it tends to be focused with the goal of treating the effected tissues,” says Cherkin. “A full-body relaxation massage is more or less full-body and it doesn’t focus on the back. It’s intended to maximize relaxation.”

A third group was told they were participating in a trial of massage therapy, but they were assigned to usual care.

Massage therapists all had at least five years of experience, and some had additional, specialized training to provide the focused, structural massage technique.

Study participants received their massages for free. People in the usual care group were paid $50 for their participation.

All study participants were followed for one year.

Before and after the 10 weekly massages, participants completed questionnaires that assessed pain and physical functioning. They were asked, for example, how easy or hard it was for them to get up from a chair or to tie their shoes.

Before getting the massage therapy, about half of study participants in each group reported taking daily medication to treat their low back pain. NSAIDs were most commonly used, followed by analgesics and sedatives. Across all groups, average scores of physical functioning were around 10 on a scale from 0 to 23. Average scores of pain were around 6 on a scale from 0 to 10.

After having 10 weeks of massage, participants in the structural massage group had average scores of 6.5 for physical functioning and 3.8 for pain. Those who got relaxation massages had average scores of 6 for physical functioning and 3.5 for pain. Those in the usual care group scored 9 for physical functioning and 5.2 for pain.

The massage groups improved in other important ways, too. After 10 weeks, they were less likely to report using medication for their low back pain than those in the usual care group. They also reported fewer days in bed and fewer days of lost work or school than those who got usual care.

The study had limitations, the researchers say, particularly that people who got usual care knew they were missing out on massages received by other participants. That might have led them to exaggerate the symptoms they reported to researchers, making massage seem more effective than it really was.

And they said because low back pain often returns after the first episode, it would probably be wise for people who use massage in conjunction with exercise.

But often, Deyo points out, low back pain hurts so much that it’s hard to move, and being inactive, studies show, can make back pain worse. Massage, he thinks, may help to break the pain-inactivity cycle.

“In some ways, this may be a way of helping patients to improve, giving them confidence that they can get some control over the problem and maybe help to ease the transition into a more active type of therapy,” Deyo says.

“I don’t see massage as the final solution,” he says, “I see it as maybe a helpful step toward getting people more active.”

 

*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider.
Please consult your healthcare provider with any questions or concerns you may have regarding your condition.
The information provided is for educational purposes only and is not intended as diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader.

In Memory Memoriam Tribute to John Steven Harris LMT in Santa Barbara 1945-2015, Obituaries…we all love you and will miss you.

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John was my friend and a great bodywork teacher. I met John at BTI. He taught his classes with a sense of humor and was very knowable with a teaching style that was very clear and concise. John was one of the best teachers that I have ever had. He treated all his student equally and I always looked forward to going to his classes. John had x-ray bodywork vision. I remember being in class with him and he was sitting way across the other side of the classroom. We were doing student massage practicing what he had just taught us. Sitting down he say’s “Nicola put a little more pressure to the left” and I thought to myself that this guy has x-ray vision.  I will always remember him and try my best to live up to his bodywork standards and help keep his bodywork legacy at BTI . We all love you John at BTI and will miss you dearly.

 

John Steven Harris 

1942 – 2015

 

Adventurer, traveler and smarter than the president, John Steven Harris aka “Harry” passed with his irreverent sense of humor, incredibly open heart, and wordplay intact to the very end. Kind to the poor and mean to the rich, John’s clever, urbane and wicked acerbic wit brought him and his hundreds of friends immense joy, as he was always his authentic, truth teller self, never apologetic and fiercely loyal. In that spirit, prior to his passing, John requested that anyone who cherished him do something kind for somebody they normally wouldn’t do something kind for.

Ahead of his time, John was a somatic educator on approaches to physical and emotional pain and has been an ally in the healing process of thousands of people. As a child his favorite outfit was his bb gun and cowboy hat, and not surprisingly, he was thrown out of University numerous times before graduating. Fluent in Spanish, John traveled extensively in South America, was once shot at and was almost kidnapped in Morocco. All fodder for future storytelling.

