Massage News Alert - July 2007

Dear Bodyworkers,

Last month we gave links to online videos and a youtube video of Ida Rolf talking about Structural Integration. Many responses and and many asked me if I have them or where they can get them. Well, we don't sell those videos, they are provided free online, and some sites need subscribtion to access other videos. But enjoy the free ones. The Ida Rolf video can be purchased from the Rolf Institute: http://www.rolf.org/risi/store.htm. They said that there is a DVD version but not available yet to the public.

As we go through the web, we frequently found good sites with great info, and our website of the month is: LA Sports and Spine, Craig Liebenson. Craig is a US Chiropractor, and write regularly on Journal of Bodywork and Movement Therapies. On this site you can find many exercises for rehabilitation you can download for lower back pain, sciatica, shoulder and more.

http://www.lasportsandspine.com/exercise.html. Enjoy it while they are free.

This month, we bring you a survey done in Canada that shows massage therapists have a high musculoskeletal injuries, especially the thumbs. So take care of yourself. We don't know how the number will look in Australia, and the survey can be easily done here. So we might try to repeat it here to get the statistics. To start, you can help us answer our online poll http://www.terrarosa.com.au/

We have news on research that shows that warming up before exercise and also coffee can decrease muscle soreness, disection that shows fascia lines exist, Chinese foot reflexology in Taiwan and much more.

This month we have many new books from Supercharging Quantum Touch, Fascial manipulation to Yoga for the CORE and Shiatsu. Check it out at our new books section.

This newsletter is our attempt to bring you what's happening in the latest research and news on massage related issues. We sell massage videos and books so the little advert is at the end of this page. Archive of our past news is at: http://www.terrarosa.com.au/news.htm

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Happy reading and stay healthy… from us at www.terrarosa.com.au

Inside this issue:

Musuloskeletal Injuries among massage therapists

Warming up decreases muscle soreness

Anatomical study reveals myofascial continuity

Korean invents new head massage brush

Global Spa Trends

Chinese Foot Reflexology

Caffeine could ease muscle pain

Complementary therapies and IVF treatment

New Books

New DVDs

Special This Month

Massage therapists beware: The highest musculoskeletal injuries are among ourselves

A recent study conducted in Canada showed that massage therapists have a high prevalence to muscular injuries, especially in the wrist and thumbs. The survey is recently published in Journal of Bodywork and Movement Therapy. The survey was conducted to registered massage therapists across Canada to determine the prevalence of musculoskeletal pain and discomfort to the low back, shoulders, neck, wrist and thumbs associated with therapeutic treatments. A total of 502 massage therapists responded to the survey. Despite the majority of the respondents indicating they received proper training in therapy postures and self-care, there was a high prevalence of pain reporting to all areas of the upper extremity.

The highest reporting of pain and discomfort was reported in the wrist and thumb (83%), followed by the neck (66%), lower back (65%), and shoulder (62%). The survey also showed that about 40% of the therapists suffer the pain and discomfort in a weekly basis. The injuries cause losses in work time and also leisure time. The prevalence of pain was higher for younger age groups which naturally correlates with those with less years of work experience reported higher prevalence of pain. Less than 10% of respondents reported changing work activities, however, over 75% reported seeking medical treatment for their pain.

The results of the survey indicated a high prevalence of musculoskeletal pain and discomfort associated with delivering massage therapy treatments. The survey has warned us again that bodyworkers must focus on proper technique posture and adhere to a regime of self-care to reduce the risks of pain and injury.

This survey is actually easy to conduct and we could do this survey in Australia. Anyone interested?

