Exercise and Bodywork Keep Joint Pain at Bay

The word arthritis strikes fear in the hearts of older adults. It often signifies aging, pain, inactivity, and disability. However, new research shows moderate physical exercise can actually ease arthritis symptoms by decreasing pain and increasing a person’s likelihood of living a normal life.

Understanding Arthritis

The most common form of arthritis– osteoarthritis, or also known as degenerative arthritis–affects more than twenty million Americans. Osteoarthritis (literally meaning “bone-joint inflammation”) is caused by wear and tear on joint surfaces and most frequently involves the hips, knees, lower back, neck, and fingers. More than half of people over sixty-five have some evidence of osteoarthritis on X-rays, although it doesn’t always manifest as symptoms.

Many problems arise from a sedentary lifestyle. Joints lose flexibility and muscles lose strength, feeding the cycle of pain, inactivity, and more pain.

Exercise Offers Sweet Relief

Vigorous walking, swimming, and bicycling boost the release of powerful endorphins, the body’s natural painkillers. When done four to five days a week, these aerobic activities improve general cardiovascular health and aid in weight management (obesity is the single biggest risk factor for osteoarthritis).

Strengthening and stretching exercises targeted at maintaining joint flexibility and muscle strength–especially for at-risk joints–slow the progression of degenerative arthritis. Yoga classes and moderate weight lifting programs are excellent ways to improve strength and flexibility. Bodywork can also provide relief.

If arthritis is slowing you down, get serious with your exercise plan. Consult your physician, work with a professional trainer, physical therapist, yoga instructor, or bodyworker, and start a gentle, progressive exercise program. Your joints will reward you for it, and you’ll free yourself from arthritic pain.

by Hope Bentley

Getting rear-ended in traffic. Face-planting at the bottom of a ski slope. Tumbling over the handlebars on your bike. Whiplash comes in many forms and can become a long-term problem if not treated correctly. Fortunately, massage and bodywork can address the ache and discomfort that come with whiplash and prevent chronic pain down the road.

Understanding Whiplash

The term “whiplash” came into use in 1928. Doctors will sometimes use “hyperextension injury,” to describe it, but “whiplash” is a more visceral account of what has happened to the victim’s neck. The neck itself has made a whip-like motion bending first towards and then away from the point of impact. As the head moves rapidly in one direction, the muscles in the neck receive the message to contract. The momentum of the head can cause strain or sprain to the muscles and ligaments in the neck as the head reaches the end of its movement.

Car accidents are the most common causes of whiplash. The American Academy of Orthopedic Surgeons reported that about 20 percent of people who have been in rear-end collisions later report whiplash symptoms. Whether front to back or side to side, whiplash can affect muscles all the way into the victim’s back and arms. The most serious form of whiplash compresses nerves in the neck and cause multiple sprains of the ligaments.

The good news is, serious hyperextension injuries are in the minority, as whiplash usually comes in the less serious version of the injury. “Fortunately, about 95 percent of the time whiplash tends to be more superficial damage, like slight muscle strains and tears,” says Ben Benjamin, Ph.D., a massage therapist who holds a doctorate in education and sports medicine. But whether the pain is minor soreness or serious discomfort, massage can provide relief and prevent chronic problems in the long run.

Whiplash Symptoms

The symptoms of whiplash include neck pain and stiffness, headaches, pain in the shoulder or between the shoulder blades (sometimes called “coat hanger pain”), low back pain, and pain or numbness in the arms or extremities.

Often people who suffer whiplash do not feel the effects until two or three days after the injury-causing incident. Benjamin explains that this delayed onset is because it takes time for scar tissue to manifest in the sprained or strained muscles and ligaments. And because scar tissue is more adhesive than regular tissue, people experience it as stiffness in the injured areas.

Whiplash affects primarily the neck, but victims shouldn’t ignore the rest of the body. This injury can pull the long muscles on either side of the spine, which reach all the way to the tailbone and can cause discomfort along the way. Discomfort or stiffness in the chest and arms can also be due to whiplash. And headaches may be the result of slowed circulation to the head caused by the swelling in the injury.

Massage Can Help

Any massage that causes a general relaxation of the client’s muscles can help relieve muscular pain in common types of whiplash injuries. In addition, massage increases the amount of oxygen that reaches the healing tissues and opens those tissues so they can receive oxygen and nutrients, thus speeding the healing process.

In addition to relaxation massage, specific bodywork methods ease acute whiplash discomfort and help prevent chronic fallout. For example, myofascial approaches restore fluidity to the fascia–normally a slippery tissue that surrounds all the moving parts inside the body–allowing freer movement of muscles and ligaments. Friction-based massage helps break up scar tissue and relieve stiffness. Trigger point therapy works by releasing tension held in tight knots of muscle. And any type of bodywork that stimulates circulation helps ease and prevent headaches.