Throughout his storied career, John was a PR professional at a law school; taught countless students chronic myofascial pain relief in workshops around the planet and locally at Body Therapy Institute; was a massage therapist at the ’84 Olympics; created a technique for barefoot sports massage and co-authored a book called “Fix Pain.”

He is survived by his better brother, a.k.a “the good son”; three natural children who he felt were better looking than he, but not as smart; a faux-da; two ex-wives; his formerly alive dachshunds Hildagard and Heidi and his sparkling sense of humor.

published in the SB independent-here's the link

http://www.independent.com/obituaries/2015/mar/24/john-harris/

 

Trigger Point Therapy

An Interview with Instructor John Harris

Sunday, April 17, 2011

Upper Back Pain Relief Santa Barbara Goleta Massage, Trigger Point, Riktr Pro Deep Tissue Massage, Nicola, LMT, 805-637-7482

“It is only the illusion of individuality that is the origin of all suffering.”— Dr. David Hawkins, The Eye of the I, p. 297

Intro. On-Line Only In-Call Special 1 1/4 hr $50.00 (1st time client’s) Mon – Fri

plus  offering senior and  veteran  in-call discounts with id.   Policies

Please call for an Appointment: 805-637-7482   Please no texts

 

Save Time and Download 1st Visit Intake Form HERE

 

 

Any of the modalities listed below can help Neck Pain, Headaches, Migraines, Shoulder & Arm Pain, Carpal Tunnel Relief, Upper Back, Low Back Spasms, Sciatica, Torso Pain, Hip, Thigh, Hamstring and Calf Injuries, Leg, Knee, Achilles and Foot Pain, Chronic Pain, Stress Relief, Myofascial Pain and Dysfunction, Therapeutic Pain Relief, Psoas and Illpsoas Pain, Scalenes Pain, Trapezius Pain, OM/ Orthopedic Massage Relief and any other muscle injuries or strains or pulls and related injuries for pain relief.

❶Nicola offers  Deep Tissue Massage,  Barefoot Deep Tissue Massage, Ashiatsu, ShiatsuCompression Massage, Sports and Injury Massage, Therapeutic Massage, Orthopedic Massage  (OM)  Myofascial Release, Trigger Point MassageNeuromuscular ReleaseSwedish Massage, Relaxing Massage, Reflexology Massage, Chair Massage, Lymphatic Drainage and some Asian bodywork in the Goleta and Santa Barbara, Ca  area’s. He also offers Healing Massage for Depression and Anxiety.

Nicola is a practicing licensed and insured professional LMT ( Licensed Massage Therapist) ( State Certification # 7239 ) and artist based in Goleta and Santa Barbara, CA. Nicola has a wide range of female and male clients from athletes, artists, UCSB, SBCC, Brooks students and faculty,  business people, educators, construction workers, elderly clients, house wives and tourists. He is very flexible in scheduling appointments either at his studio which is located in the Goleta, Ca area now.  He can also make professional appointments at Holistic Centers in Santa Barbara, Buellton, Key2Fitness or can make home or out call or mobile massage visits in the Tri – Counties area. He also works with other local area professional massage therapists and can offer couples massages and can schedule male and female therapists to come to your home for a amazing couple’s massage. Maybe you own a business with a large group of people or have a large party of people.  Nicola can organize as many therapists as you need to accommodate your specific needs.

 

Massage Therapy for Upper Back Pain

Perfect Area No. 11, the erector spinae muscle group of the upper back

1,000 words, published 2005, updated 2012
Another great artical by Paul Ingraham, Vancouver, Canadabio

Trigger points (TrPs), or muscle knots, are a common cause of stubborn and strange aches and pains, and yet they are under-diagnosed. The 13 Perfect Spots (jump to list below) are trigger points that are common and yet fairly easy to massage yourself — the most satisfying and useful places to apply pressure to muscle. For tough cases, see the advanced trigger points treatment guide.

