Here at Relaxing Massage London, we have experienced lots of questions when we just started running the business in London Bayswater area, and we’d like share our knowledge to others who love massage as well but have some doubts. We all have the same questions. Hopefully here you’ll find some answers.
Q I have a client with very, very tight hamstrings. She is a runner. I gave her some deep tissue massage few times but they are still tight. I have advised a lot of stretches, almost every day combined with heat therapy and rest (no running) I also advised her to use a tennis ball under the hamstring when sitting in order to relax the muscles. But they are still tight. What else can I do??
A Tight hamstrings often accompany a lordotic back. It may be that she is lordotic so they are trying to overcome this.
1) You could include stretches for the low back
2) Ask her to flatten her back whilst standing
3) Do pelvic tilts whilst standing.
To check whether the hamstrings are long and tight do a straight leg raise. Normal is 80°-90° . If she has this or greater then it suggests her hamstrings are long and tight.
Also, try MET to the opposing muscles, ie the quadriceps and hip flexors. Hamstrings must relax a little when quadriceps contract in this manner so that may help.
Q Can a prolapsed disc heal itself in 6 months?
A It usually heals itself but can take 6 months depending on the severity. In extreme cases they operate.
Q What is CPD?
A Continuing Professional Development (or CPD for short) is defined by The Health Professions Council as: “a range of learning activities through which health professionals maintain and develop throughout their career to ensure that they retain their capacity to practice safely, effectively and legally within their evolving scope of practice”. Once having qualified as a physical therapist – whether in massage, reflexology, sports massage, aromatherapy etc, you need to be able to show that you are keeping up-to date with current practises and reflecting on your personal practice in a structured way. Most qualified therapists belong one association or another, such as the FHT, CThA, APNT or IFA (to name but a few) As a member of an association you are required to complete a certain number of CPD points per year, ranging from 10-50 points depending on the association and as a rule, one CPD point is awarded per hour of study Under the proposed Voluntary Self-Regulation Schemes you will not be allowed to register unless you have completed your annual CPD. You can gain your CPD in a number of ways and your association will be able to give you their set of criteria but as a guide CPD can be categorised into:
a) Work-based learning – eg. reflective practise, mentoring another therapist
b) Professional activity – eg. writing an article for publication, joining a committee group
c) Formal/educational – eg. one-day workshops or seminars/conferences
d) Self-directed activities – eg. reading articles, seeing exhibitions related to your practise
Up to 50% of CPD points can be gained through work-based learning and self-directed activities. Evidence of your learning must be documented in a portfolio. To give you more ideas take a look at Jane’s article “50 Ideas for CPD” on our Resources page or check out of very own Free CPD page But always check with your association for what they expect you to achieve during the year.
Q A client was presenting with pain in the muscle of both lower legs (they thought it could be peroneus longus) when walking fast. Pain was worse running either on treadmill, grass or pavement. This person has been told by another professional that the sheath surrounding the muscle is tight and therefore making the muscle tight.
A It sounds like either shin splints (usually at the front of the leg) or chronic compartment syndrome (not acute compartment syndrome). Unusual in peroneals (now called fibularis longus by the way!). Ideas:
2) Ice for pain
3) Lots of stretching. STR better than MET but tricky on fibularis, I know.
4) Stripping to all calf muscles and STR to calf muscles.
5) Check trainers are well cushioned
6) To keep training he could try:
– swimming (with float between legs) using lots of arm movements combining breast stroke and front crawl and back crawl, for example.
– using a rebounder (one of those small trampolines)
– rowing or cycling but stop if leg pain continues. Walking up hill on treadmill is great exercise too but stop if pain in legs persists.
Q My client has carpal tunnel syndrome, is there anything I can do?
A Rest from using forearms. Use STR to all of upper limb included with holistic massage in attempt to decrease tension in the carpal tunnel.
Q I saw a client with very swollen knees – she’s had right knee pain for some number of years and it’s been diagnosed as “wear and tear”. The Clarks Sign test was positive. The medial side of both knees are v. swollen.
I think this might respond to Manual Lymphatic Drainage (MLD). Am I right? If so, do you only do MLD and no other massage? Or, do you do MLD and then massage? Also her right knee looks very slightly thinner than the left. Is this significant?
A Yes. Oedema from osteoarthritis can be treated with MLD.
You can do MLD as well as other types of massage providing they are suitable. MLD is slow, you work distal to proximal ie ankle, to knee, to hip, effluraging towards the heart.
1) Strapping can help support the knee temporarily providing it is not too swollen. A compression bandage also helps.
2) Non weight-bearing exercise is good such as swimming, cycling, rowing, providing this does not cause discomfort to the patellofemoral joint.
3) It suggests she is weight bearing more on one side than the other, common when one knee is more painful than the other.
Q Is tendonitis the same as muscle-tendon overuse? or muscle-tendon rupture?
How do you assess tendonitis? How do treat tendonitis?
A No, tendonitis is an inflammation of the muscle tendon. To assess:
You need to palpate for heat, swelling and tenderness.
You need to load the joint – the result will be positive
You can treat with general massage to the affect area including STR to reduce
adhesions and stretches . Recommend that your client REST. For example, for Supraspinatus Tendinosus refrain from abducting the arm.
Q Can I advise a client to stretch before their running event?
A For pre-event work, no static stretches for 2 hours beforehand. You want the muscle to retain it’s ‘explosive’ quality, therefore dynamic stretching is generally given.
Q Can I perform STR after the event as they suffer from very tight hamstrings after they run?
A For post-event STR you can apply gentle STR as there may be microtrauma and the athlete will be full of natural painkillers so may not feel the pain of a possible bruise/torn muscle..
Q I know that Muscle Energy Technique (MET) and Soft Tissue Release (STR) both stretch a muscle, but can you clarify the difference between the techniques for me?
A MET stretches the entire muscle.
STR stretches part of the muscle. If you happen to do STR on a trigger spot it acts like trigger point work..
Q Am I correct in saying that lactic acid is a toxin and that massage removes these toxins?
A Correct, lactic acid is a toxin, but there is no evidence that massage helps remove toxins.
Hope the FAQs above could help you out.
Enjoy better massage, enjoy live.