Finally, the incident that caused the whiplash in the first place, (a car wreck, for instance) can be traumatic. Massage helps relax a client’s psyche as well as their muscles, helping her or him work through the emotional issues induced by the accident.

Because the neck is such a delicate part of the body, it is important to proceed with caution. Benjamin advises waiting a few days after the accident to seek treatment. This allows the initial scar tissue to knit, which is an important part of the healing process. The initial treatment should be extremely gentle, and if there is a chance of a fracture, a concussion, any disc problem or other serious injury, the client should make sure to see a physician first.

Let the Healing Begin

It used to be that physicians would immobilize whiplash injuries with a cervical collar, but now health care professionals advise a more temperate course for their patients.

“I recommend gentle neck movement within your range of motion while lying on a pillow,” says Benjamin. Movement may help prolong the benefits of the massage by continuing to circulate blood, oxygen, and nutrients through the healing tissue. “Heat or cold, whichever feels better, can also help,” says Benjamin. “Soaking in a hot bath can also be beneficial.” Limiting physical activity for a few days and getting plenty of rest in the wake of a whiplash injury is also a good idea.

Whiplash is traumatic and should be addressed soon after the injury to avoid any chronic problems. If you or someone you love is suffering from the repercussions of whiplash, consider a bodywork session to ease the discomfort. Massage can help lessen muscle pain, induce relaxation, and ease the trauma often associated with whiplash. You’ll be back to your old self in no time.

by Cathy Ulrich

“Do you get headaches?” I asked Cindy. She had come to see me for massage to address her neck and shoulder pain but hadn’t mentioned headaches.

“Well, yes,” she said. “I’ve always had headaches and, now that you mention it, they seem to be worse when my neck hurts.” Cindy went on to say she suffered from them as often as 2-3 times a week and typically treated them with ibuprofen.

Like many Americans, Cindy suffers from chronic, frequent headaches. Her neck pain finally prompted her to seek help, but she was so used to the headaches, she thought they were something she simply had to live with. What Cindy didn’t understand was that frequent headaches are not normal and, with a little proactive planning, there is something that can be done to manage and even prevent them.

Types of Headaches

Headaches come in many varieties. Following is a short list of the most common types.

Migraines: Migraine headaches occur when the blood vessels in the brain become dilated, usually due to a chemical reaction, such as food allergies or a stress response. They often start with visual disturbances and quickly develop into severe head pain accompanied by nausea, vomiting, dizziness, and sensitivity to light. They’re usually felt on one side of the head, but can be on both sides. Migraines are often managed with medications and avoidance of foods known to trigger them, such as red wine, chocolate, aged cheese, and nuts. However, some bodywork techniques can also be effective in easing migraines or decreasing the frequency of these painful headaches.

Tension Headaches: Exaggerated by stress, tension headaches are related to poor posture, jaw problems (such as temporomandibular joint disorder, or TMJ), and neck pain. Many people describe a headache that starts at the base of the skull and then moves in an arc over the ears and behind the eyes. Tension headaches are most often caused or exacerbated by poor posture, work station positions, and body mechanics, creating undue stress on the upper neck muscles.

Mixed Headaches: The term mixed headache is used to describe a tension headache that leads to a migraine. Typically, the tension headache starts first and the chemicals produced from the pain of it create conditions for a migraine to develop. In people with patterns of mixed headaches, the best way to avoid the onset of a migraine is to treat the tension headache.

Bodywork Options

A treatment regimen that includes bodywork, attention to body position, and stress management can help prevent or greatly reduce the frequency of headaches, in turn reducing your reliance on medication and the need to avoid food triggers. There are many different bodywork techniques, each with specific approaches for treating headaches. Following is a short list of techniques often effective in treating recurring headaches.

Swedish Massage

A tension headache, by its very name, implies the presence of stress and tension. Swedish massage, on the other hand, promotes relaxation and relieves muscle tension. When muscles become tight due to stress or poor posture, they eventually adapt a chronically shortened state. Swedish massage teaches the body how to let go of muscle tension and resets muscle tone.

Integrative Bodywork

Rolfing, Hellerwork, Structural Integration, and CORE are examples of the types of bodywork designed to improve posture and structural alignment. A primary cause of chronic headaches is poor posture, which produces tension in the neck and shoulders because the weight of the head is not properly balanced on top of the spine. Integrative bodywork can produce lasting postural change for greater ease of movement. By selectively freeing the soft tissues, integrative bodywork literally can change postural alignment and remove the stresses and strains on the muscles that cause headaches.

