Brian Bennett RMT ART, Active Release Technique Provider
Active Release Technique Balanced Living Massage Therapy & Wellness Centre Markham
Massage Therapy, Markham
Brian Bennett RMT, ART, treating patients at Ironman USA in Lake Placid, New York 2008, as part of the medical team
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RUNNING SEASON IS HERE !!!
By Brian Bennett RMT, ART, CKTP.




Staying injury free this year means knowing the signs and symptoms, and how to treat the problem quickly.

The snow and ice is finally gone, and spring is in the air. This is a great time of year of the year to be a runner, considering that you don’t have to wear eight layers of clothing to brave the cold! Everywhere you look, people are hitting the trails and side streets tying to work off those extra few pounds we seem to put on in the off season. You’re generally just starting to run again on a regular basis, or you’re starting to increase your mileage preparing for one of the many spring races. Unfortunately, this is when athletes get the most injuries.

Most running injuries last only a few weeks and in many cases are preventable. The following lists the top 5 running injuries seen at Balanced Living Massage Therapy and Wellness Clinic, and is intended  to give you a basic understanding of what causes the injury and possible treatments available.

Achilles Tendonitis
The Achilles tendon attaches the calf muscles to your heel. With increased strain or irritation the fibers can become inflamed, and painful. A tight or fatigued muscle can predispose you to this. General treatment may include decreasing the activity level, anti-inflamatories and ice to decrease swelling, beginning a regimented stretching program, massage and/or physiotherapy, and addressing improper foot mechanics with new shoes and/or orthotics.

Illiotibial Band (ITB) Syndrome
The IT band is a long band of fascia and muscle spanning from the pelvis to the outside of the knee. 3 main factors can contribute to causing pain and inflammation: over-pronation (when the foot rolls in excessively), supination ( when the foot rolls out), and lack of flexibility in the muscles attaching onto the IT band (Gluteus maximus and Tensor fascia latea). Depending on cause, treatment can include stretching and strengthening programs with special attention to hip strengthening, ultrasound, ice, massage therapy, and orthotics to address improper foot mechanics.





Plantar Fasciitis
The planter fascia runs from your heel forward to the base of your toes. When a strain is placed on the fascia, pain is felt in the front of the heel, where small tearing may be taking place. Pain may be most pronounced with getting out of bed in the morning. Treatment may include orthotics to decrease strain on the plantar fascia, massage therapy to break down and realign scar tissue, taping to support the longitudinal arch, stretching of the fascia, strengthening of the intrinsic foot muscles, and anti-inflammatories.

Shin Splints
A catch all phrase used by the public for lower leg and shin pain. This can actually be one of several different conditions.

1.Compartment syndrome: Where an increase in pressure in certain muscles can cause extreme pain and decreases in circulation to the leg
2.Tendonitis/Periostitis: Abnormal strain placed on the muscles. Tendons and on the covering around the bone that the tendon is attached to.
3.Stress fractures: When exposed to increased strain and fatigue, minute fractures may result in the bones of the lower leg

Symptoms may include an aching /throbbing pain that you may or may not be able to run through, and can become worse after the activity. Pain is generally felt along the inside of the shins and may radiate out. Treatment is dependent on the individual pathology but generally includes proper shoe selection, orthotics, physiotherapy, ultrasound, massage therapy, cross-training, rest, ice compression, elevation (RICE).

Delayed onset muscle soreness (DOMS)
This is more a symptom than an actual pathology, but it’s the one condition that all runners will be hit with eventually. It’s that aching, throbbing pain you get as your finishing that long run or that you feel for up to 3 days after a very strenuous workout. There’s no definitive answer as to the cause, treatment or prevention, yet it’s believed to be caused by a build up of lactic acid, metabolites and micro tearing in muscles and tendons throughout the body. To decrease the chance of this, ensure you slowly increase workout intensity and duration. Getting a massage can help to increase blood flow through the muscles thereby flushing out the lactic acid and increasing nutrients traveling to the muscles. Hot baths with Epsom salts have also been found to be useful.

Prevention is better than a cure: the five prevention “pillars” are:
1.Regular stretching of “runner’s muscles”(calves, hamstrings, quads, glutes, lumbar spine).
2.Adequate strength base in runners muscles-achievable only with appropriate resistance training.
3.Fresh shoes (maximum of 450 to 500 miles per pair) specific to your foot type .
4.Gradual increase in mileage (10% increase per week is a conservative start with at least 1-2 running rest days per week)
5.Seek medical care with in 10 days of onset of any ache or pain not resolving with mileage reduction, ice, stretching, and anti inflamatories.

Other things to keep in mind:

·Excessive weight is generally associated with beginner athletes, the more weight on top of  repetitive stress the faster an injuy will occur, weight loss should be incuraged through proper nutrition and less stressfull  crosstraining activities.
·Environment: Running on concrete or other hard surfaces invites injury’s. Running on roads or paths that are cambered can cause undue stress on the lower leg structures such as the knee and ankle.


Good luck- enjoy the miles

What is Massage Therapy, & What to expect your first Massage
By Brian Bennett RMT, ART, CKTP.
(as published in Alive Magazine)

Massage therapy can mean different things to different people, to one person it may mean an hour of pampering at the spa, to another it may be a 15-minute in chair massage at the office, or a therapeutic session to assist recovery from a traumatic injury.

Massage Therapy is the assessment and treatment/manipulation of the soft tissues and joints of the body to assist the body in the healing process and prevention of injuries, it can assist in maintaining homeostasis and physical function, rehabilitation of acute or chronic injury, and also to relieve pain.
Massage therapy maybe seen in different settings, the most common of which is a therapeutic/wellness clinic setting, here you will discus the goals of your treatment with a registered massage therapist, these may include general relaxation or possibly treatment and rehabilitation for specific injuries.

