2018 – EMOTIONS

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Touch is the first sense to develop in humans and the brain devotes a large part of its senses to touch. There are approximately 5 million touch receptors on our skin and 3 million on our fingertips, making touch one of the most powerful sensations in the body. Touch releases certain hormones, namely oxytocin and endorphins, which is why a mother’s hug can literally make everything feel better. Oxytocin is known as the ‘cuddle drug’ and actually binds opiate receptors for pain relief and it’s involved in the healing of pain. One of its other functions involves social bonding and oxytocin encourages you to share your feelings. It seems we have seven primal emotions, and they are either positive or negative, as you will see in the chart below. Our brains make use of vital neurochemicals. One of these is neuropeptides. Mood, energy, pleasure, pain, weight gain, cognitive reasoning, ability to form memories, and immune system regulation are all tied in with neuropeptides. What makes peptides so interesting are not only their chemical properties, but also their ability to carry an electrical charge which can change a cell’s chemical composition. It seems, “our experience of feelings is the ‘vibrational dance’ that occurs as peptides bind to their receptors; the brain interprets different vibrations as different feelings.” (Taken from a workshop on “Emotions & The Body” given in Johannesburg). Anger is an interesting emotion to examine, and if we have been angry for a long time, cellular receptors learn to accept only the ‘anger vibrations’ and reject those receptors that cause us to be happy. It seems that even on a cellular level our emotions can negatively affect our health in the long-term. IMPORTANT PARTS OF THE BRAIN Frontal Lobe: The frontal lobe is the area of our brains responsible for higher cognitive functions. These include: Problem solving; Spontaneity; Memory; Language; Motivation; Judgement; Impulse control; Social & sexual behavior   Prefrontal Cortex: Controls personality, concentration & higher cognitive function (behavior & emotions)   Left & Right: The different sides of our brains also perform different functions. The Left brain is involved language and related movement, helps convert thoughts into words; and is involved with positive thoughts. The Right brain is concerned with order and planning, non-verbal abilities and negative thoughts. What is interesting is the role fascia plays in response to stress. It becomes thicker in response to real or perceived threats, as well as any other activation of the sympathetic autonomic nervous system. Given the complexity of our emotions and how they affect us all at a cellular level it’s important to encourage your clients to train themselves to veer away from angry and negative thoughts. This includes high...

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2018 – Adhesive Capsulitis

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ADHESIVE CAPSULITIS It’s not uncommon to have clients who come for a massage session as a result of adhesive capsulitis (commonly known as a frozen shoulder). In nearly all cases this is painful and causes restricted movements. This is a condition characterised by stiffness and pain in the shoulder joint. Signs and symptoms usually start gradually, worsen over time, and over time resolve – usually between one and three years. Dr. Peter Jones presented a workshop at the recent Massage Therapy Association’s (MTA) AGM. He talked about the risk of developing frozen shoulder increasing if a person is recovering from a medical condition or procedure that prevents them from moving their arm — such as a stroke or a mastectomy. Symptoms Frozen shoulder typically develops slowly, and in three stages. Each stage can last a number of months. Freezing stage includes: Gradual onset of shoulder pain at rest Sharp pain at extremes of motion Pain at night with sleep interruption 2/9 months Aggressive treatment should be avoided Activities that cause pain should be avoided Frozen stage. Pain may begin to diminish during this stage. However, the shoulder usually becomes stiffer, and using it becomes more difficult. Pain starts to subside Shoulder becomes stiffer/ progressive loss of glenohumeral motion 9/15 months Thawing stage. Spontaneous, progressive improvement of range of motion 15 to 24 months It’s important to take a proper case history in order to establish an effective treatment protocol. This includes asking What Where When Why As well as any red flags Besides regular massage of the affected areas, the therapist might suggest the following: Heat (before/during), packs, shower Freezing – pain free = low intensity +short duration Frozen -> aggressive stretching to improve ROM = load bearing + prolonged stretches Thawing – increase stretch frequency & duration...

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2013 – The relationship between Adhesive Capsulitis or Frozen shoulder and Diabetes Mellitus