 

Pain Location Problems Related Muscles
anywhere in the upper back, mainly between the shoulder blades scoliosis erector spinae muscle group
“Big Red Books” Reference: Volume 1, Chapters 18 & 27
see chart of all spots below

This “spot” is too large to really be called a “spot” — it’s more of an area. The thick columns of muscle beside the spine are routinely littered with muscle knots from top to bottom. Nevertheless, there is one section of the group where massage is particularly appreciated: from the thick muscle at the base of the neck, down through the region between the shoulder blades, tapering off around their lower tips. There is no doubt that this part of a back massage feels even better than the rest — even the low back, despite its own quite perfect spots, cannot compete. Area No. 11 belongs in this series even though it is not, strictly speaking, a single spot.

Why is Area no. 11 perfect?

Many people suffer from what I call “brick back” — that is, their upper back feels like a brick, specifically between the shoulder blades. It is dense, rigid, and sometimes seemingly impervious to pressure, as though the spine is held so tightly by the muscles that it has been fused.

This condition is the work of the erector spinae muscle group. The erector spinae are the thick columns of muscle on either side of your spine. They often feel ropy and hard, and are a natural target for massage. Trigger points in the erector spinae are numerous, like a string full of knots, and they can be loud complainers. Unlike many of the other Perfect Spots, which are unfamiliar, people are often well aware that they have knots in the upper back: their only question is, “How do I get rid of them?” Even people who do not have obviously painful trigger points in this area will usually find that massage here feels especially good.

There is no definite, satisfying explanation for why these muscles accumulate so many nasty active and latent trigger points. Along with the shoulders, lower back, and hips, they just seem to be a favourite spot for stress and anxiety to express itself.

Evolution doesn’t care if we’re comfortable, as long as we survive.

The cause may also be structural. Most people think that the spine is a marvel of biological engineering, and so it is — but it is engineered by natural selection for quadrupeds, not bipeds. We have the same basic spinal anatomy as every other vertebrate on Earth, but we are the only ones using it in an upright position on a daily basis. Bipedality has advantages that are so valuable that we’ve evolved that way even though it may be painful. Evolution doesn’t care if we’re comfortable, as long as we survive.

And, of course, stress and evolution aside, the upper back and shoulders both often suffer from common activities such as sitting, slouching and computer work!

How do you find Area No. 11?

Finding this area is easy, because it’s big and the landmarks are obvious. Start by finding the spine. Now move just to one side of the spine. There is a groove here between the spine and the bulky column of the erector spinae.

You will find sensitive knots at the bottom of the groove, on the inner edges of the erector spinae, and on top of them. This is true for the entire back, but the most useful area ranges from the base of the neck to about two thirds of the way down between the shoulder blades.

Like any of the other Perfect Spots, you can find a knot and press on it until the tension eases. However, because there are so many knots in these muscles, a couple of other approaches produce even more satisfying results.

The first is called “stripping,” in which you lubricate the skin and slide slowly and strongly along the length of the groove, using a thumb, fingertips, the heel of your hand, knuckles, or even an elbow. The amount of pressure you use depends completely on the person you are massaging. Keep it manageable! This technique will treat many trigger points instead of just one: more bang for your buck.

The erector spinae are often quite ropy, and sometimes feel surprisingly like guitar strings.

Another way of treating several trigger points at once is called “strumming” or “frictions.” (Not the same idea as friction massage, but the same movement.) The erector spinae are often quite ropy, and sometimes feel surprisingly like guitar strings. Especially when this is the case, you can create a delicious sensation of release by rubbing back and forth (side to side) across the fibres with your fingertips. This does not require lubrication, as the skin moves with the fingers.