Reference: Wayne J. Albert, Nadine Currie-Jackson and Carolyn A. Duncan. A survey of musculoskeletal injuries amongst Canadian massage therapists. Journal of Bodywork and Movement Therapies. Available online 10 May 2007, doi:10.1016/j.jbmt.2007.03.003   

http://www.actmonline.com/pdfs/research/ResearchStudy_MuscoskeletalInjuries.pdf

Warming up decreases Muscle Soreness After Exercise

Does warming up and stretching before exercise make any difference in muscle soreness? Rob Herbert, an Associate Professor in physiotherapy at the University of Sydney, investigated the efficacy of warming up and cooling down on delayed onset muscle soreness, which is the soreness that happens a day or two after participating in an unaccustomed exercise.

Theory has suggested some mechanisms that it involves some sort of damage to muscles. There's a controversy about whether the damage is inside the cells or on the outside of the cells but that damage triggers a series of events that eventually sensitises nerve endings and causes soreness.

The study involves 52 healthy adults who didn't have any muscle soreness and the subjected them to walk backwards down hill on a treadmill for half an hour, to make them sore. The trial also randomised the participants so that half of the subjects warmed up before hand and half of them didn't. The warm up is by walking forwards uphill on a treadmill at a low speed. And each of the same subjects also got randomised to either do cool down or not cool down. The cool down is performing light exercise following the exercise. The old theory behind that is that it gets rid of the lactic acid and all the rubbish out of your muscle.

The study found that the warm up reduced the amount of muscle soreness that people experienced after exercise, the reduction was small but it was real. It didn't get rid of it but typically it reduced it by about one and a half points on a ten point scale. The ten points being the worst pain and zero being no pain, and warming up reduces a couple of points. Meanwhile cooling down does not have any effect on muscle soreness.

Another group of researchers in Melbourne think that muscle tears are just an extension of muscle soreness. That is, if the muscle damage which produces soreness gets severe enough you'll get a muscle tear. So they're using interventions which they think will reduce muscle soreness as a mechanism of trying to prevent muscle tears. One of the strategies that they're working on is trying to get muscles to produce lengthening contractions so the muscle contracts but it lengthens as well. They get people to do that repeatedly in training and prior to participating in sport. They think that might reduce the risk of muscle tears but this is yet to be proven.

On stretching before exercise.  A couple of years ago the researchers did an exhaustive literature review on this, and all of the studies that have been done looking at the effects of stretching on soreness show very conclusively that the stretching doesn't reduce soreness, it has no effect whatsoever.

On stretching and injury. There have been two large randomised studies done on this and they seem to indicate that there's no effect of stretching on injury risk. Those studies (in Australia) were done on army recruits and some people think that we need to replicate those studies on community populations. But the best evidence we have at the moment from studies on army recruits says there's no effect.

An international study of stretching out of Norway is going to happen in February 2008, wanting people to register on the web when the trial begins and they will conduct a study to investigate the effects of stretching on injury.

http://www.abc.net.au/rn/healthreport/stories/2007/1976798.htm

Roberta YW Law and Robert D Herbert Warm-up reduces delayed-onset muscle soreness but cool-down does not: a randomised controlled trial. Australian Journal of Physiotherapy 2007;53:91-95

 Anatomical study reveals myofascial continuity

It has been known that many muscular pains, typical of myofascial pain syndromes, may move from one segment to another. In fact, the term “rheumatism” means “a flux” . Attempts to manage this phenomenon clinically have employed a variety of physical modalities deriving from different theoretical perspectives (trigger points, myofascial release) the most ancient theory is that of acupuncture, with its meridian lines distributed according to precise areas, never physically demonstrated.Well-documented myofascial trigger points (Travell and Simons, 1983) do indicate the existence of a connection between the location of pain and its origin, often quite a distance away, thereby confirming the concept of continuity between different segments.

Beside the popular Anatomy Trains from Thomas Myers, the French school has hypothesized the existence of a functional connection between muscular groups with the same motor action, coining the term "chaînes musculaires". The Italian school Antonio Stecco called it "Fascial Manipulation" (We just recently imported this book, please check it out here) with a model explaining sequences of myofascial connections crossing the entire body, linking the head to the toes and the centre to the periphery.