Deep Tissue Therapies

The integrative therapies mentioned above, as well as neuromuscular therapy and myofascial release, use similar techniques to free connective tissue. A chronically tensed muscle tends to maintain that tension, even after the stressful event has passed. Deep tissue techniques free the connective tissue glue, creating a new way for the muscle to function.

Reflexology

Like acupuncture, reflexology works to move energy blockages in the body. By stimulating points on the feet that correspond to organs in the body, reflexologists can promote relaxation, reduce pain, and restore energy flow. Several scientific studies have shown that reflexology is a viable treatment for migraines, in some cases working as well as, or better than, medication–and without the side effects.

Craniosacral Therapy

Craniosacral therapy addresses the inherent, gentle, rhythmic movement of the bones in the skull and their effect on the fluid that surrounds, bathes, and cushions the brain and spinal cord and runs throughout the body. Cranial bones move in miniscule amounts as a response to the production and absorption of cranial fluid. With head trauma, whiplash injury, or even severe stress, cranial bone movement can be compromised, resulting in headaches, dizziness, ringing in the ears, or vision disturbances. This therapy restores the normal movement of the cranial bones and fluid.

By addressing the root of the problem, regularly scheduled bodywork sessions can greatly reduce headaches as well as your need for medication. Remember, headaches are not normal, and you don’t have to live with them.

by Art Riggs

Injuries such as chronic back pain, trick knees, and sticky shoulders are not necessarily something you just have to live with. Massage techniques might hold the key to unlocking this old pain.

Will Massage Help?

The benefits of massage will depend on the extent of the injury, how long ago it occurred, and on the skill of the therapist. Chronic and old injuries often require deeper and more precise treatments with less emphasis on general relaxation and working on the whole body.

Massage works best for soft tissue injuries to muscles and tendons and is most effective in releasing adhesions and lengthening muscles that have shortened due to compensatory reactions to the injury. Tight and fibrous muscles not only hurt at the muscle or its tendon, but can also interfere with proper joint movement and cause pain far away from the original injury.

Therapists who perform such work often have specialized names for their work–such as orthopedic massage, neuromuscular therapy, myofascial release, medical massage, etc.,–but many massage therapists utilize an eclectic approach combining the best of the specialties.

It Works!

A recent Consumer Reports article ran the results of a survey of thousands of its readers and reported that massage was equal to chiropractic care in many areas, including back and neck pain. Massage also ranked significantly higher than some other forms of treatment, such as physical therapy or drugs.

If that nagging injury persists, consider booking a massage. Be sure to discuss the injury with your practitioner: How did you receive the injury? Have you reinjured it? And what exactly are your symptoms? Often, the body compensates in one area to protect another that has been traumatized, and this can create new problems.

Discuss the issues with your massage therapist. (Sometimes just talking about old injuries can play a significant role in the healing process.) Together, the two of you can work to determine a treatment plan.

by Hope Bentley

Talk of good posture often generates images of women walking in a circle with books balanced on their heads or soldiers standing at attention. But good posture does not have to be rigid or ridiculous. In fact, far from ridiculous, it may be the key to good health.

According to Patrick Wroblewski, a Boulder, Colorado-based structural integration practitioner, “Good posture is a dynamic, working awareness of how gravity is coming down through the body.” In other words, just as the body moves and changes throughout the day, so should posture.

Wroblewski explains that many people come in to his practice with complaints of lower back pain, and stiff necks and shoulders, most of which have a direct correlation to poor posture. If a person sits hunched in front of a computer screen all day, it’s likely the head hovers towards the screen, the lower back has collapsed and the tail bone is supporting the weight, and legs are crossed or splayed. Bad standing posture includes the same hunching or lateral misalignment, like standing with a hip cocked to one side. These common forms of less-than-perfect posture mean less-than-healthy consequences for the body.

Does Posture Matter?

Ever feel low on energy? Get sick often? Experience headaches or digestive upset, like constipation or diarrhea? Feel less agile than you used to be? Your postural habits may be behind these symptoms.

Proper posture means the body is aligned so that all the muscles work as they were designed to. On the other hand, poor posture leads to inefficient movement, causing the muscles to have to do extra work. For instance, if the head isn’t resting correctly on top of the neck and spine but hovers over the chest instead, the muscles at the back of the neck have to remain contracted to hold the head up. The results? Circulation becomes hindered, and oxygen and nutrients have a hard time flowing through the body. Contracted muscles are less able to receive hydration and energy, and the tissue eventually becomes hard and fibrous. Eventually, muscles can pull bones out of alignment and cause serious problems and discomfort.

