Healing Hands Massage Therapy

09/05/2025

Band Syndrome (ITBS) 🦵⚡️💥
is a medical condition that causes pain on the outside of the knee that causing overuse injury of lateral knee, typically due to friction between the IT band and the lateral femoral epicondyle as the knee repeatedly bends and straightens.

🔶️ Causes / Risk Factors

☑️Repetitive or Overuse from activities like running, cycling, or hiking

☑️Muscle imbalances, particularly weak hip abductors and gluteal muscles

☑️Poor foot biomechanics (flat feet or excessive foot pronation)

☑️Sudden increases in training volume or intensity

☑️ Structural issues like leg length discrepancies or foot pronation

☑️Preexisting iliotibial band tightness

☑️Cooling down too quickly after exercising.

☑️Lack of rest.

☑️Not stretching enough before exercising.

☑️Pushing yourself too hard during exercise.

☑️Running on a tilted or curved surface.

☑️Running downhill.

☑️Warming up too quickly before exercising.

☑️Worn out shoes

🟨 Signs & Symptoms

》Swelling and inflammation in the affected area
》Pain on the outer thigh, knee, or hip

》 Sharp or burning pain on the outside of the knee

》Pain worsens with running downhill or climbing stairs

》Tenderness or tightness along the iliotibial (IT) band

》Clicking or popping sound when bending the knee

》Warmth and redness

》Difficulty walking or running due to pain

Test

✅ Noble’s Compression Test
✅ Ober’s Test
✅ Renne’s Test

Management

👉 Acute Phase

🔹️ Ice and rest
🔹️ Activity modification

👉Rehabilitation Phase

▪️ Stretching exercises -
》Glutes, quads, and hamstrings muscles stretch
》Side-Lying Leg Raises
》Clamshells
》Standing IT Band Stretch

▪️ Foam rolling lateral thigh

▪️ Strengthening: Gluteus medius, core, and hip stabilizers

▪️ Correct biomechanics during running

▪️ Footwear/Orthotics

▪️Proper arch support

▪️Gait retraining if needed.

🏠 Home Advice

》 Alternate running directions on tracks

》Gradually increase training load

》 Stretch regularly post-activity

》 Use foam rollers 1–2× daily

💠 Early management = faster recovery. Don’t ignore the outer knee pain!



🔸️Run on even surfaces
🔸️Replace your running shoes regularly
🔸️Ease up on your training
🔸️If you run on a track, make sure you run in both directions
🔸️Have an expert check your stance for running and other sporting activities
🔸️Stretch your outer thigh and hamstrings regularly.

09/01/2025

09/01/2025

(PTS)👨‍⚕️⚡
✍️Pronator Teres Syndrome is a condition caused by entrapment of the median nerve in the proximal forearm, particularly between the humeral and ulnar heads of the pronator teres muscle, leading to forearm and hand a variety of symptoms.
👉 The pronator teres muscle is responsible for pronation, the rotational movement of the forearm that turns the palm downward.





☑️Origination of the head of the Humeral: Instantly over the humeral medial epicondyle, common flexor tendon, and deep antebrachial fascia.
☑️Origin of Ulnar Head: Medial side of the coronoid process of an ulna bone.



Middle of the lateral surface of a radius.



The median nerve, C6, and C7.



Ulnar artery, anterior recurrent ulnar artery.



The Pronator teres muscle pronates the forearm and assists in elbow flexion. It acts synergistically with a pronator quadratus. If a flexed elbow, then the muscle fibers are shortened and less able to produce force.
》Synergist: Pronator Quadratus
》Antagonist: Supinator, Biceps Brachii.

■ Causes
》Age and Gender
》Repetitive pronation and supination of the forearm (e.g., sports, manual labor)

》Occupational overuse (e.g., typists, factory workers)

》Trauma or hypertrophy of pronator teres

》Fibrous bands or ligament of Struthers

》Muscle hypertrophy from weightlifting

》Sports Activities.

🔵 Signs & Symptoms

🔥 Pain in the proximal volar forearm, palm, and/or fingers

☑️ Numbness and tingling in the thumb, index, middle, and radial half of the ring finger

☑️ Weakness in the Muscle in the forearm, wrist, and/or fingers

☑️ Symptoms worsen with resisted pronation or elbow flexion

❌ No night symptoms (unlike Carpal Tunnel Syndrome)
☑️Aching in the forearm
☑️Pain that raises with activity, but enhances with rest
☑️Tenderness when pressing on a pronator teres muscle.

🧪 Diagnosis

🔷 Physical exam:

☑️Resisted pronation test (reproduces symptoms)

☑️Tinel’s sign over pronator teres

☑️Resisted flexion of the FDS to middle finger causes pain

☑️Negative Phalen’s test (differentiates from CTS)

📸 Imaging:

💡 MRI/Ultrasound (to rule out masses)

⚡ EMG/Nerve Conduction Study – confirms median nerve entrapment at the forearm level

factors of Pronator Teres Syndrome:
》Diabetes.
》Hypothyroidism
》Alcoholism.
》Any type of trauma at an elbow.