When you arrive for an appointment the therapist will have you fill out a health history questionnaire to find out any health problems, which may need addressing. The therapist will review any symptoms you may be having and then will suggest a course of treatment. You may ask any question you have at any time.

After the therapist has reviewed the treatment with you and you have consented to the treatment plan, she/he will leave the room to allow you to undress to your comfort level, and to get on the massage table between the sheets.
When you are ready the therapist will return and insure you are comfortable on the table, there will most likely be relaxing background music playing, soft lighting.
Each area of the body that is to be worked on will be undraped appropriately allowing access to the tissue. During treatment we may move or support the arms, legs, or head to facilitate the massage, try to relax, let go, and allow the therapist to do all the work, be limp as a rag doll. Only the part that is being worked on is uncovered, and your modesty is always maintained. Always let the therapist know if any thing is uncomfortable or irritating, if there is too much or to little pressure being applied.
On completion of the treatment the therapist will leave the room to allow you to get dressed, together you will discuss what the therapist findings where, and any self care you may be able to do in order to prolong the effects of the massage, and to prevent the reoccurrence of your muscle tension.

Massage Therapy is the perfect support to natural health

Massage Therapy has been used for thousands of years, Hypocrites in 400 BC discussed “gently rubbing” a dislocated shoulder to help with healing.
The effects of massage are both psychological and physiological in nature and work on all the systems of the body, circulatory, respiratory, lymphatic, muskuloskelatal, and immune systems. The results are undeniable. Some benefits may include a sense of well being, increased range of motion, decreased stress levels, decreased scar tissue and adhesions, removal of metabolic waste from the tissue, increased white blood cell activity, decreased pain, and assist in the healing of injuries.




Brian Bennett R.M.T. is a Registered Massage Therapist, with clinics in Brampton & Markham
As well he provides on-site therapy for corporate and special events, he can be reached at www.balancedlivingwellness.com or onsitemassagetherapy@hotmail.com.



Kinesio Taping
By Brian Bennett RMT, ART, CKTP.

History of Kinesio taping
The Kinesio taping method was developed nearly 25 years ago by a doctor in Japan. From there it spread through professional athletes and sports teams  quickly, including the 1988 Olympics with the    Japanese athletes, the 1996 Olympics with the American teams, & the tour de France in 2001 with the U.S. postal service team.
Today the Kinesio taping  method can be seen on every one from athletes to pregnant women  and every one in between.

What does kinesio tape do?
Kinesio tape can be used therapeutically for several reasons:
Assisting in relaxing  an overused, irritated muscle.
Stimulating a weak or tired muscle.
Providing tactile input to increase proprioception or awareness of a muscle or joint, as proprioception increases, more attention is given to an area of the body, which increases use and in turn increases strength.
Assisting in holding a joint in position so an over stretched muscle is provided time to shorten and heal.
Aids in the movement of Edema, and swelling.
Helps to decrease pain, in injured tissues.

Why is this different than regular athletic tape ?
Conventional Athletic tape is designed to restrict the range of motion of affected muscles and joints, for this purpose several layers are applied around the affected tissue, applying significant pressure to the area decreasing blood and lymph flow. Athletic tape is usually applied just before the sports activity & removed right after.
Kinesio tape on the other hand, is a woven, latex free, porous tape that offers recoil when stretched length wise only, up to 140%. The adhesive is a heat activated acrylic, laid out with gaps to allow skin to breath. For treatment of damaged muscles, the tape is applied to stretched tissue, the taped skin will form convolutions after application, increasing movement of lymph and edema, in the dermis. Damaged joints & ligaments are taped in neutral with tape stretched  to support the joint, yet allowing full range of motion.

What conditions does Kinesio Tape treat ?
Many conditions can be treated including:
Sports Injuries                                          Repetitive Strain Injuries
Shoulder Conditions                                Knee Conditions
Low Back Strain/Pain                              Subluxations/Herniations
Carpal Tunnel Syndrome                        Shin Splints
Tennis Elbow                                           Whiplash
Post Surgical Edema                               And many more       

Wearing Kinesio Tape
Before coming in for tape application, insure the area is clean and dry, the tape will not adhere properly if you have lotion on the skin, tape should be applied at least an hour before activity or swimming to allow adhesive to stick properly.
If you notice any irritation, swelling, redness, or itching remove the tape. If the edges begin to lift,  simply trim off excess to prevent it from getting caught on clothes and being pulled off more.
You can shower with the tape on, just pat it with a towel to dry, do not use a hair dryer, excessive heat will make removal more difficult.
When removing tape, take your time, you can place a thin layer of baby oil, or tape remover over the area, let soak for 15 minutes. Loosen one end and begin slowly peeling away, this may be easier in the bath tub,. After removal, use plenty of lotion to hydrate skin and relieve any irritation.
Kinesio Tape normally  remains in place for 3 to 5 days, before removal, excessive body hair will prevent the tape from bonding to the skin.



Kinesio Taping  In the news & Endorsements
In Lance Armstrong's book ”Every Second Counts” he is quoted“ Something better than any laser, wrap, or electric massager….The Tape. It is a special hot-pink athletic tape that came from Japan and seemed to have special powers. Every morning before the stage, they would tape us all up, different parts of our bodies…..George’s back, Chechu’s knees. Sometimes we’d be so wrapped up in hot-pink tape that we’d look like dolls, a bunch of broken dolls. But the next day the pain disappeared-it was gone.”
The march 2008 issue of Triathlon Canada features a Picture of top Canadian triathlete Tara Norton with her shoulder Kinesio Taped for a dislocation injury. The february 2009 issue of Runners World has an article on self taping with Kinesio Tape.