For the best results from strumming, carefully feel around in the groove between the spine and the bulkiest column of the erector spinae for a single clearly identifiable “string” of muscle. You may need to press quite firmly to do so. You can use the same technique quite broadly and lightly across the entire group, but it doesn’t feel nearly as dramatic as deep strumming of individual strands.

How does Area no. 11 feel?

Heavenly! In my experience, strumming in the very uppermost part of the back is one of the most vivid sensations in all of massage. However, this combines both a location and a specific technique — which doesn’t affect everyone the same way. At its best, though, the sensation is deeply penetrating and people often speak of feeling it “in my chest.”

Nowhere is the idea of “good pain” or a “sweet ache” more obvious than it is here. While many trigger point releases have a satisfying quality, these muscles produce the gold standard of good pain by which all other good pains are judged. Only excessive pressure on the most unhappy backs will feel sharp or burning. Most people will experience a deep, spreading, warming ache.

While many trigger point releases have a satisfying quality, these muscles are the gold standard by which all others are judged.

These muscles also often produce extravagant referred sensations. A wide variety are possible. Most commonly, feelings of (good) pain or pressure will spread down and outwards. The shoulders often respond, as do the chest and throat. With several trigger points being released at once, some people sometimes report a widespread feeling of being pleasantly paralyzed throughout the entire torso! The sensation may be “breathtaking,” which can be alarming if it’s too strong, or wonderful if the pressure is tolerable.

Although the arch of the foot (Spot No. 10) may be the nicest single spot for massage in the body, it is just a mere spot, and far from the core. By contrast, the summed effect of all the trigger points in this area is so potent and useful that I always request treatment for it every time I see a massage therapist myself.

Appendix A: Is trigger point therapy too good to be true?

Trigger point therapy isn’t too good to be true: it’s just ordinary good. It can probably relieve some pain cheaply and safely in many cases. Good bang for buck, and little risk. In the world of pain treatments, that’s a good mix.

But pain is difficult and complex, no treatment is perfect, and there is legitimate controversy about the science of trigger points. Their nature remains somewhat puzzling, and the classic image of a tightly “contracted patch” of muscle tissue may well be wrong. What we do know is that people hurt, and it can often be helped.

The Perfect Spots are based on a decade of my own clinical experience as a massage therapist, and years of extensive science journalism on the topic. Want to know more? This is the tip of the iceberg. I’ve written a whole book about it …

Appendix B: Quick Reference Guide to the Perfect Spots

1Perfect Spot No. 1 — Massage Therapy for Tension Headaches

Under the back of the skull must be the single most pleasing and popular target for massage in the human body. No other patch of muscle gets such rave reviews. It has everything: deeply relaxing and satisfying sensations, and a dramatic therapeutic relevance to one of the most common of all human pains, the common tension headache. And no wonder: without these muscles, your head would fall off. They feel just as important as they are. Read more 

for pain: almost anywhere in the head, face and neck, but especially the side of the head, behind the ear, the temples and forehead related to: headache, neck pain, migraine muscle(s): suboccipital muscles (recti capitis posteriores major and minor, obliqui inferior and superior)

2Perfect Spot No. 2 — Massage Therapy for Low Back Pain

This Perfect Spot lives in the “thoracolumbar corner,” a nook between your lowest rib and your spine — right where the stability of the rib cage gives way to the relative instability of the lumbar spine. Muscle tends to bunch up around this joint between the last of the thoracic vertebrae and the first of the lumbar. The sweet spot consists of trigger points in the upper-central corner of the quadratus (square) lumborum muscle and in the thick column of muscle that braces the spine. Read more 

for pain: anywhere in the low back, tailbone, lower buttock, abdomen, groin, side of the hip related to: low back pain, herniated disc muscle(s): quadratus lumborum, erector spinae