⭕ Conservative Treatment

○ NSAIDs for inflammation 💊
painkillers or anti-inflammatory medications such as ibuprofen.
🧊 Rest, ice, and activity modification

🛑 Physiotherapy Management

👉Take a rest in between the activity.
👉Apply an Ice massage over the pain area.
👉Stretching of the pronator teres muscle.
👉Stretching of flexor muscles of the wrist.

👉Massage technique.
👉Kinesio taping technique.
👉Dry needling technique.
👉Myofascial release of pronator teres.
👉Electrical modalities like TENS, and the US, diminish the pain and spasm, and tingling sensation.

👉Patient education and advice on Modified activity/sport

👉Ergonomic changes

👉Gentle nerve gliding exercises (median nerve flossing)

👉 Splinting to reduce nerve tension (especially during work)
👉Soft tissue mobilization of pronator teres

👉Manual therapy and deep transverse friction massage

👉Gradual strengthening of forearm flexors (supination muscles) and extensors

👉Acupuncture might be effective in releasing muscular tension.

■Patient Education:
✅Hammering.
✅Ladling food.
✅washing dishes.
✅Playing table-tennis.
✅Pouring drinks, activity performed by waitresses.
✅Carry the books frequently performed by librarians.
✅Twisting the clothes.

🛑 Surgical Treatment 🩺

Considered if:

❌ No improvement after 3–6 months

🧪 Confirmed compression on EMG

✂️ Surgical decompression of the median nerve

🏠 Home Advice

❌ Avoid repetitive forearm twisting

🖐️ Take frequent breaks from hand-intensive work

🧘 Regular stretching

🧤 Use ergonomic tools (e.g., wrist rests, soft grips)

of pronator teres syndrome
🔷Flexor Stretch
🔷Nerve Flossing
🔷Standing Palm Press
🔷Supinator Strength Training
🔷Standing Curl and Press
🔷Myofascial Release

09/01/2025

Chronic back pain persists for 12 weeks or longer, even if the initial injury or cause has been treated.

■ Mechanism:
》Pain signals continue due to ongoing tissue damage, degenerative changes, or nerve sensitization.
》In some cases, the nervous system remains in a “pain memory” state, where it continues to send pain signals without an active injury.

》Emotional and psychological factors may intensify pain perception.

■ Common Causes:

👉 Degenerative changes: Osteoarthritis, degenerative disc disease.

👉 Spinal structural issues: Spinal stenosis, herniated discs.

👉 Nerve-related pain: Sciatica, nerve root compression.

👉 Chronic conditions: Fibromyalgia, ankylosing spondylitis.

👉 Post-surgical pain: Persistent discomfort after spinal surgery.

■ Risk Factors:

🔷 Advancing age (wear and tear of spinal structures).

🔷 Repetitive strain at work or during sports.

🔷 Obesity (extra pressure on spinal structures).

🔷 Smoking (reduces blood flow to spinal tissues).

🔷 Untreated acute back pain that progresses.

■ Symptoms:

☑️Dull, deep, or burning pain, often persistent.

☑️May radiate to buttocks, legs, or other areas (radicular pain).

☑️Stiffness, muscle weakness, and reduced mobility.

☑️It can affect mood, sleep, and overall quality of life.

■ Management:

⭕ Multidisciplinary approach combining:

🛑 Physical therapy: Core strengthening, posture training.

🛑 Medications: NSAIDs, muscle relaxants, nerve pain agents.

🛑 Lifestyle changes: Weight management, ergonomic adjustments.

🛑 Interventional procedures: Nerve blocks, epidural injections.

🛑 Mind-body techniques: Cognitive-behavioral therapy, mindfulness.

🛑 Surgery is considered only when other treatments fail and a structural cause is identified.

🔵 Prognosis:
Chronic back pain may not fully resolve, but it can often be managed effectively with consistent treatment and preventive strategies.

08/30/2025

🏃🏻‍♂️McKenzie👨‍⚕️ Method Exercises for Neck and Arm Pain (Radicular Pain) 💥
pain from the neck to the arm due to nerve root irritation or compression-often caused by a herniated disc, degenerative changes, or poor posture.

Method Cervical Protocol (Direction-Based Therapy Focus on Extension)

⭕ The GOAL is centralization of symptoms (bringing pain from the arm back to the neck).

1. Chin Tucks (Cervical Retraction)
- Sit/stand tall.
- Pull your chin straight back (like making a double chin).
- Hold 2-3 seconds, repeat 10 times.

👉 Purpose: Centralize arm pain and correct posture.

2. Cervical Extension in Sitting
- After chin tuck, look slightly upward.
- Gently extend your neck backward.
- Return to neutral.
- Repeat 10 times.
- Do only if tolerated and no increased arm symptoms.

3. Cervical Retraction in Lying (Progression)
- Lie flat on your back.
- Tuck your chin and gently push the back of your head into the surface.
- Hold 3-5 seconds, repeat 10 times.
- Advanced progression for those without severe pain.

4. Lateral Movements (if symptoms are unilateral)
- Chin tuck + side bend away from painful side.
- Used only under therapist guidance.

🛑 Guidelines:
- Stop if arm pain increases.
- Look for centralization (pain moves from arm to neck = good sign).
- Avoid prolonged forward head posture and phone use.