The bottom line is, poor posture can lead to muscular stress and fatigue, which can in turn lead to deficient circulation, compromised immunity, and poor lymph flow–which brings us back to low energy, frequent illness, headaches, digestive issues, and waning agility. So to answer our earlier question, yes, posture matters.

Perfecting Posture

Correcting poor posture requires undoing the hardening, or fibrosis, of the muscles that have been habitually contracted, allowing them to relax and the bones to move back into place. Perhaps a simple concept, but not an easy task.

Wroblewski uses a combination of techniques to help correct posture: Swedish massage can help increase circulation and release chronically held areas. Deep tissue massage helps wake up the body and reverse some of the fibrosis in the tissue. And other bodywork techniques can further precipitate postural adjustments. He says, “Any kind of manipulation–craniosacral, acupressure–can cause an unwinding of tension and allow the body to release to the position in which it belongs.”

Wroblewski also recommends movement education, an umbrella term that includes many types of bodywork, such as Alexander Technique, Feldenkrais Method, Hellerwork, and Trager Approach. Movement education advocates that one’s body structure and movements can get stuck in habitual, unhealthy patterns. Movement education unwinds the patterns and teaches the body, as well as the mind, anew. This is done through a series of sessions where practitioners may use hands-on manipulation to teach the student different, more efficient ways to move, sit, stand, reach, bend, lift and walk. Ultimately, this balances the body and allows energy to move freely.

Movement education techniques may be especially beneficial for people suffering from chronic difficulties, but also for anyone trying to achieve higher levels of physical and mental wellness.

According to Wroblewski, bodywork can induce a “neutral reprogramming,” so that people can start from scratch and learn to recognize when good posture is breaking down. Then the necessary adjustments can be made.

What’s a Body To Do?

Desk jobs are notorious for wreaking havoc and causing postural impairments. Sitting for hours on end staring at a computer screen is likely one of the worst things you can do to your body. If you spend a lot of time sitting, make sure both feet are flat on the ground to give yourself a “tripod” of stability for the spine to rest on. Also, be sure to take frequent breaks, even if it just means walking to the window for a moment, or getting a glass of water. And when standing, distribute weight evenly between both feet, and don’t lock the knees or ankles.

Good posture takes practice, practice, practice and constant reminding. Wroblewski suggests leaving reminders in places where you will run into them throughout your day.

Old habits die hard, and this is true for muscular habits too. Be sure to schedule a series of massage treatments to help retrain the body. And talk to your practitioner about stretches and posture tips that can enhance your massage sessions. As you progress, you will notice less joint and muscle pain, fewer headaches, more energy, and possibly even stronger immunity and better digestion. Finally, you will develop a stronger awareness of your body and an increased sense of well being.

There have been many studies done on the numerous benefits massage can give you. I stumbled upon an entertaining (and enlightening) article on massage and how it benefits you in more ways than you think. 

Good Medicine

By Editorial Staff

Originally published in Body Sense magazine, Fall 2001.
Copyright 2001. Associated Bodywork and Massage Professionals. All rights reserved.

As you lie on the table under crisp, fresh sheets, hushed music draws you into the moment. The smell of sage fills the air and you hear the gentle sound of massage oil being warmed in your therapist’s hands. The pains of age, the throbbing from your overstressed muscles, the sheer need to be touched — all cry out for therapeutic hands to start their work. Once the session gets underway, the problems of the world fade into an oblivious 60 minutes of relief and all you can comprehend right now is not wanting it to end.

Evidence is showing that the more massage you can allow yourself, the better you’ll feel. Here’s why.

Massage as a healing tool has been around for thousands of years in many cultures. Touching is a natural human reaction to pain and stress, and for conveying compassion and support. Think of the last time you bumped your head or had a sore calf. What did you do? Rubbed it, right? The same was true of our earliest ancestors. Healers throughout time and throughout the world have instinctually and independently developed a wide range of therapeutic techniques using touch. Many are still in use today, and with good reason. We now have scientific proof of the benefits of massage – benefits ranging from treating chronic diseases and injuries to alleviating the growing tensions of our modern lifestyles. Having a massage does more than just relax your body and mind – there are specific physiological and psychological changes which occur, even more so when massage is utilized as a preventative, frequent therapy and not simply mere luxury. Massage not only feels good, but it can cure what ails you.

The Consequences of Stress
Experts estimate that 80 percent to 90 percent of disease is stress-related. Massage and bodywork is there to combat that frightening number by helping us remember what it means to relax. The physical changes massage brings to your body can have a positive effect in many areas of your life. Besides increasing relaxation and decreasing anxiety, massage lowers your blood pressure, increases circulation, improves recovery from injury, helps you to sleep better and can increase your concentration. It reduces fatigue and gives you more energy to handle stressful situations.