One of a recent work by the Italian published in the forthcoming issue of Journal of Bodywork and Movement Therapies evaluated the myofascial continuity of the anterior region of the upper limb. The acupuncture model describes three yin meridians in the anterior region of the upper limb: the lung, the pericardium and the heart meridians. The Anatomy Trains have superficial and the deep front lines. And Stecco's Fascial Manipulation distinguishes a total of six sequences in the upper limb, arranged according to the three spatial planes. Muscle components, particularly those fibres that are inserted into overlying fasciae and septa, form these sequences together with fascial components. In the anterior portion of the upper limb, there are three sequences, the antemotion, mediomotion and intra-rotation sequences.

Source: Stecco et al. (2007)

Fifteen cadavers were dissected between the various muscles involved in the movement of flexion of the upper limb. The study demonstrated the existence of specific myofascial expansions, with a nearly constant pattern, which originate from the flexor muscles and extend to the overlying fascia. In all specimens, the deep fascia of the upper limb formed a sheath, which covered all the arm muscles.

The clavicular part of the pectoralis major sends a myofascial expansion, with a mean length of 3.6 cm, to the anterior region of the brachial fascia, and the costal part sends one to the medial region of the brachial fascia (mean length: 6.8 cm). Manual traction via forceps, applied to the clavicular part of the pectoralis major muscle, produced lines of force that spread along the anterior part of the brachial fascia; conversely, traction applied to the costal part of the pectoralis major muscle produced lines of force that propagated towards the axilla and the medial region of the brachial fascia.

The biceps brachii presents two expansions: lacertus fibrosus (or bicipital aponeurosis), first oriented medially, with a mean height of 4.7 cm and a base of 1.9 cm, and the second, less evident one, longitudinal expansion (mean length: 4.5 cm, mean width: 0.7 cm). When traction was applied via forceps to the biceps tendon, two lines of force appeared: one in a median direction, corresponding to the arciform fibres, and one in a longitudinal direction, along the central part of the forearm.

At the wrist, many collagen fibre bundles forming the flexor retinaculum reinforced the antebrachial fascia. Distally, the latter continued with the palmar fascia which, in turn, was reinforced by the aponeurosis of the palmaris longus. The palmaris longus sent some myofascial expansions to the flexor retinaculum and to the fascia overlying the thenar muscles (mean length: 1.6 cm, mean width: 0.5 cm). When manual traction was applied in a proximal direction to the palmaris longus tendon, simulating the contraction of this muscle, lines of force appeared in both the palmar and thenar fasciae.

The study demonstrates the existence of an anatomical continuity between all the muscles of the flexor region of the upper limb. Some authors considered these expansions to be simple anatomical variations.

During flexion, as these muscles contract, the anterior portion of the brachial and antebrachial fascia is subject to tension. As the fascia is rich in proprioceptive nerve endings,the authors hypothesized that this tension activates a specific pattern of receptors, contributing to perception of motor direction. If the muscular fascia is in a non-physiological state, these mechanisms are altered, and the proprioceptors in the fascia may be incorrectly activated, thus giving rise to many types of extra-articular pain.

Antonio Stecco's book "Fascial Manipulation" is now available from our website: http://www.terrarosa.com.au/book/fm.htm. We just recently imported them from Italy. A great anatomical reference for those interested in Anatomy and working with myofascial release.

Reference:

Antonio Stecco, Veronica Macchi, Carla Stecco, Andrea Porzionato, Julie Ann Day, Vincent Delmas and Raffaele De Caro. Anatomical study of myofascial continuity in the anterior region of the upper limb. Journal of Bodywork and Movement Therapies 2007. doi:10.1016/j.jbmt.2007.04.009  If you are interested in to obtain this article, email us.