“Do you have Pain in your knee’s”
(Iliotibial Band Friction Syndrome)


Lateral knee pain is a frequent problem especially in runners, the main cause being Iliotibial band friction syndrome. ITBFS occurs as a result of friction between the IT band and the lateral epicondyle of the femur when passing 30 °. This friction can lead to tendonitis or an inflammation of the bursa located between the two structures.

The symptoms of IT Band friction syndrome is felt as an ache or burning pain over the lateral epicondyle of the femur (the lower part of the knee, on the outside), and may have associated crepitus. Pain may be elevated by running, especially on long distance runs or increased intensity i.e. tempo runs and hill training, also on resisted knee flexion and extension over 30° (due to posterior displacement of the IT band and retinaculum).

IT Band friction syndrome is most common on distance runners who have either inappropriate training habits and/or abnormal biomechanics, both resulting in increased strain to the lateral knee. Biomechanically, an athlete may be prone to pronation, which causes a varus strain on the knee, excessive lateral tilting of the pelvis causing strain to the proximal band.

Short term treatment deals mainly with symptomatic relief.
ŸNSAIDS - Nonsteroidal anti-inflammatory drugs to decrease inflammation and
continual irritation.
ŸElectrical Modalities - Such as IFC (Interferentral Current) and ultrasound to
assist with inflammation reduction.
ŸSoft tissue therapy - The use of deep tissue massage to decrease muscle and
fascial tension and restrictions.

Long term treatment deals mainly with prevention of causative factors, such as biomechanics, muscle imbalances and training habits. Recommended treatment may include:
ŸOrthotics from a chiropractor, chiropodist, or a podiatrist, to keep the foot on a stable supported surface,
ŸProper shoe selection to assist in keeping the foot stable throughout the gait cycle.
ŸStrengthening of the lateral hip muscles to assist in stabilization of the pelvis and leg.
ŸStretching on a regular basis to decrease tension transferred to the distal IT Band, which caused the friction. your Massage Therapist can help set up a stretching program for you.
ŸMassage therapy to reduce adhesions, and release the involved structures.
ŸSelective training habits to decrease downhill running, and time spent training on cambered roads, i.e. change surfaces to run on.
ŸCorticosteroid injections to the bursa to reduce stubborn or nagging inflammation.
ŸSurgery to release the IT Band and remove the bursa. 


If you are experiencing pain in or around your knee’s, it is important to seek medical attention quickly in order to prevent chronic conditions that may take a long time to heal, if you have any question drop by the clinic.


Post Race Recovery

Brian Bennett RMT, ART, CKTP
Ironman Triathlete, &  Marathon Runner.


Could you believe, how you recover from a race can be almost as important as how you prepare for it!

So you have been preparing for this day for weeks and possibly months, the race is great! Now what?
Now we recover, is there a right way and a wrong way? How can I get ready for my next race in a few weeks?.
Follow these guide lines and I can help tilt the scales in you favor.

Prior to the race, plan for what you will do when you are finished, check-in a bag that will hold warm clothes and food or drinks, also some spare change and you cell phone, this will help you get back home quicker, and in more comfort.

AFTER THE RACE
COOL DOWN -  Once you have crossed the finish line don’t stop, keep moving, let your heart rate slowly return to normal levels, this will aid in circulation, preventing cramping by bringing nutrients and oxygenated blood to needy tissue. If the weather is cold put on warm dry clothes soon, it is easy to get a cold with you immune system impeded.

DRINK -  Dehydration is a key after racing, you body may be very dehydrated due to insufficient drinking on course, combine this with the effects of heat, wind, excretion and your body may be ready to drop, fluids/electrolytes are needed by the body for proper nerve impulse firing and body cooling.
Ingest at least 2 cups of electrolyte mix with in the first 10 min post race, this varies with race conditions, in extreme heat you should easily double this amount

EAT-  Refueling contributes to your recovery by aiding cellular repair and replacing important energy stores, with in the first 15min post event is crucial for abortion, the body is super receptive for loading a quality fuel. 10 to 20 grams of protein would be ideal, this can be through a dry or liquid source, a protein drink is a great choice as it assists in fluid recovery,

STRETCH  -  Progress through your sport specific muscles as you cool down by slowly and carefully doing some light stretches, calves, shins, quads, hams, glutes, etc. pay attention to your body and avoid cramping.

MASSAGE  - some races have massage therapists on site free or a small charge, now is a great time for a little flush of the legs, not to deep just think of it as getting the lactic acid moving, 10 to 15 min is all that’s needed, don’t forget to book a massage for later in the week.


AT HOME
REST  -  Sit down with you feet up, take a nap, you deserved it. Now is not the time for a walking tour of the city.

ICE/HEAT -  Your muscles are swollen and inflamed, lactic acid and other metabolites are pooled in the tissue slowing down your recovery, to help with this try filling the tub with cold water add some ice cubes, and submerge your legs for 5 to 10 minutes or more, (watch for frost bite & hypothermia).
A hot bath with Epsom salts can also increase circulation and draw out lactic acid from the interstitial tissue in muscle, and also help warm you up if still cold from racing in bad conditions.

COMPRESSION  -  The newest fad on the market are compression socks/garments, these items are often worn to help the body recover pre/post race by increasing circulation to the muscles, these can be pricey approx $30 to $60 a pair

ELEVATION  - Get your feet up! Nothing beats gravity for trying to draw blood back to the core of the body and decrease inflammation of the muscles and joints.