Massage is a perfect elixir for good health, but it can also provide an integration of body and mind. By producing a meditative state or heightened awareness of living in the present moment, massage can provide emotional and spiritual balance, bringing with it true relaxation and peace.

The incredible benefits of massage are doubly powerful if taken in regular “doses.” Dr. Maria Hernandez-Reif, from the Touch Research Institute (TRI) at the University of Miami, is known for her massage research, along with colleague Tiffany Field. Together, they and other researchers have done outstanding work proving the value of massage. While their studies have shown we can benefit from massage even in small doses (15 minutes of chair massage or a half-hour table session), Hernandez-Reif says they know from their research that receiving bodywork 2-3 times a week is highly beneficial. And if we lived in a fantasy world, Hernandez-Reif has the answer. “I feel a daily massage is optimal.”

It’s undoubtedly a wonderful thing when your therapist begins unwinding those stress-tightened muscles, and your day’s troubles begin to fade away. But it’s the cherry on top to know this “medicine” only gets better with frequency.
 

What You Already Know: The Benefits of Massage
In an age of technical and, at times, impersonal medicine, massage offers a drug-free, non-invasive and humanistic approach based on the body’s natural ability to heal itself. So what exactly are the benefits to receiving regular massage and/or bodywork treatments?

- Increases circulation, allowing the body to pump more oxygen and nutrients into tissues and vital organs.

- Stimulates the flow of lymph, the body’s natural defense system, against toxic invaders. For example, in breast cancer patients, massage has been shown to increase the cells that fight cancer.

- Increased circulation of blood and lymph systems improves the condition of the body’s largest organ – the skin.

- Relaxes and softens injured and overused muscles

- Reduces spasms and cramping

- Increases joint flexibility.

- Reduces recovery time, helps prepare for strenuous workouts and eliminates subsequent pains of the athlete at any level.

- Releases endorphins – the body’s natural painkiller – and is being used in chronic illness, injury and recovery from surgery to control and relieve pain.

- Reduces post-surgery adhesions and edema and can be used to reduce and realign scar tissue after healing has occurred.

- Improves range-of-motion and decreases discomfort for patients with low back pain.

- Relieves pain for migraine sufferers and decreases the need for medication.

- Provides exercise and stretching for atrophied muscles and reduces shortening of the muscles for those with restricted range of motion.

- Assists with shorter labor for expectant mothers, as well as less need for medication, less depression and anxiety, and shorter hospital stays.

The Need for Touch
As a society, we are touch deprived and this can lead to disease or emotional dysfunction. From the cradle to the nursing home, tactile stimulation and the emotional assurance of caring touch bring about a sense of well-being and security. In numerous studies conducted on massage for infants, TRI researchers have found improved weight gain and development in pre-term infants, improved weight gain and motor behavior in cocaine-exposed infants, and improved weight gain and decreased stress behavior in HIV-exposed infants. Full-term infants also benefit with increased alertness and social behavior, less crying and increased weight gain.

FAQ’s

What should I wear during the massage?

For a full body massage, most people undress completely. However, you may choose to wear underwear if that is more comfortable for you. I discourage female clients from keeping their bras on as it keeps me from being able to fully work on the back and shoulders as needed. I do give each client a few minutes of privacy to undress and get onto the table and under the sheets. The client is covered with a sheet and blanket at all times except the area that is being worked on.

What is the draping policy?

I have been asked this question a few times with prospective clients wishing to find a therapist that will work with them fully undraped. Although I understand those who feel that being completely undraped is how they prefer to have their massage, I fully drape my clients as is required by law. I use full sheets and a blanket if it is cold. If needed, I drape women with a towel to cover their chest when working on the abdomen. If a client tends to run hot, I am happy to keep the legs and arms uncovered to make the client more comfortable. I often use the sheets as an extra “tool” when I do specific techniques.

Can I talk during the massage?

The key to a massage is relaxation and allowing yourself to enjoy the experience. It’s not uncommon for many people to be more relaxed talking. After all, they’re lying undressed on a table with a stranger touching their skin. Talking makes the therapist become more human and personal to them, and having this interaction makes it easier for them to place their trust in the therapist, and therefore make it easier for them to relax. Many clients talk in the initial stages of a massage, and as the massage progresses, they slip farther into a state of total relaxation and become quiet.

There are times when you should speak up during a massage. If anything makes you uncomfortable, please bring it to my attention. If you’re too cold or too hot, the room is too bright and hard on your eyes, or if you prefer the strokes to be deeper or lighter, please let me know. Feel free to speak up, if something about the massage isn’t working for you.

What if I’m overweight or embarrassed about my body?

You wouldn’t believe how many times I’ve heard someone say they’d get a massage if they lost weight first or didn’t have that cellulite on the back of their thighs. Don’t let this stop you. You’re denying yourself quite a pleasurable experience!