3Perfect Spot No. 3 — Massage Therapy for Shin Splints

Perfect Spot No. 3 is in your shins — seemingly an unlikely place for muscle knots! But there is meat there, and if you’ve ever had shin splints then you know just how vulnerable that meat can be. Even if you’ve never suffered so painfully, your shins probably still suffer in silence — latent trigger points in the upper third of the shin that don’t cause symptoms, but are plenty sensitive if you press on them. Read more 

for pain: in the shin, top of the foot, and the big toe related to: shin splints, drop foot, anterior compartment syndrome, medial tibial stress syndrome muscle(s): tibialis anterior

4Perfect Spot No. 4 — Massage Therapy for Neck Pain, Chest Pain, Arm Pain, and Upper Back Pain

Deep within the Anatomical Bermuda Triangle, a triangular region on the side of the neck, is the cantankerous scalene muscle group. Massage therapists have vanished while working in this mysterious area, never to be seen again. The region and its muscles are complex and peculiar, and many lesser-trained massage therapists have low confidence working with them. Read more 

for pain: in the upper back (especially inner edge of the shoulder blade), neck, side of the face, upper chest, shoulder, arm, hand related to: thoracic outlet syndrome, lump in the throat, hoarseness, TMJ syndrome muscle(s): the scalenes (anterior, middle, posterior)

5Perfect Spot No. 5 — Massage Therapy for Tennis Elbow and Wrist Pain

Just beyond your elbow, all the muscles on the back of your forearm converge into a single thick tendon, the common extensor tendon. At the point where the muscles converge, in the muscles that extend the wrist and fingers, lies one of the most inevitable myofascial TrPs in modern civilization: Perfect Spot No. 5. It is constantly and greatly aggravated both by computer usage today and by the use of a pen in simpler times — and by the occasional tennis match, then and now. Read more 

for pain: in the elbow, arm, wrist, and hand related to: carpal tunnel syndrome, tennis elbow (lateral epicondylitis), golfer’s elbow (medial epicondylitis), thoracic outlet syndrome, and several more muscle(s): extensor muscles of the forearm, mobile wad (brachioradialis, extensor carpi radialis longus and brevis), extensor digitorum, extensor carpi ulnaris

6Perfect Spot No. 6 — Massage Therapy for Back Pain, Hip Pain, and Sciatica

When you have back pain, buttock pain, hip pain, or leg pain, much or even all of your trouble may well be caused by trigger points in the obscure gluteus medius and minimus muscles, a pair of pizza-slice shaped muscles a little forward of your hip pocket. Other muscles in the region are usually involved as well, such as the gluteus maximus, piriformis, and the lumbar paraspinal muscles. However, the gluteus medius and minimus are a bit special: their contribution to pain in this area is particularly significant, and yet people who have buttock and leg pain rarely suspect that much of it is coming from muscle knots so high and far out on the side of the hip. Read more 

for pain: in the low back, hip, buttocks (especially immediately under the buttocks), side of the thigh, hamstrings related to: sciatica, trochanteric bursitis, low back pain muscle(s): gluteus medius and minimus

7Perfect Spot No. 7 — Massage Therapy for Bruxism, Jaw Clenching, and TMJ Syndrome

Your masseter muscle is your primary chewing muscle — not the only one, but the main one — and it covers the sides of the jaw just behind the cheeks. It’s also the main muscle that clenches your jaw and grinds your teeth, unfortunately, and it’s one of the most common locations for trigger points in the entire human body. It is probably an accomplice in most cases of bruxism (that’s Latin for “grinding your teeth”) and temporomandibular joint syndrome (a painful condition of the jaw joint), plus other unexplained painful problems in the area. Read more 

for pain: in the side of the face, jaw, teeth (rarely) related to: bruxism, headache, jaw clenching, TMJ syndrome, toothache, tinnitus muscle(s): masseter