EAT AGAIN  - 4 things need to be kept in mind, glycogen stores, anti oxidants, protein,  & PH balance.
Have a complex or high GI carbohydrate to replenish muscle glycogen stores, this can be some thing like some left over pasta. Protein is needed to help the body rebuild damaged muscle, a low fat protein like tuna or chicken can be added to that pasta. (Aim for .50 gr per pound of body weight over the next day or two). Anti oxidants help the body fight free radicals the damage tissue, vitamin A & C are great examples, one of the best sources of anti oxidants are dates, pop a couple of these as a snack.
Avoid beans, wheat, grains, soy and peanuts as these may slow or block the absorption of protein in the body.

NEXT DAY
ACTIVE RECOVERY  -  Now is not the time for another hard run, avoid heavy training, it’s been said that your body needs aprox a day per mile of racing to recover properly, a 5k takes 3 days, a 1/2 marathon takes 13 days, a marathon takes 27 days.



STRETCH  - After a hard work out or race the muscles in your legs have small micro tearing in them, this will heal over the next few days, but may not heal ideally to help with this light stretching can help with realigning scar tissue and adhesion as seen with massage, and insure proper range of motion.
Try doing some light Active Isolated stretching which uses more movement than static held stretches, this may reduce possibility of injury

TWO DAYS LATER
SPORTS MASSAGE  -  A good post race massage within 2 days after the event can help to increase circulation, flushing out lactic acid and other metabolites, and bring nutrients to the damaged tissue helping it to regenerate and decrease delayed onset muscle soreness. Massage also helps break down adhesions and scar tissue which is beginning to form and realigns adhesions with muscle tissue.


MENTAL REVIEW  -  Review your race, your performance, where your goals achieved?, is there anything to change or do differently?. The next step is to review your short term goals, what are the next races on you schedule, refocus on these

WEEK ONE & TWO
Follow the same ideas stated above, work on quality recovery including hydrotherapy (heat and cold), get lots of sleep, stretch often, include a mix of cross training (deep water running/cycling/swimming), ease back into light runs with decreased intensity & duration using soft surfaces, eat well (think nutritious food), take care of nagging injuries with massage /physio, and most important listen to your body, it will let you know what you can and can’t do .



When to use Heat and Cold
By Brian Bennett RMT, ART, CKTP.

As a therapist in the clinic, I am often asked by my patients if they should put heat or ice on their sore muscles.  There is no set answer, patients must first  figure out which stage of recovery they are at and treat appropriately.

Phases of Recovery

Acute Phase:  The first 24 to 48 hours after a soft tissue  injury are the most critical.  At the time of injury there is associated damage to blood vessels.  As a result, blood & lymphatic fluid accumulates in the area around the        damaged tissue and results in swelling and compression of adjoining tissues.  Symptoms include redness, swelling, pain, and decreased function of a joint accompanied by muscle spasm and guarding.
Swelling and increased pressure may inhibit the healing of damaged tissues.

Initial Treatment (Acute)
In the acute phase every effort must be made to reduce the amount of bleeding at the site of injury.  The most important method of doing this is summarized in the acronym R.I.C.E.
Rest, Ice, Compression, Elevation.
By resting the area you will decrease the likelihood of continuing to cause damage to the area.  The application of ice immediately after injury results in a reduction in pain and causes local vasoconstriction or a pressure on the veins and capillaries that reduces bleeding, swelling, inflammation and muscle spasm.  Ice should be left on for 15 to 20     minutes then off for the same amount of time and repeated frequently throughout the day. 
Compression through the use of a tensor bandage or compression splint will also aid in decreasing the amount and severity of bleeding in the tissue.
Elevating the injury is used mainly with injures to the arms and legs where the extremity should be placed above the level of the heart.  Elevation works mainly by limiting the amount of swelling and edema in the tissue by using gravity.


Sub Acute Phase
This stage occurs within 2 days and continues for up to 3 weeks or possibly longer.  Wound closure takes 5 to 8 days for muscle and skin, tendon and ligament take 3 to 5 weeks.

Sub Acute Treatment
In this phase you will use a contrast of heat for 3 minutes followed by cold  for 1 minute.
This contrast creates a mechanical or pumping force which works to draw out inflammation.

Chronic Phase 
This stage begins at around 2 to 3 weeks and may continue for up to 1 - 2 years.  Generally no swelling is present but there may be a loss of full range of motion. There will often be a dull aching sensation easily brought on with over exertion.  The area of pain will be greatly   reduced from the initial injury becoming more specific.

Chronic Treatment
It begins with the use of heat widely used for pain reduction and to increase healing.  Heat causes an increase in blood flow to the area which will begin to bring more nutrients and oxygenated blood to the area and flush out toxins, lymph, and other metabolites.  Heat will also begin to soften the collagen fibers of scar tissue (adhesions) that begin to form during the healing process.

Risks & Cautions
Use caution with extremes of heat or cold as the soft    tissues of the body are easily damaged with burns and frost bite

Topical Analgesics
Sometimes known as sports rubs or heat rubs most commercially available ones contain substances such as Menthol, Methyl Salicicylate, Camphor, Arnica, and  Eucalyptus oil.  The majority act as counter irritants that inflame the skin and produce redness of the skin, dilate blood vessels and stimulate pain and temperature receptors.  The type and intensity of effect depends on the chemical used and its dosage.  Topical analgesics are available without prescription at drug stores, health food stores and many health care facilities including “Balanced  Living”.

Salycilates 
These are the same ingredients found in oral pain medications containing aspirin.  These compounds may work by inhibiting prostaglandins, hormone like substances that contribute to pain and inflammation.  Topical Analgesics containing this product include:  Aspercreame, Bengay, and Flexall.

