Yorkville Massage Therapy » Physical exercise

A case of carpal tunnel

Matvey Kipershtein — Mon, 30 Nov 2009 22:30:59 +0000

I have been observing a very interesting trend in the people I treat. Clients who are physically active heal much faster. Sounds obvious right? But why?

Many patients tell me stories that start like: “I think I hurt my wrist because I use my mouse too much, do you think I have carpal tunnel?”

What I observed in my practice, is that people tend to hurt themselves not because they moved that body part too much, but because they don’t engage the rest of their whole body enough.

Take that carpal tunnel for example. The wrist is really an extension of the arm which in turn is connected to the ribcage. If you sit at your desk all day without moving and stretching, the ribs become rigid, the breathing laboured and the neck muscles strained.

This will decrease circulation and drainage to the arm and the wrist. Add to that a million mouse clicks you do during the day that inflame your wrist and you have yourself a carpal tunnel problem.

If you are active and exercise every day, you body will take care of that inflammation and clear it up when you sleep during the night. But if your circulation is sluggish, the body needs more time. So it doesn’t recuperate and at the end of the week you can’t even hold a coffee mug. Sounds familiar?

A simple daily exercise routine is an easy solution. It will energize you, improve your mood and help to prevent these nagging problems.

What is a good posture?

Matvey Kipershtein — Thu, 12 Nov 2009 16:15:05 +0000

A good posture is sign of physical health and emotional wellbeing.
So, what is a good posture?
Have you ever looked at a person with slouched shoulders and thought that he must be upset? Do you notice that your chest lifts up when you feel proud after accomplishing something important? Does your back get tired after sitting at your desk for a long time and you start feeling lethargic?
Body’s posture shows obvious connection with the state of mind. On the other hand, there is an immediate physical impact that a bad posture has on the rest of the body. Collapsed chest impedes breathing and functioning of heart. Head shifted forward can restrict the nerves controlling the arms, and shortened muscles at the back of the neck may cause tension headaches.
We spend too much time sitting while driving a car, watching TV, or at work. But there are very simple steps we can take to start changing those bad habits.
The following article explains in more detail why it can be difficult sometimes to maintain a good posture, and what simple steps we can take to improve and shed away bad habits.

Click here to read this article

Tennis elbow and wrist extensors stretch

Matvey Kipershtein — Wed, 28 Oct 2009 13:49:05 +0000

Tennis elbow is a very common syndrome that affects manual laborers and racquet sport players. It is usually experienced like pain at the outside of the elbow which can radiate down the forearm. This is often accompanied by the decrease in the grip strength.

This dysfunction involves the muscles located on the outer site of the forearm. These are collectively called wrist extensors and their function is to cock the wrist back. Another important role of this muscle group is to counterbalance the muscles that clench the fist and flex the forearm thus making these movements smooth and well coordinated.

There are numbers of reasons for the tennis elbow. It can be inflammation of the wrist extensors tendons around the elbow, or trigger points in the muscle.
My experience treating patients shows that the best way to treat this dysfunction and to prevent it from reoccurring is to gently stretch the involved muscles few times a day for at least a minute at a time, and to ice the outside of the elbow.

So here’s the stretch:

Wrist extensors Stretch

Extend your arm with the palm facing downward and gently pull your wrist down till you feel a nice comfortable tension along the outer side of your forearm. You can fine tune the stretch by slightly rotating your forearm.
Use very gentle force. If it hurts, you are pulling too hard, back off a bit. Breath and feel muscles relax as you exhale. Hold the stretch for at least a minute.
At the end of the stretch put ice pack over the outside of the elbow and keep it there for about 10 minutes.
Here is a good article on tennis elbow that also has a number of strengthening exercises for the involved muscles.

Being a manual therapy patient

Matvey Kipershtein — Wed, 21 Oct 2009 19:56:03 +0000

I strongly believe that as a health-care practitioner it essential to receive the treatments to enhance your own skills.
Just two days ago I did a morning run and probably had pushed myself a bit too hard.
I felt that something was wrong with my arm for the whole day and the next morning I woke up with intensely stiff and painful neck. The pain also traveled down my right arm and shoulder blade. I knew which neck segment needed to be treated. But I couldn’t do it myself.
I contacted a very good friend. He is a physiotherapist and successfully applies a variety of manual therapy techniques in his practice. He performed very detailed assessment of my body and executed perfect treatment plan. So one day later my necks moves freely and the pain is almost gone.
But what I’ve learned is not the techniques that he used, but how to understand my own patients better. Strangely, during the assessment I felt that I don’t really need the treatment. I am perfect. “I am a massage therapist myself; I am not supposed to get aches and pains.” There was some sort of inner resistance.
This made me realize that when I am treating patients in my clinic, I have to listen more deeply to the whole story that their body is telling me. There are so many layers to reality. And the key is to take my ego out of the picture.
I put myself in my friend’s place. If I were to pay attention to that “inner resistance” I would probably give up and say to myself: “You feel perfect? No need for the treatment even though you came for my help? So be it. You’re fine, go home and suffer in silence”.
To be a good therapist is to learn the humility that allows you to be truly helpful to the people. Sometimes it’s not the technique, but the practitioner’s presence, just listening, simply being there.
One more lesson learned. So next time when my patient tells me that they are fine, but that nagging pain just won’t go away, I will know what to do. There’s no me, there’s no pain. Just the person in front of me doing the best he or she can to get better.