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Author: Erika Kruger Massage therapists are very familiar with the signs and symptoms of adhesive capsulitis (AC), the chronic fibrosing condition of the shoulder joint capsule, also known as frozen shoulder, shoulder periarthritis, or obliterative bursitis. But what is not readily known is that diabetes mellitus is one of the risk factors for this condition. In fact according to Dr Gordon Cameron, “(s)ome experts think that shoulder problems in diabetics are so common that they should be regarded as a complication of diabetes and not a coincidental event”. A variety of conditions involving contractures in joints and peri-articular soft tissue and accompanying joint mobility limitations have been identified in diabetic patients (Friedman 1989). In young, insulin-dependent diabetics it involves mostly the small joints of the hands and is usually less painful while in older diabetics, the large joints of the upper extremities also develop contractures. (Friedman 1989, Smith, Burnett & McNeil 2003:30) The most disabling of the common musculoskeletal problems in diabetics, is AC. The condition is characterised by progressive, painful restriction of shoulder movement. It develops in up to 20% of diabetic patients (Cameron) and is seen in especially insulin dependent diabetics with type 1 diabetics. According to Walk, the numbers may exceed 35%. Patients with diabetes are also more difficult to treat, take longer to heal and may be left with some residual trouble even with treatment. Furthermore there is a link with the duration of diabetes and the age of the patient (Smith et al 2003:30). Causes and Risk Factors AC is usually classified as either a primary condition or a secondary condition. Primary or idiopathic AC refers to cases where there are no significant and specific reasons for the pain and immobility. It arises spontaneously with no obvious preceding trigger factor. The secondary type of frozen shoulder develops after trauma, surgery or illness. Patients presenting with diabetes as well as a number of other medical conditions such as hyper- and hypothyroidism, cardiovascular disease, tuberculosis and Parkinson’s disease, appear to be predisposed to develop secondary AC. The natural history of the disease is characterised by three distinct phases: painful, adhesive, and resolution phases (Smith et al 2003:30). The painful phase starts with the gradual onset of an aching shoulder developing into a widespread pain pattern often worst at night and when lying on the affected side. This phase can last anywhere between 2-9 months. During the next phase stiffness starts to become a problem although pain level usually does not alter. The affected shoulder starts to interfere with daily tasks such as dressing, preparing food, carrying bags and working. Muscle wastage may be evident due to lack of use. This stage can last between four to...

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2013 – Benefits of Massage

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Therapeutic Massage Therapy is the mobilisation of soft tissue, for example: muscle, fascia and body fluids, to restore normal systemic and biomechanical, or functional, use. Massage is used to treat most musculo-skeletal and associated problems. Massage contributes towards improved circulatory, lymphatic and neurological functioning. Massage can be stimulating or soothing depending on the technique, depth and speed used and is both safe and effective when carried out by a trained registered therapist who, with the co-operation of the patient, helps to create balance and harmony from within. Therapeutic Massage is indicated as a relevant choice of health care in the following: Health maintenance and health promotion – Promotes general tissue health and encourages lifestyle and general health awareness. Stress management – Helps relieve associated muscular tension and encourages general relaxation. Post-operative care – Helps reduce recovery period and speeds up elimination of anaesthetic, as well as reducing pain and stiffness associated with bed-rest. Emotional and/or psychological disorders – Releases endorphins that help to uplift and reduce depression. Terminal illness – Helps reduce pain and discomfort associated with long term bed-rest as well as providing support and reducing the effects of emotional stress for the patient as well as the family. Chronic pain – Helps break the “pain – spasm” cycle whilst reducing associated muscle tightness. Care of the disabled – Provides emotional support as well as assisting in the maintenance of general tissue health. Sports’ participation – Improves performance and recovery and reduces the likelihood of serious injury. It is important to choose a registered Therapeutic Massage Therapist with care. Members of MTA are required to abide by a Code of Ethics that ensures patients are treated according to recognised professional and ethical standards. All members of MTA are registered with the Allied Health Professions Council of South...

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2013 – Habitual postural stances: Therapeutic massage can prevent the development of inappropria

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Like father, like son, like mother like daughter is often applicable to postural carriage. The reason for this is that from an early age humans learns to mimic their role models. Many other factors influence the adopted habitual postural stances such as: 1. ergonomic activities resulting in long hours of habitual biomechanical use in a particular manner 2. habitual postural sets resulting in muscles strengthening and weakening to support the stresses and strains on the frame 3. injury resulting in biomechanical limitations result in dysfunctional use 4. emotional vulnerability resulting in the adoption in protective or aggressive stances Despite the causes of habitual stances structural compensation takes place along the lines of stress and tension created by the load on the structures. The load-bearing muscles become strong developing an abundance of red muscle fibres and non-load-bearing muscles become weak developing an abundance of white muscle fibres. SHORT MUSCLES Strong muscles shorten to support load and weak muscles extend reciprocally. Load-bearing muscles develop energy conserving fascial support along the lines of tension locking the muscles in the short position. This in turn causes restricted movement and shifts the body’s postural centre causing uneven pressure and tension on joints resulting in eventual uneven wear and tear if left untreated. This causes degeneration of the articular cartilage that is often the cause of osteoarthritis resulting in lifelong chronic joint pain and further postural compensation to avoid pressure on the joint. LONG MUSCLES Locked long, weak muscles stretch the nerve sheath placing the nervous tissue under tension resulting in pain. This results in alterations to postural position to unconsciously shorten the long muscles to ease tension on the stretched nervous tissue in an attempt to relieve the pain. This once again causes a shift in the postural centre and if left untreated results in lines of fascial shortening developing to support the new stance, red and white fibres adjusting once again to accommodate the load distribution. MICROSTRUCTURE OF SKELETAL MUSCLES The microstructure of skeletal muscle tissue is adapted according to function as follows: Muscles that are adapted to support load are termed postural muscle and are able to sustain slow continuous contraction without becoming fatigued. They have an abundance of mitochondria and a well developed network of capillaries to ensure that metabolic demands are sustained by the delivery of sufficient nutrients. These muscles fibres appear red to the naked eye due to the rich blood supply. Muscles that are adapted for movement on the other hand are termed phasic muscles and these are able to move in and out of contraction repeatedly but are not able to sustain the contraction for extended periods. Phasic muscles do not require large quantities of mitochondria to...

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