Counter Irritants 
Irritants (menthol, etc.) stimulate the nerve endings on the skin to cause feelings of hot/cold or itching.  This phenomenon of fooling the brain has been around for hundreds of years to help treat mild to moderate pain.  This is found in brands such as Arthicare, Icy Hot and Deep Cold.

Capsaicn  
A natural product, a highly refined and concentrated form of the active ingredient found in hot peppers.  It works by depleting the amount of a neurotransmitter called substance P, which is believed to send pain messages to the brain.  This product is sold under the brands Zostrix, and Menthacin.

Botanicals & Others
There has been a recent surge in the use of botanicals and other natural products due not only to their proven effectiveness but also to the fact that they are more natural and safer.  Some of the ingredients include Arnica, Calandula,            Belladonna, Echinacea, Esterfied Fatty Acids, and Eucalyptus.  These are sold under the brands Traumeel, Zeel, Celadrin, and many others.

To find a product that is right for your condition, think about seeing our Naturopath who is trained in Botanicals and  Homeopathy.  Also many of these products are available here in our clinic or at Turquoise Holistics, in Markham.
Sports Massage


Whether working out in the gym, taking part in a yoga class,  preparing for a marathon, or skiing on the weekend, taking part in your favorite sport can be fun and a great workout,. But it can also be the source of sore joints and muscles,. With-out some simple precautions like stretching, warming up, proper rest & treatment of injuries with massage therapy and physiotherapy.   Many athletes and weekend warriors alike seek massage therapy regularly to help them perform their best and reach there fitness goals.
WHY IS IT SO IMPORTANT ?
To gain strength, speed, or endurance an athlete must continue to fatigue their muscles in order for them to become stronger and faster. To achieve this athletes need to reduce the recovery time needed between workouts, this can be done with regular massage.
PRE-EVENT MASSAGE
A pre event massage is brief & invigorating , lasting 10 to 20 minutes . It’s performed  20 minutes to an hour before the event, and is aimed at warming up the tissue, bringing oxygenated blood to the area, and energizing the nerves. It’s performed over the clothes, and provides the athlete a chance to focus and visualize their event.
POST-EVENT MASSAGE
After your event when you have cooled down, a post event massage will help you to relax and recover from your work out or event,. The goal is to ease pain and muscle soreness, decrease swelling in the tissue and help you recover faster. Your therapist will use long slow compressive strokes to flush out lactic acid & metabolites, and force new oxygenated blood & nutrients to the muscles
MASSAGE CAN HELP WITH….
Stress
Massage is one of the best known antidotes for stress. Reducing stress gives you more energy, decreases muscle tension, and improves your outlook on life, allowing you to focus again.
Tight muscles
Massage can help reduce hypertonic/tight muscles and relieve the associated pain, by kneading and stretching the muscles and decreasing stimulation of the surrounding nerves
Delayed muscle soreness
Delayed onset muscle soreness is believed to be caused by the small micro tearing of the tissue and the accumulation of metabolites/lactic acid in the area. By increasing circulation  massage will assist in its removal and decrease delayed post-exercise pain felt 24 to 48 hours after the work out.
Injuries
At some point every one working out in the gym or competing in a favorite sport will become injured, it may be a minor strain or a major injury.
A variety of massage techniques can treat injuries such as sprains, strains, &  tendonitis. Because massage increases circulation it can reduce inflammation/ swelling and increase the supply of  nutrients needed in healing.
In addition your body often repairs injuries with  random scar tissue consisting of tightly matted collagen fibers, which tear easily making it hard for healing to occur and make normal range of motion tender or restricted. Specific techniques in massage are proven to break down these random fibers, realign them with the muscle tissue, there by  making them more pliable, stronger, and decreasing their pressure on underlying nerves resulting in less pain.
You may experience some discomfort  with initial treatment of the injury, but this should lessen quickly. It’s important to let your therapist know if your treatment is painful so they can alter their technique and work within your individual comfort level.
INJURY PREVENTION
By receiving regular massage therapy during your training, You  aid the body’s natural ability to heal itself,. As a therapist we can also find areas of the body that may be tighter or more tender than others, that you may not have noticed, and we can treat this area to decrease the likelihood of future injury.

Infant Massage



Congratulations on your new bundle of joy!  After 40 long weeks of anxiously awaiting the arrival of your new baby, he/she is finally here. Now that you have brought your baby home, you want to do everything to promote a healthy and happy baby.  Incorporating massage therapy into your baby’s routine just might help.
The Benefits of Massage for Babies:
·gives baby reassurance and a feeling of being loved
·helps relax the baby
·promotes better sleep
·facilitates body awareness
·boosts the immune system
·sensory stimulation
·improves skin condition by improving blood circulation throughout the body
·helps digestion
·helps waste elimination
·helps parents and caregivers learn about baby
·relaxes parents
·it is a pleasurable experience
·stimulates the production of oxytocin – a hormone produced by both males and females which can be a useful pain reliever and has a calming effect on a person
Getting  Started:
·make sure that you are in a comfortable position that you can remain in for fifteen minutes
·play gentle music to set the mood to help both of you relax
·make sure the room is warm and there is a comfortable surface for the baby to lie on
·it is best to do massage after the baby’s bath or before bedtime
·make sure you have a clean diaper nearby if needed
·massage baby with a gentle oil to help reduce friction on the skin
·begin with very light touch and gradually increase the pressure
Things to Remember:
·sometimes baby may be tired and massage is too much stimulation – don’t be discouraged, just try again after a nap
·when baby starts to crawl, baby is more active and may not need as much massage
·when baby is teething, don’t forget the face – kiss and stroke face to release tension there
·you are baby’s mirror – make sure you are relaxed and ready before you begin massage
·baby massage is intended to be a therapeutic and playful activity that will bring pleasure to both of you

How to Massage Your Infant:
Begin each massage with permission and a relaxed disposition. You may find that you are only able to massage the legs and arms, don’t let this discourage you. In time you will feel comfortable with all the strokes and your timing will improve. You will be able to give a full body massage in 15-20 minutes.

