Pain Relief for racers at Bayfield Race Week!

My colleague, BeckySue, and I are providing massage for the racers during Bayfield Race Week 2012 in Bayfield, WI. As a pain relief specialist I want to know how I can best help them. To answer my own questions, I thought about what kinds of pain people who sail might have. I thought more and I tried to mimic some of the repetitive actions used in sailing to get more ideas. I researched pain associated with sailing. I even interviewed someone from the Wayzata Yacht Club.

What I found out was that most people have pain between their shoulder and their neck. Many have forearm pain in an area that we massage therapists call the "wad of three," (For more information about forearm pain, please read my blog post entitled Tour De Cycling Anatomy). Still others have low back pain and knee pain.
There is a famous quote by Ida Rolf, a founder of the structural integration types of bodywork. It goes: "Where you think it is, it ain't." I want to relieve pain by correcting postural malalignment, breaking up adhesions, restoring muscles to a more normal resting length and freeing nerves that may be entraped by soft-tissue.

When Bayfield Race Week racers come to me for their massage, I will provide a brief but solid assessment: Is one shoulder higher or lower? More anterior? Do they stand with a forward bend?When they stand, do I see the back of the hands? These types of observations give me clues about the kind of pain they may be experiencing.  For example, if I see a high shoulder on the right, I can lengthen the muscles that elevate the shoulder. On the low side, I can restore the shoulder depressors to a more normal resting length. Similarily if I see a lot of the back of their hands, I know that the "medial rotators of the humerus" will need some TLC. If they bend forward when standing, I can lengthen the muscles that flex the hips, thereby taking some strain off the muscles that are stuck check reining the spinal flexion.

So... you might be wondering what does all of this mean to the Bayfield Race Week racers, in English?  It means that I use Precision Neuromuscular Therapy techniques to address structural shifts, restore muscles to a more normal resting length, relieve trigger points that can refer pain, and free nerve entrapments. People LOVE the way they feel when they are closer to neutral balance alignment and the work feels GREATwhile it is being performed!

Thanks for reading and have a remarkable, pain-free Bayfield Race Week!

Gina McCafferty, LMT
Pain Relief Specialist

Tour de Cycling Anatomy

Are you coming to Washburn, WI for the Superior Vistas Bike Tour? As an avid cyclist and Licensed Massage Therapist I’m very excited to be providing post-event massage at the tour finish in Thompson’s West End Park in Washburn, WI.

If you’ve never ridden up here, you’re in for a stunningly beautiful and deliciously hilly treat. But as I’m sure you’re aware, sometimes our sport causes muscular pain and postural imbalance.  Too often, our cycling associates have pain. They go in for an x-ray which turns out clear, but the pain is still there. The lack of results can be frustrating. This is where a qualified bodyworker such as one who understands “neutral balance alignment” can be a great help. Read on, and we’ll go on a mini Tour de Cycling Anatomy.

When we ride, we use the same muscle groups over and over, to the exclusion of other muscles (their antagonists) which creates a postural imbalance or structural shift. The quadriceps, for example, can get tight/short from overuse. The shortening of the rectus femoris muscle,, especially since it crosses both the hip and the knee, has the ability to rotate the pelvis forward or downward creating a structural shift that can cause low back pain. If we aren’t in neutral balance alignment, the way we sit on our bikes can also create an imbalance that may lead to pain.

A couple of weeks ago I provided therapeutic massage for a different bike tour came through Bayfield, WI. Like most people, they drooled a little with the back and neck work, but what they were really taken with was anatomical specificity with which I worked. Cyclists are very smart. They could tell when I was working on the specific tight/short muscles that needed to be restored to a normal resting length. Any ideas which ones I am talking about? The Hand, Wrist and Forearm of course!

Seriously. We all do it... We get a little tired and we start to put our weight on our hands and handlebars instead of using our core for support. The muscles that flex our wrists get all stretched tight/long. The wrist extensors are contracted (tight/short) for the entire ride.  Here’s what I did to help: First I applied a technique called myofascial release (MFR) to the flexor and extensor retinaculum. Think of that as the roof and floor of the carpal tunnel. I created more space in there for the tendons of the carpal tunnel to pass through. Then I used some deep gliding strokes in between the extensor muscles to check for any “stickiness” that would prevent their ease of movement. I used deep gliding strokes along the extensor carpi radialis longus and brevis, the extensor carpi ulnaris, and the extensor digitorum. I squeezed and sifted and kneaded the “wad of three” and then used more MFR to  pin and stretch the muscles. Working up the arm, I acknowledged the biceps, the triceps and deltoids. At the chest I stretched the pecs a little and then lastly I worked under the clavicle where the scalene insert on the first and second ribs. This is very important as sometimes the pectoralis muscles and scalenes can entrap nerves causing numbness in the fingers and hands.