As a therapist, I have seen bodies in every imaginable shape and size, from young to old, and I’m not there to judge your physique or ogle your body. I am a professional therapist and have found massage to be an effective way to help relieve pain and stress for men and women alike, regardless of age and weight. I am proud of what I can offer to people in need of help or just wanting to luxuriate in the sense of touch.

When do I get off the table?

I often have to implore my clients to not just “jump” off the table once I leave the room. Sometimes getting up too quickly from a session can be disorienting and may undo some of the good work I’ve done. I usually give a client 10 to 15 minutes to slowly get off the table, get dressed and adjust to the real world. I tend to wait outside for the client to come into the reception area. If there is a need for me to re-enter the room while the client is inside, I will give a good loud knock at the door. Sometimes I need to knock as clients have gone to sleep!

Should I tip?

I’ve been asked this question many times, as clients get a bit confused as to what the tipping protocol should be for massage therapy. Most therapists, whether working at a spa or independently as I do, tend to receive tips from their clients ranging between 15 and 20%. Tipping is usually a barometer for how well I am doing and if I am continuing to provide a high quality of bodywork for my clients. Of course you are not obligated to do so, and I will not be offended if you don’t tip.

What is ergonomics?

Ergonomics is the process of optimising human well-being and performance. This involves assessing and improving safety, comfort, productivity and ease of use of equipement. In the workplace, ergonomics usually relate to the employees workstation, which in a high number of cases, is a desk and computer.

How should my desk be set-up?

In order to set-up your desk, chair and computer correctly and avoid developing poor posture and injuries, follow these simple (but prolific) guidelines:

The Chair:

1. Ensure you have a good chair with lumbar support, head and arm rests.
2. Adjust the height of your chair so that when sitting at your desk the following are true:

• Your thighs are supported by the chair when your feet are flat on the floor and there is a right angle at the knee.
• When you place your fingers on the middle row of keys, your forearms rest on the desk.
• There is no bend at the wrist (i.e. a straight line from your wrist, across to your hand and fingers)
• Your elbows are supported by the arm rests when your forearms are rested on the table. Some chairs have adjustable arm rests which you can move to the right height for you. Those without adjustable arm rests can be raised by wrapping foam around the rest until it is the right height and tape it in place.
• You may require a foot rest under your feet if your desk is too high to have your forearms supported on the desk and feet flat.
• Adjust the back support so that when you sit upright the lower back is supported fully. If the curvature of the chair does not match your back you may require additional lumbar support.
• Ensure there is at least a 2″ (5cm) space between the back of the knee and where the chair seat stops.

The Monitor

1. Now that your chair is correctly positioned, adjust the height of your computer monitor. The top of the monitor should be at eye level, meaning you keep your head straight and look down slightly with your eyes. Monitor height can be adjusted using boxes, books, etc.
2. Check that the monitor is directly in front of you.
3. Move the chair close to the desk until you are in a position where the elbows (when the forearms are resting on the desk) are directly under the shoulders.
4. From this position the screen should be 22-26″ (55-65cm) away from you. If not, position it at this distance. If you had it closer than this you may need an eye examination.

Your Desk

1. Your desk should be kept clutter-free to allow for all of your equipment to be positioned correctly.
2. If when your chair is positioned correctly your desk is too low or high, consider purchasing a new desk. This may seem like drastic and expensive action but it may save you hefty treatment bills later down the road!

Mouse and other equipment

1. Position your mouse as close to you as you can whilst maintaining the elbow beneath the shoulder, the elbow supported on the arm rest and the wrist on the desk.
2. When using your mouse, move the arm whilst keeping the forearm rested on the desk. Don’t use the wrist to move the mouse as this can lead to repetitive stress injuries.
3. Position your phone and any other equipment that is not permanently in use to the left hand side, within arms reach.

What is pain?

Pain is the signal that something has gone wrong in the body. When the body speaks it is good to listen. If the pain diminishes and disappears within a few days, there is usually nothing to worry about. If the pain persists for more than several days, becomes more frequent or hurts with less and less activity then the body is giving the person an important message: “Pay attention!”

The sooner appropriate healing begins, the better are the person’s chances of full recovery. Early warning signals are too frequently ignored and often result in more severe injuries, which may incapacitate the person for months or years. Curtailing activities or resting for a few days may be all that is needed. In other circumstances it may be necessary for the person to be treated by a physician or hands-on health care practitioner.

Pain is often divided into two main types: acute and chronic

Acute pain
Acute pain is the result of tissue damage and is generally short-lived. The pain gradually disappears through the course of normal healing. Acute pain has an identifiable cause and purpose. Due to the short-term nature of acute pain, persistent psychological reactions rarely result.