Wrist flexors stretch

Matvey Kipershtein — Wed, 14 Oct 2009 21:17:36 +0000

Muscles that help you grip an object in your hand or flex your wrist are located on the inside of the forearm. Most of them are attached at the bone that is on the inner side of the elbow, very close to the “funny bone”. Because of this shared attachment it is very common to develop pain at this spot if your job or sport activity demands prolonged strenuous gripping. It happens a lot with golf players, hence the term “golfer’s elbow”, or with manual labourers who need to use a tool such as a screwdriver.

Very often this pain is diagnosed as tendonitis, and anti-inflammatory is prescribed to kill the pain. It is common that this pain is caused by the increased muscle tension of the wrist flexors that is not met by adequate strength at the attachment sight at the elbow. Taking the medicine will only mask the symptoms and from my experience will make the problem worse when the painkiller wears out. This happens because the person will not feel the pain which is the warning sign and will continue with the activity that further irritates the painful spot.

Apart from receiving professional advice and going for a therapy, there is a very simple stretch that a patient can do. I know it works, because a few months ago my father called me complaining of this type of pain and weakness of his grip after assembling a table. I emailed him the stretch instructions with pictures, and after a few days of stretching and icing he was pain free, and the strength of his grip came back.

So here’s the stretch

Wrist flexors stretch

Pull your wrist down very gently until you feel a mild resistance at your forearm. I know that you can probably go a few inches further, but stop here and breathe for a few moments. Feel your forearm relaxing till you can pull a little bit more without increasing the resistance.

Most people tend to overdo their stretches and pull really hard. This is a very common mistake. The muscle will recognize this pull as a threat, and will contract to protect itself. This is a reflex, the same thing happens when you get your knee tapped with a hammer at the doctor’s office and your leg jerks up. We can’t control it, and a contracting muscle can not be stretched. If you pull too hard, you will damage the painful spot even more.

So the best thing is to take it easy and allow your body to relax. Hold the stretch for at least a minute progressively pulling down more bit by bit and repeat it a few times a day

Morning stiffness

Matvey Kipershtein — Wed, 30 Sep 2009 12:38:14 +0000

Many people I talk to complain that they have started to experience general body stiffness after the age of 30. I used to brush these remarks off until I started to experience it myself.

Morning stiffness if accompanied by sharp joint pains and lasts more than 45 minutes can be a sign of arthritis or fibromyalgia. However, from my personal experience and from taking many health histories of my patients I realized that in most cases there is nothing to be worried about. There are few simple steps you can take to alleviate these discomforts.

Typically, a very simple physical activity will take care of it. I have been doing yoga for many years, and right now I find it very helpful for my morning stiffness.

Usually a few rounds of sun salutation will get my body limber and mind fully awake.

Take a look at this website for instructions on how to perform this routine. http://www.santosha.com/asanas/suryanamaskar.html

As with any physical activity keep in mind your limitations. Don’t push it, especially if you are new to yoga. Besides, it is your first warm up for the day. It should never hurt. Feel the nice, comfortable tension with every stretch. A sharp pain tells you that you went too far. Your yoga postures don’t have to look exactly like the pictures you see on the website. Nobody is judging you; you are doing it for yourself. If you can’t reach the floor with your forward bends, use a stool or a table to support your arms.

On the last note… Some people do have arthritis or another inflammatory condition that makes their mornings the worst time of the day. If you are worried about it, don’t wait till it goes away by itself. Book an appointment with your massage therapist; see someone with an expertise in the field to get a professional opinion.

Advice for the massage therapy patients

Matvey Kipershtein — Sun, 20 Sep 2009 19:21:15 +0000

I have been practicing massage therapy for a few years and have seen a variety of patients. One issue has stricken me over and over again. It is my habit to explain to my patients the importance of what they do after they leave my clinic, of how to take care of themselves after the treatment is over. I noticed that only a few would follow my advice. And then I realized why. My patients come from all walks of life; everybody is very smart and intelligent. But they just don’t know what I know about how body works, what harms it and what benefits it. That is why I am dedicating this blog to sharing the information on how people can help themselves by doing simple things like stretches and physical activity.