Both avid cyclists and those who enjoy leisurely riding can benefit from bodywork that strives for neutral balance alignment because it decreases pain and improves ease of motion. Pain free ease of motion is necessary for building strength, endurance and flexibility. A qualified bodyworker can help with that by addressing the structural, functional and neural aspects of pain and by treating the pain referred by trigger points.

I hope you’ve enjoyed your Tour de Cycling Anatomy! Have a stellar, injury-free Superior Vistas Bike Tour and be sure to say hi after your ride!

Gina McCafferty, L.M.T.

What do you mean by "Pain Relief Specialist"?

Many people have heard me, a L.M.T., say “I’m a Pain Relief Specialist” or “I help people have less pain and more range-of-motion” and I get such varied responses that I would like to use my first blog to explain what more about I mean. I've been providing therapeutic massage and neuromuscular therapy for pain relief since 2005 and I’d like to answer some frequently asked questions such as what makes Precision Neuromuscular Therapy (PNMT) different? And what conditions can be improved with neuromuscular therapy?

PNMT founder, Douglas Nelson, sums up the former well in one of his texts. “Precision Neuromuscular Therapy is less a modality than it is an approach to treatment of musculoskeletal pain. Rather than being tied to a certain treatment technique, PNMT is committed only to the end result. We measure accurately, treat precisely and aim for stellar results. If the results are less than remarkable we switch strategies instead of doing the same technique harder or longer than the first time.  PNMT takes time and effort to master the palpation, anatomical mastery and clinical reasoning processes”.

My colleague, Nicole Ftacnik (a Certified PNMT practitioner in Cincinnati, Ohio) has this to say about the kind of work that we do: “PNMT is a treatment using soft tissue manipulation techniques for dysfunction and pain caused by misalignment of the body by the muscular skeletal system. Misalignment or distortions of the body may be caused by muscle imbalance, which are caused by poor posture, repetitive movement patterns, and/or trauma. Restoring weight bearing equality and symmetry are essential for good health, which is why it is so important to bring people into neutral balance alignment!” That is exactly right.

Most of the pain I treat comes from one of 5 causes. When a client comes into my office presenting with pain I have to decide which of 5 elements of pain it is before beginning the journey to neutral balance alignment. The 5 arenas that cause pain are:

• Ischemia: Lack of blood flow to the muscle.

• Structural : Any distortion of the optimal position and carriage of the frame will have a negative impact on the muscles, connective tissues and joint function.

• Functional: This category includes muscular strength, length, ability to relax/release and the ability to fire in the appropriate and/or optimally efficient order

• Trigger Point/Referred pain: Includes the various kinds of trigger points that disturb muscle function, refer pain, or reduce muscle length. Referred pain is often pain felt at a place different than the origin of injury.  Carpal tunnel symptoms, for example, can be caused by problems in the neck, shoulder or upper arm that misaligns the muscles and tendons down the arm. The pain may not be felt in the shoulder, but instead pain that is similar to carpal tunnel. When the “carpal tunnel syndrome” is treated directly, it never seems to go away.

• Neural: Neural pain includes both the ability of nerves to affect muscular function and the capability for muscles to influence or entrap nerves.

By now, you have an idea that precise treatment (as opposed to broad, general gliding strokes) can restore your muscles to a more normal resting length (optimally, neutral balance alignment) and you may be wondering what conditions NMT can improve. Some examples of common conditions that PNMT is successful with include, but is not limited to: Low back pain, neck and shoulder pain, headaches/migraines, TMJ dysfunction, whiplash injuries, frozen shoulder, sciatica, osteoarthritis, plantar fasciitis, tennis elbow, carpal tunnel syndrome' shin splints, tendonitis, bursitis, muscles spasms, cramps, strains, postural distortions, fibromyalgia... and many more!

Hope this helps you on your way to a pain-free lifestyle once again!

Gina McCafferty, LMT