 Korean invents Oversized Brush for Head Massage

Global Spa Trends

While massage therapy is the most-requested treatment at U.S. spas, in Australia massage is only second after facials. The results of global survey was released recently by the International SPA Association. The first ISPA Global Consumer Report in June 2007, looks at spagoers around the world. The full report is scheduled for release in November, 2007, and promises to fascinate anyone who is interested in spas as a global phenomenon. Here's what they've released so far:

* Initial findings point to more than 150 million active spa-goers worldwide. In terms of sheer numbers the United States has more active spagoers than any other country -- 32.2 million. Thailand comes in second at 27.1 million, followed by Japan at 19.1 million, Italy at 17.8 million and Germany at 11.5 million. Australia is at the lower end, at 2.5 Million.

* Regardless of where they live, the primary reasons people visit spas are to relax and relieve/reduce stress.

* The study also looks at spagoers by gender and here there are huge differences by country. In Germany, which has a strong bathing tradition, and Thailand, where massage is inexpensive and widely enjoyed, spagoing is almost evenly matched between men and women. (53% vs 47% and 54% vs. 46 %, respectively.)

* Spagoing by men has grown greatly in the United States, but they're still just 31% of the market -- less than most of the other countries surveyed. Only Canada at 29% and the United Kingdom at 22% had a lower percentage of men going to spas. In Australia is higher, male is at 43%. The spa-behavioral differences by gender are consistently different. In general, men tend to seek treatments that “get work done,” meaning they enjoy a deep tissue massage or other body treatments. Women, on the other hand, are much more likely to receive treatments that enhance their appearance, such as services for their face, hands or feet.

* Swedish massage does not rule everywhere, as it does in the U.S. In the U.S. massage, 63% of spagoers have received a massage in the last 12 months, followed by manicure (57%) and pedicure (56%). But other countries have very different preferences. In Australia, facials (46%), followed by massage (35%), and sauna/steam (34%). Thailand's #1 treatment is reflexology (65% in the last 12 months). And sauna and steam bath (which don't require a therapist) are the preferred modality in Japan, Italy, Germany, France, Spain and Austria. Facials are the preferred treatment in U.K., Australia, Canada and Singapore.

From the report, we could hint that here are still rooms for massage in the spa, so should get into the spa industry.

http://spas.about.com/b/a/257673.htm

http://www.experienceispa.com/ISPA/Media+Room/Press+Releases/Global+Spa+Research+Release.htm

Chinese Foot Reflexology

We recently went to Taiwan, and one of the popular things you can do is having a foot reflexology. It is known that Chinese Medicine includes foot reflexology from about 2000 years ago, but do you know that foot reflexology in Taiwan, Hong Kong, Malaysia, Singapore, South Korea, Japan, SE Asia and Mainland China only comes to light in the 1980s and introduced by a Swiss Priest? The story sounds like a TV series or can be made into a movie, but foot reflexology was not really practiced and virtually unknown in Taiwan and South East Asia until the 80s. I

(100 Yuan about $3.50 for foot reflexology)

It began in 1977 when Father Josef Eugster, a Swiss missionary to Taiwan, was suffering from severe rheumatoid arthritis in his knees. Medicine was of no help, and his physicians piously told him, a young man of 37, that the disease was "the cross you have to carry." A fellow missionary massaged his foot and gave him a reflexology treatment. Few treatments and his arthritis pain was reduced. He was then given a book on foot reflexology "Good Health for the Future," by Swiss nurse Hedi Masafret. When he first used reflexology on himself he could barely stand the pain, but he kept at it. Within two weeks, to his amazement, the arthritis disappeared, never to return.

A drama unfolded when, in 1981, a woman with hyperthyroidism, signified by her bulging eyes, came to him. After receiving daily sessions for two weeks, her eyes slowly moved back into their cavities. After three weeks, she had recovered. The woman was Li Wen, a well-known Taipei broadcaster, and she taped a radio interview with Fr. Josef, which led to a television interview. The programs received a tremendous response in Taiwan, and soon thousands of people were streaming into Fr. Josef's small parish near Taitung, located in the southern part of the country. All the local hotels and churches filled; lines of hopeful patients started at 3 a.m. Fr. Josef and his helpers worked day and night. They didn't realize, however, that what was happening in Taitung had an immediate effect on drugstores and in physicians' offices around the country-the sale of medicine dropped precipitously, and people lost faith in their physicians. Swiftly, the medical establishment reacted by pressuring the government to stop Fr. Josef immediately. He even received anonymous death threats.