Chronic Pain
Chronic pain by definition is pain that persists for more than six months. Some people with chronic pain conditions have symptoms for months or even years. Chronic pain may be the result of a specific injury (such as an injury to your back or knee) or an ongoing chronic medical problem (like arthritis, cancer, or shingles). Chronic pain may also occur for no apparent cause, baffling patients and doctors alike. It can hurt all the time or occur on and off. Chronic pain often limits everyday functioning and may lead to additional stressors such as sleep problems, medication side effects, reduced capacity for performing work, financial hardship, and strain on significant relationships. As such, the experience of chronic pain and its accompanying stressors may create feelings of frustration, hopelessness, and helplessness–greatly affecting a person’s quality of life.

Pain and Posture

Repetition of postural imbalances over a period of time can lead to pain. The repetition of almost any action that puts the body out of alignment and forces the muscles to compensate will lead to pain. With the buildup of this repetitive imbalanced motion you may find that you suddenly have chronic back or neck pain without every having “done anything” to your back or neck.

Posture may be a major factor in your pain if:

* There are periods in the day when there is no pain
* The pain is confined to areas above the knee
* The pain is worse when sitting for prolonged periods or standing up from that sitting position
* The pain decreases or goes away when walking
* The pain is worse when getting up in the morning, but improves after about a half hour
* The pain is worse during or right after prolonged bending or stooping

If your pain is related to posture, it can be alleviated with diligent application of some simple exercises.

Exercise

Exercise tends to decompress the body and encourages joint mobility, giving some space between your joints and encouraging joint lubrication . It also helps to tone, stretch and loosen muscle fiber as well as break up muscle adhesions. Exercise promotes blood and lymph circulation, which helps to get rid of waste residing in the muscle.

Avoid exercise within two hours of bed time. Exercising produces endorphins, which can interrupt or delay getting to sleep. Morning or early afternoon are the best times to exercise.

Hot and Cold Therapy

Heat Therapy
Heat therapy improves circulation: drawing blood into the target tissues. Increased blood flow delivers needed oxygen and nutrients, and removes cell wastes. The warmth decreases muscle spasm, relaxes tense muscles, relieves pain, and can increase range of motion.
Hot packs in any form should always be wrapped in toweling to prevent burns. Punctured commercial hot packs should be immediately discarded, as the chemical agent/gel will burn the skin.
Use heat 20 minutes at a time at least 24 hours after a minor injury or 48 hours after a more serious one. Place a heat pack directly on the injured area — do not add pressure. Do not apply to broken skin.

Cold Therapy (Cryotherapy)
Cold therapy produces vasoconstriction, which slows circulation reducing inflammation, muscle spasm, and pain.
The duration of cold therapy is less than heat therapy; usually less than 15 minutes. The effect of cold is known to last longer than heat.
Cold or ice should never to applied directly to the skin. A barrier, such as a toweling, should be placed between the cold agent and the skin’s surface to prevent skin and nerve damage. Punctured commercial cold packs should be immediately discarded, as the chemical agent/gel will burn skin.
After you strain a ligament or muscle, it is generally best to use cold (ice or a cold pack) immediately and then for the next day and 1/2. It’s usually wise not to use heat, such as a heating pad, until swelling and bruising has stopped.
Cold is usually used first because it reduces swelling and inflammation. Use Ice for the first 48 hours after an injury. Apply for 20 minutes, remove for 20 minutes, then repeat. Do not apply directly to the skin — put a thin towel over the skin for protection, or freeze a cup full of water, tear off the top rim and move the ice over the injury. This helps control bleeding by constricting blood vessels. Cold acts as a local anesthetic and so relieves pain. Usually the bruising associated with acute inflammation stops within 1 to 3 days.  To relieve muscle spasms, minor sprains and strains, it’s usually best to apply cold for 20 minutes intervals at a time every 4 to 6 hours for the first day and a half. Commercial cold packs may be safer than using ice. Prolonged exposure to cold, especially ice, can result in frostbite to tissues. Later in the process, you may relieve pain by applying heat, rather than cold, to your injury.

Alternate Heat and Cold if you have soft tissue damage and/or stretched ligaments, such as an ankle sprain. Heat aids in restoring range of motion. Apply cold for 20 minutes per hour as desired for the first 24 hours. The next day, apply warmth for 20 minutes per hour as desired.
Caution: Don’t apply cold for more that 24 to 36 hours or warmth for more than 72 hours.

Why get a massage when you are pregnant?