Legs:
·Milking – starting at the hip milk the leg toward the foot
·Wringing – gently wring the leg from the hip to the foot
·Petrissage – small, gentle circles with your fingertips, starting at the hip working your way down to the foot
·Sole of the foot – stroking, walking, compressions and circles
·Top of the foot – stroking, walking, compressions and circles
·Counting toes – “This little piggy”
·Gentle range of motion to the hips, knees and ankles – excellent to use when your infant is constipated
·Effleurage – Swedish milking towards the heart
·Stroking
·Touch relaxation – holding limb and talking to your infant

Arms:
·Milking – starting at the shoulder milk the arm towards the hand
·Wringing – gently wring the arm from the shoulder to the hand
·Petrissage – small, gentle circles with your fingertips, starting at the shoulder working your way down to the hand
·Palm of hand – stroking, walking, compressions and circles
·Back of hand – stroking, walking, compressions and circles
·Counting fingers
·Small circles around the wrist
·Gentle range of motion to the shoulder, elbow and wrist
·Effleurage – Swedish milking towards the heart
·Stroking

Chest and Abdomen:
·Effleurage – draw a heart with the pams of your hands, moving up over the shoulders and down around the sides              of the abdomen
·Water wheel – hand over hand on the abdomen
·Thumbs to Sides – using gentle pressure, going out to the sides at the level of the umbilicus
·Sun and Moon – using CLOCKWISE circles with one hand trace its pattern with the other
·I LOVE YOU – tracing the digestive tract – it’s upside down to you!
·Petrissage – gentle circles around the digestive tract
·Butterfly stroke – stroking down from one shoulder across to the opposite hip and repeating fro the other shoulder              to hip
·Effleurage – heart pattern

Face:
·Smooth out the forehead
·Thumbs across the eyebrows
·Down the sides of nose
·Smile on upper lip and lower lip
·Petrissage – gentle circles around jaw
·Over ears and under chin
·Stoking the entire head

Back:
·Back and forth
·Effleurage
·Petrissage – gentle circles around areas of support, either side of spine, and shoulder blades
·Figure 8 to buttocks – good for relieving gas, constipation and colic
·Swooping/stroking to buttocks
·Swooping/stoking to ankles
·Gentle rocking


Sports Nutrition


What’s it going to take to fuel YOUR ride?
Nutrition, or lack thereof, can make of break a ride.  Many athletes participating in endurance events have difficulty nourishing their bodies well enough to optimize performance.  Consider the following simple guidelines to ride faster, stronger and with far more comfort and pleasure!
When planning nutrition it is important to consider the type of ride you are embarking on: are you going on a social ride or are you challenging your body to a longer distance ride?
Let’s consider the social ride first: this ride is done at a comfortable pace of 50-60% of maximum effort for 1-2 hours.  The goal of this type of ride is to enjoy the pace and to have energy left over at the end of the ride.  Follow these basic guidelines if you’re going out for a social ride:
Eat a carbohydrate rich breakfast 30-45 minutes prior to your ride.
Eating during the ride is OPTIONAL for any ride lasting 2 hours long or LESS.
Eating a well balanced diet throughout the day after a social ride is adequate to replace the energy lost during the ride.
Fluid intake should be one bottle per hour (slightly more in hot weather). DRINK BEFORE YOU ARE THIRSTY.
Secondly, the long distance ride: the Ride for Karen is a good example of a long distance ride.   This ride is longer than the 2 hour social ride and, because of its length, can lead to hypoglycaemia or low blood sugar (affectionately referred to as “hitting the wall” or “bonking”).  Snacking on this ride is essential.  Hitting the wall is an unpleasant experience that should be avoided at all costs!  Follow these basic guidelines for the Ride for Karen and other long rides that you may be participating in:
Four days prior to the event, increase your carbohydrate consumption to 70-80% of your daily calories.  You should be consuming at least 600g of carbohydrates per day, 2-3 days before the ride.
Try eating a 300g carbohydrate-loaded breakfast at least 3 hours before this ride.

Starting at the beginning of the ride, eat regular snack , energy gels or sports drinks to replace your estimated calories burned per hour.  Be sure to carry food with you or plan stops along the route.

Immediately after the ride (in the first 10-15 minutes), consume a carbohydrate snack.  This will assist recovery and cut down on muscle soreness.  Be sure to eat a high carbohydrate meal that evening AFTER the event.

General Guidelines:

If you are cycling regularly (3-5x/week, 1-2 hours each time), consider increasing your complex carbohydrate load to 60-70% of your daily caloric intake.  Complex carbohydrates are generally low in fat and assist at replacing stored energy that you have lost during your regular rides.  Oatmeal, brown rice and whole grains are healthy sources or complex carbs.

Keep hydrated!  Drink plenty of water before and after rides.  Electrolyte replacement becomes imperative on rides lasting longer than one hour and can be achieved with a variety of sports drinks.  At least one bottle of fluid should be consumed every hour—a general rule is 1/4 of a bottle every 15 minutes.  Consider carrying electrolyte tablets with you if you have a tendency towards cramping.

Rest.  After hard efforts on the bike, be sure to get adequate R&R to assist in efficient and effective recovery.