During this intense period, still in 1981, he and his workers were forced to quit their practice. Thousands of letters from the public, angry with the government for banning reflexology, poured into the offices of the president and vice president of Taiwan. The controversy came to somewhat of a conclusion when Fr. Josef was invited to speak to the vice president in Taipei and explain what was going on. With the reluctant cooperation of the health minister, Fr. Josef was subsequently allowed to continue his work in a hospital setting for two years, not as an endorsement of reflexology but as a way to contain it.

At about the same time, the Church hierarchy was also pressuring Fr. Josef to stop, saying that reflexology was not his proper work. Though he firmly believed that he was simply doing what Jesus did in helping people, the strain was great. He finally took a leave of absence, resting, praying and meditating at a Benedictine convent in Israel. There, he came to some important realizations. One was that every reflexologist must first take care of his or her own health. "This must be taken seriously," he says. "We can only do as much work for others as the amount of good health we are in."  Secondly, he decided that the future of reflexology in Taiwan would be best served by placing his work into the hands of others. He turned to his "adoptive" brothers, Joseph and Thonet Chen. (It is a tradition in Taiwan that a foreigner will be "adopted" by a Chinese family. Mr. and Mrs. Chen were Fr. Josef's Taiwanese adoptive parents. Their sons, Joseph and Thonet, had known Fr. Josef since they were in their teens.)

In 1982, just a year after his work with Li Wen had created such publicity, the brothers started the Rwo Shur Institute. (By that time, Fr. Josef had become so famous in Taiwan that his associates insisted the institute must be named for him; in Chinese his name is Rwo Shur.) Both of them were trained by Fr. Josef.  Gradually, Fr. Josef's technique has become widely known in Asia as the Rwo Shur Health Method, although Westerners usually refer to it as Taiwanese-style reflexology. And since the time he first introduced his technique in his adopted coun- try, the Taiwanese government has slowly come to accept reflexology as a viable health-care method. Fr. Josef estimates that 20 percent of Taiwan's population receives reflexology sessions regularly.

So what is the difference with Western Reflexology? My experience is: Chinese Reflexology is more dynamic, rigorous, and more painful. The therapist used their knuckles and the second phalanges joint to "rub" and stimulate the reflex point. Sometimes it can be very aggressive and painful (as with other Chinese bodyworks). http://www.youtube.com/watch?v=qsZ52Ox95Is It starts with a warm foot bath, dipping your foot in a warm water with salt. Then the pain begins with rigorous reflex points stimulated from the base, side, front and lower part of the legs. Then finishes with warm towel wrapping over the feet.

The techniques and story of Chinese reflexology can be found in our books section

Caffeine could ease muscle pain

That morning cup of coffee may help ease post-exercise muscle soreness, if preliminary research is correct. In a small study of female college students, researchers found that a caffeine supplement seemed to lessen the muscle pain that crops up a day after a challenging workout.

Known as delayed-onset muscle soreness, the pain is common a day or two after a workout that was more intense than normal. Exercise that involves eccentric contraction of the muscles is particularly likely to cause delayed muscle pain. In eccentric contraction, the muscle produces a force while it's being lengthened. This happens when a person runs downhill, for example, or lowers a weight during a bicep curl.

Exercisers and researchers alike have tried many ways to prevent this post-exercise soreness, including over-the-counter painkillers, stretching and massage -- but studies have found no cure-all for the problem. In the current study, published in the Journal of Pain, researchers at the University of Georgia in Athens looked at the effects of a caffeine supplement on delayed muscle pain in nine young women.