8Perfect Spot No. 8 — Massage Therapy for Your Quads

A lot of quadriceps aching, stiffness and fatigue emanates from an epicentre of “knotted” muscle in the lower third of the thigh, in the vastus lateralis, a huge muscle — one of your biggest — that dominates the lateral part of the leg. Stretching it is effectively impossible, but massage is an option: although often shockingly sensitive, Perfect Spot No. 8 can also be quite satisfying. It also often complicates or contributes to other problems in the area, especially runner’s knee (iliotibial band syndrome). Read more 

for pain: in the lower half of the thigh, knee related to: iliotibial band syndrome, patellofemoral pain syndrome muscle(s): quadriceps (vastus lateralis, vastus lateralis, vastus medialis, rectus femoris)

9Perfect Spot No. 9 — Massage Therapy for Your Pectorals

The “pecs” are popular muscles. Of the 700+ muscles in the human body, the pectoralis major is one of the dozen or so that most people can name and point to. It also harbours one of the most commonly-encountered and significant — yet little known — trigger points in the human body, and can produce pain much like a heart attack in both quality and intensity. Read more 

for pain: anywhere in the chest, upper arm related to: “heart attack,” respiratory dysfunction muscle(s): pectoralis major

10Perfect Spot No. 10 — Massage Therapy for Tired Feet (and Plantar Fasciitis!)

The tenth of the Perfect Spots is one of the most popular of the lot, and right under your feet — literally. It lies in the center of the arch muscles of the foot. This is one of the Perfect Spots that everyone knows about. No massage is complete without a foot massage! Read more 

for pain: in the bottom of the foot related to: plantar fasciitis muscle(s): arch muscles

11Perfect Spot No. 11 — Massage Therapy for Upper Back Pain

This “spot” is too large to really be called a “spot” — it’s more of an area. The thick columns of muscle beside the spine are routinely littered with muscle knots from top to bottom. Nevertheless, there is one section of the group where massage is particularly appreciated: from the thick muscle at the base of the neck, down through the region between the shoulder blades, tapering off around their lower tips. There is no doubt that this part of a back massage feels even better than the rest — even the low back, despite its own quite perfect spots, cannot compete. Read more (this page!)

for pain: anywhere in the upper back, mainly between the shoulder blades related to: scoliosis muscle(s): erector spinae muscle group

12Perfect Spot No. 12 — Massage Therapy for Low Back Pain (So Low That It’s Not In the Back)

At the top of the gluteal muscles lies a Perfect Spot among Perfect Spots: a sneaky but trouble-making brute of a TrP that commonly forms in the roots of the gluteus maximus muscle, just below the pit of the low back, but experienced as low back pain. This is the kind of spot that the Perfect Spots concept is really all about — not only does it tend to produce a profound and sweet ache when massaged, but the extent of the pain that spreads out around it is almost always a surprise. Read more 

for pain: in the lower back, buttocks, hip, hamstrings related to: low back pain, sciatica, sacroiliac joint dysfunction muscle(s): gluteus maximus

13Perfect Spot No. 13 — Massage Therapy for Low Back Pain (Again)

Some of the Perfect Spots are perfect because they are “surprising” — they aren’t where you thought they’d be, and it’s delightful to discover the real source of pain. Others are perfect because they are exactly where you expect them to be — and what a relief it is to be able to treat them. Perfect Spot No. 13 is perhaps the ultimate, the quintessential “right where I thought it was” trigger point: right at the very bottom of the thick columns of muscle, in the “pit” of the low back. Read more 

for pain: in the low back, buttocks, hamstrings related to: low back pain, sciatica, sacroiliac joint dysfunction muscle(s): erector spinae muscle group at L5

14Perfect Spot No. 14 — Massage Therapy for Shoulder Pain

I avoided adding Spot 14 to this series for many years, because it’s a little tricky to find. But precision is not required: although there is one specific spot that’s especially good, nearly anywhere just under the ridge of bone on the shoulder blade is worthwhile, and often a surprising key to pain and stiffness everywhere else in the shoulder… but especially all the way around on the other side, facing forward. Read more 

for pain: any part of the shoulder, and upper arm related to: frozen shoulder, supraspinatus tendinitis muscle(s): infraspinatus, teres minor