Balanced Living Massage Therapy & Wellness Centre is a multidisciplinary clinic offering : massage therapy, acupuncture, naturopath, bracing, homeopathy, custom orthotics and chiropody.
For further information we can be reached:
2673 Bur Oak Ave., Unit 1, Markham
905-209-1005
         Fax: 905-209-8656
www.markhammassagetherapy.com

Pregnancy Massage and its Benefits
By: Farlene Soong RMT

Benefits:

There are numerous benefits for having a massage, however; there are even more advantages for pregnant mothers. As the nine months pass by, a woman will undergo changes in her life. Whether these changes are emotional, physical or psychological, massage can decrease stress and promote overall well being, this can help a mother cope with the pregnancy stages.
Some benefits are:
- Increases circulation: Decreases the load on a mother’s heart to pump sufficiently and increase the blood circulation to mother and baby. This helps gain the energy the mother needs and vitality
- Eliminates waste products: The waste products (ie. Lactic acid, Cellular waste) are moved through the muscles to the lymphatic and circulatory system. This allows muscles to be more healthy and allows the mother to be more energetic
- Decreases pain/discomfort: Massage relieves those muscle/joint aches, knots, tension, cramps/spasms experienced through the pregnancy stages
- Decreases depression/anxiety: Massage increases relaxation and can help stabilize hormone levels
- Improves digestion: Abdominal massage can help a pregnant mother decrease constipation and increase normal bowel movements.
- Helps reduce stretch marks: Massage can improve skin elasticity by using different fascial techniques.
       - Helps reduce swelling/edema: Specific mas           
      sage techniques (ie. Lymphatic drainage) are used
      to decrease interstitial fluid in ankles or wrists

Massage Positions:

The positions of pregnant mothers can be prone, supine, semi-reclined, or side lying. Depending on the stage in pregnancy, the position will be modified with pillows, towels or frequent changes in positioning during treatment.
  - First Trimester: Can be positioned in any comfort
       able position
     - Second Trimester/Third Trimester: If there is a special pregnancy pillow used, a mother can lie prone on the table and monitored regularly. If not, DO NOT LIE PRONE. Semi-reclined, side lying and supine are ideal.

Contraindications:

   ØAvoid deep massage and fascial techniques
    over the low back during the first trimester
    ØAvoid abdominal, low back and sacral
   massage during the first trimester. This can help
   reduce the risk of miscarriage
ØAvoid joint play and mobilization techniques
   to the entire body up to six months after delivery  
   ØNo deep massage over varicose veins

Self-care during Pregnancy:

qDiaphragmatic breathing is useful to help
   increase relaxation
qAvoid standing or crossing your legs for a
   long period of time. This will help reduce the
   varicose vein severity
   qIncrease stretching to neck, shoulders, and
   gluteals. Especially if leg cramps occur, pointing
   your toes to the ceiling will help decrease the
   cramping

** Stretching your gluteal muscles a.k.a “Gluts” is very beneficial to decreasing low back discomfort **

Massage can also help with other discomforts that can be associated with pregnancy: Headaches, Migraines, Dizziness, Anxiety, Sinus Congestion, Fibromayalgia and many more. Massage should not be terminated once a mother gives birth but received regularly for maintenance purposes.  Massage however; is not only important for a mother, but also for the infant. Some benefits for infant massage are:
- It allows mother and infant to build a bonding relationship with each other
- Increases over all relaxation and decreases anxiety
- Promotes muscle stimulation and circulation
- Improves digestion and decrease in gas build up or colic infants


Things to know:

·If a patient has diabetes, a snack is recommended before or after a massage
·Gluteal massage is very beneficial to decrease low back pain
·A towel or pillow must be used under the right hip in second and third trimesters in supine and semi-reclined positions. This is to help reduce the pressure of the fetus off the aorta and inferior vena cava and avoid supine hypotension.
·Heat is great to decrease pain, increase local circulation to tense muscles
·Contrast or cold baths are great to decrease edema/swelling
·Essential oils (Geraium, lavender, lemon) are great to use to increase relaxation to muscles in baths

**All Registered Massage Therapists are qualified to massage infants and teach parents the best techniques to use for their babies. **


Tennis Elbow
Brian Bennett RMT, ART, CKTP

For 9 days this past summer, I had the enviable task of providing Massage Therapy for the Tennis Masters series at York University.  For those 9 days I found 3 common injury patterns amongst most of the athletes:
Low back tension and pain
Shoulder/ upper back muscular pain and tension
Lateral (tennis elbow or extensor tendinosis) and to a lesser extent medial (golfer’s elbow or flexor tendinosis) pain.
Extensor tendinosis is seen generally as an insidious and progressive pain localized to the outside of the elbow, almost directly on the bone (epicondyle).  This is the    origin for many of the muscles involved in wrist extension and often  strained in the backhand stroke of tennis.  The resulting inflammation and degeneration (microscopic  tears and scarring) of at lest one of these muscles that causes the pain.  The progression of this pain is most  often from poor technique in the average player combined with relatively inadequate strength, endurance and flexibility.  In the advanced player it’s generally more of a muscle imbalance and over use cause rather than technique. This condition is also seen frequently in those that use computers for long periods typing, due to the use of the wrist extensor muscles.
Initial treatment in the acute phase consists of rest from tennis for several days, with the use of anti-inflammatories such as Aspirin and Ibuprofen and ice being helpful.  In the more chronic phase it’s important to address the causes by seeing a good tennis professional who can work on your swing to decrease the strain on the injured area and to develop a sound stretching and warm up program prior to your match. Massage Therapy and Physiotherapy have been found to be very helpful in decreasing scar tissue and promoting the haling of the areas involved.  This is achieved through muscle stripping and cross fibre frictions to break down scar   tissue; myofascial release is used to decrease adhesions between the fascia and underlying muscles.  Trigger point release to decrease “knots” and irritations in tight bands of muscle and appropriate hydrotherapy (use of heat and/or cold) to either decrease swelling in the area and to increase blood flow and increase extensibility of muscles.  Ultrasound also assists in healing.  CortisoneInjections as well as “Shockwave Therapy” can also be used.  Shockwave therapy is a new therapy in Canada that uses high energy sound waves to breakdown scar tissue and promote healing.  This approach is quick, requiring an average of 3 treatments, each lasting about 10 minutes.  Toronto SEMI is one of the few centres in Canada making use of this new technology.