First, in a simulated workout, the researchers used electrical stimulation to produce eccentric contractions in the women's thigh muscles -- enough to cause moderate day-after soreness. Next, they repeated the procedure over the next two days, but on each day, the women took either a caffeine pill or placebo pill one hour before the muscle workout. Neither the women nor the researchers knew which pill was given on which day.

Overall, the women reported significantly less muscle soreness during the workout when they took caffeine instead of the placebo. The supplement had about the amount of caffeine found in two cups of coffee. The theory is that caffeine eases delayed muscle pain by blocking the activity of a chemical called adenosine, which is released as part of the inflammatory response to injury. Adenosine can activate pain receptors in body cells, explained Victor Maridakis, the study's lead author. 

But before downing a couple of cups of coffee before your workout Maridakis recommends careful consideration of the possible side effects of caffeine. "The negative side effects of caffeine are increased feelings of anxiety, heart palpitations, increased blood pressure, upset stomach, increased urination and disrupted sleep," he said. "Caution should be used when consuming caffeine so not to exacerbate these side effects."

Combined with the first story on warming up, so you might want to take coffee first, warm up before you do your vigorous exercise :-)

http://www.reuters.com/article/healthNews/idUSN1735339920070118

Maridakis V, O’Connor PJ, Dudley GA, McCully KK. Caffeine Attenuates Delayed-Onset Muscle Pain and Force Loss Following Eccentric Exercise, Journal of Pain March 2007 (Vol. 8, Issue 3, Pages 237-243).

Complementary therapies and IVF treatment

Women who use complementary therapies while trying to conceive by IVF are less likely to get pregnant than those who use conventional medicine alone, research indicates. A study of 818 Danish fertility patients revealed that pregnancy rates were about 20 per cent lower among users of alternative medicine, such as reflexology and acupuncture, than among those who did not use such treatments.

The findings could mean that complementary medicines that have a biological effect, such as herbal remedies or nutritional supplements, interfere with fertility drugs or other aspects of IVF treatment. However the results could also be interpreted as women who turn to alternative medicine, tend to be more stressed by their infertility, and may have been trying for longer to get pregnant. The lower success rate could reflect that these patients are willing to try anything to improve their chances of having a child.

“It may be that complementary therapies diminish the effectiveness of medical interventions,” said Jacky Boivin, of Cardiff University, who led the research. “Or it may simply be that persistent treatment failure encourages women to seek out complementary and alternative therapies.”

Edzard Ernst, professor of complementary medicine at Exeter University, said: “Similar associations have been made in cancer patients. Those who use complementary or alternative medicine [CAM] are on average more distressed and more depressed. The important question is whether the chicken or the egg came first. “The most likely explanation is that those women who are prone to stress and have more health problems are more likely to try CAM. So CAM could only be a marker, and not the cause of stress and lower success rates.”

The study, which was conducted with the University of Copenhagen, found that 31 per cent of the fertility patients had used an alternative treatment, with reflexology and nutritional supplements the most popular. Such patients suffered from greater stress, and the researchers said that they could have turned to complementary medicine to address this. Previous small studies have indicated that techniques such as acupuncture may help with relaxation.

Dr Boivin said: “We found that women who went on to use complementary therapies, for example reflexology and nutritional supplements, during their treatments were more distressed and emotionally affected by their fertility problems than nonusers. “This difference in stress may mean that women used complementary and alternative therapies for stress reduction, and if this were the case it would be important for future research to establish whether these achieve this goal more effectively than conventional psychological therapies.”

The team now intends to follow up the patients over five years to assess pregnancy rates over a longer period. “It is important to do this because we are concerned that, with persistent treatment failure, women might become more and more susceptible to deceptive advertising about ineffective complementary and alternative therapies or other unproven treatments,” Dr Boivin said

http://www.timesonline.co.uk/tol/life_and_style/health/complementary_medicine/article2028679.ece