Carrying a baby inside you changes your center of gravity and puts a lot of stress on your back, neck, abdominal muscles, and shoulders. Pregnancy also relaxes your ligaments, so that your pelvic joints are less stable, and changes your posture, pulling your pelvis forward. Add to that the extra weight you’re carrying and you’ve got yourself an aching lower back.

Massage therapy addresses those different needs through varying techniques that aim to relax muscle tension and improve lymphatic and blood circulation through mild to medium pressure applied to the muscle groups of the body. Swedish Massage is the recommended prenatal massage method during pregnancy because it addresses many common discomforts associated with the skeletal and circulatory changes brought on by hormone shifts during pregnancy.

Massage is beneficial for almost every woman that is pregnant. Even women carrying multiples babies can benefit greatly from massage. There may be certain conditions that may or may not be related to the pregnancy that would preclude massage or certain types of massage. This may include women at risk for pre-term labor, women with blood clots or clotting disorders, and other ailments.

Women with the following conditions should speak with a health care provider prior to receiving a massage:

• High risk pregnancy
• Pregnancy induced hypertension (PIH)
• Preeclampsia
• Previous pre-term labor
• Experiencing severe swelling, high blood pressure, or sudden, severe headaches

What are the benefits of pre-natal massage?

Many studies have indicated that massage therapy performed during pregnancy can reduce anxiety, decrease symptoms of depression, relieve muscle aches and joint pains, and improve labor outcomes and newborn health.

Hormone Regulation
Studies done in the past 10 years have shown that hormone levels associated with relaxation and stress are significantly altered, leading to mood regulation and improved cardiovascular health, when massage therapy was introduced to women’s prenatal care. Hormones such as norepinephrine and cortisol (“stress hormones”) were reduced and dopamine and serotonin levels (low levels of these hormones are associated with depression) were increased in women who received bi-weekly massages for only five weeks. These changes in hormone levels also led to fewer complications during birth and fewer instances of newborn complications, such as low birth weight. The evidence points strongly to maternal and newborn health benefits when relaxing, therapeutic massage is incorporated into regular prenatal care.

Reduction of Swelling
Edema, or swelling of the joints during pregnancy, is often caused by reduced circulation and increased pressure on the major blood vessels by the heavy uterus. Massage helps to stimulate soft tissues to reduce collection of fluids in swollen joints, which also improves the removal of tissue waste, carried by the body’s lymph system.

Improvement of nerve pain
Sciatic nerve pain is experienced by many women in late pregnancy as the uterus rests on muscles of the pelvic floor and lower back. The pressure of the uterus spreads tension to the muscles of the upper and lower leg, causing them to swell and put pressure on nearby nerves. Massage therapy addresses the inflamed nerves by helping to release the tension on nearby muscles. Many women have experienced significant reduction in sciatic nerve pain during pregnancy through regular massage.

Other potential benefits of prenatal massage:

• Reduced back pain
• Reduced joint pain
• Improved circulation and reduction of swelling
• Reduced muscle tension and headaches
• Reduced stress and anxiety
• Improved oxygenation of soft tissues and muscles
• Better sleep
• Relief from muscle cramps, spasms, and myofascial pain, especially in the lower back, neck, hips, and legs.
• Reduces stress on weight-bearing joints.
• Improves outcome of labor and eases labor pain.
• Enhances the pliability of skin and underlying tissues.
• Provides support for the new mother with physical and emotional strains of mothering.

Is pre-natal massage safe throughout the entire pregnancy?

Yes, it is! Women can begin massage therapy at any point in their pregnancy – during the first, second, or third trimester. No matter where you are in the childbearing year, massage may have many benefits for you and your baby.

What is different about getting a massage while pregnant?

Massage during pregnancy differs from a regular massage in a couple of ways. The biggest way it differs is that the person receiving the massage is pregnant, and therefore knowledge of pregnancy and the anatomy of a pregnant woman are very important. This means that positioning during a massage is critical to the safety and well being of both the mother and the baby she is carrying.

The massage table will be set up so you will lie in a semi-reclining position. This is not only really comfortable, but safe for baby. Also you will turn from side to side to do your back and hips, there are body pillows, wedge pillows and extra padding to make you comfortable. There are massage tables with cut-outs for the belly and swollen breasts to allow the woman to lay face down somewhat comfortably. This position is actually discouraged because it puts unnecessary pressure on the lower back and spine and it is not something I do with my pregnant clients.

Trained prenatal or pregnancy massage therapists are aware of pressure points on the ankles and wrists that can gently stimulate pelvic muscles, including the uterus. Certified prenatal massage therapists are trained to avoid very specific and intentional pressure to these areas during pregnancy. Any woman who has experienced pre-term contractions or consistent Braxton-Hicks contractions should alert her therapist to that fact so that pressure points can be avoided completely.