Other modifications can include switching to a two-hand back hand or at least addressing your back hand
technique with the help of a qualified instructor, changing to a properly fitted racket with proper grip size, larger sweet spot and decreased vibration, pre and mid-season strengthening of the arms and shoulders is often effective in allowing the muscles to endure strain and fatigue with less injury, stretching of the muscles involved in tennis may also decrease tension in and symptoms of tennis  elbow and finally the use of a counter force brace such as an Air Cast or Cho-Pat may help to disseminate forces  being applied through the wrist extensors to the lateral epicondyle.

If you have found pain or tenderness in the area mentioned, make an appointment with a good Sports Doctor, Physioterapist or Massage Therapist to have it assessed and treated.  There is no reason you can’t recover from this quickly and get back to the court when treated properly.
Headaches

Millions of people suffer from chronic headaches.  Although not usually medically serious, the distressing effects of chronic headaches include loss of work time and reduced quality of life, including the constant necessity to cope with pain and decreased enjoyment of family and recreational activities.  Because more than one factor often combines to produce chronic headaches, a multifaceted approach may be the most effective treatment.  Therapeutic massage is one approach that has been shown to reduce and even prevent headaches, and may play a vital role in your treatment  plan.
What kind of headaches do you have?
Although multiple factors and symptoms are often involved in headaches, they are usually classified into the following types:
Tension headaches as episodic, brought on occasionally by stress, or chronic, the daily non-stop variety.  Tension headaches vary in pain level and are sometimes accompanied by band-like pressure around the head.  They originate from tight, contracted muscles and trigger points (irritable spots that refer pain elsewhere) in the neck, head, and shoulders.  Poor posture habits, mental and physical stress, and disturbed sleep patterns can all contribute to tension headaches.
Migraine headaches are characterized by intense, one-sided pain, which may extend to the face and back of the head.  They can be accompanied by nausea, dizziness, extreme fatigue and sensitivity to light or sound, and can last from several hours to several days.  Migraines are often hereditary and affect women more than men.  Although the exact cause of migraines is not known, some researchers believe that a chemical or nervous system imbalance affecting the opening and closing of blood vessels in the head plays a  major role.  Many factors can contribute to the onset of a migraine.  They include stress, lack of sleep, hormonal changes, food allergies, hunger, depression and neck injury.
Headaches Due to Neck Injury
Muscle and ligament injuries in the neck often cause referred pain to the head, which is experienced as a headache.  These headaches can be caused by a sudden trauma such as whiplash or have a gradual onset from repetitious activities such as working at a computer for hours everydayMuscle tension and scar tissue in neck injuries can limit movement, restrict blood flow and cause trigger points.  The end result is pain and inflammation in both neck and head.

Other Types of Headaches

Rebound headaches are very common and are caused by accumulated toxins from over use of painkillers such as aspirin, Tylenol or prescribed medications.  It is important to determine the cause of the original pain and be treated so you can gradually eliminate your medications.
Cluster headaches occur in a series and then disappear for months at a time.  Like migraines, these severe headaches involve the dilation and constriction of blood       vessels.
Post -traumatic headaches are a result of head injury and may occur immediately or well after the injury.  Note that post-traumatic headaches often go hand in hand with headaches due to neck injury.  Other kinds of headaches include those caused by sinusitis, allergies TMJD (temporomandibular joint dysfunction), high blood pressure, head and spine infections, glaucoma, meningitis, tumors and strokes.  It is important to receive medical  attention for all these types of headaches.  Also, because there is a chance that a sudden severe headache could indicate an emergency.  If you ever experience head pain unlike anything you’ve ever experienced before seek medical help immediately.

How massage therapy can help?

Massage helps relieve headaches by releasing tight, shortened muscles, trigger points, and fascia (connective tissue surrounding muscle and other structures) in the neck and head.  When muscle and fascia relax and       become more pliable, pressure lessens on nerves and blood vessels and circulation improves.  This flushes away irritating waste products and brings fresh oxygen and   nutrients to tissue, resulting in pain relief. If your headache is due to injury, massage therapy can reduce restrictive scar tissue and promote healing in the muscle and ligaments of the neck.  If poor posture is contributing to your headache massage can help by relaxing over-worked muscle groups.  You can then practice specific exercises to become more aware and help improve postural habits.  Finally, as the body relaxes, so does the mind, reducing anxiety that may be part of your headache patterns.  A  single massage can provide much needed short-term   relief.  For example: a session to relieve muscle tightness or anxiety may ward off a tension headache.

For more lasting effects, a series of massages may be necessary.  During a severe migraine episode you may not want to be touched. However, as a preventative measure massage can help reduce accumulated physical and mental stress and, overtime, reduce the frequency and intensity of migraine episodes.

Relax and Feel Better

Whatever type of headache you have, the relaxing and invigorating effects of massage can relieve tension and lift your mood.  When you focus on the pleasant sensation of relaxation the persistent grip of pain recedes.  The nervous system calms and your breath slows and deepens, restoring a feeling of well-being and energy.  When you feel better, it’s easier to take care of yourself in other ways, such as exercising of changing your diet.  Finally, massage therapy may be one of your most powerful allies in coping with the stress and discomfort of chronic headaches, offering a decrease of headache pain and frequency, and increase enjoyment of work, play and family life.